Surgical Techniques - Care of Patients with Special or Complex Needs 2-B

Question 1

includes preoperative, intraoperative, and postoperative phases

Answer 1

perioperative

Question 2

resistance of the skin to deformation

Answer 2

skin turgor

Question 3

patients with reproductive issues of gender issues

Answer 3

sexually-related disorder

Question 4

patients whose small anatomical structures alter the size of equipment and instruments needed for a surgical procedure

Answer 4

pediatric

Question 5

patients with asthma, medication allergies, or latex allergies

Answer 5

severe allergy

Question 6

non-native speaking patient in which English is not their primary language; requires a translator; has cultural or religious practices that vary from the majority of the population

Answer 6

language, cultural, or religious barriers

Question 7

patient who has a cognitive disorder that primarily effects reasoning, memory, perception, and problem solving due to disease processes, such as dementia and Alzheimer’s disease

Answer 7

geriatric

Question 8

patient who faces humiliation or embarrassment because of their size, often causing them to delay seeking health care, sometimes with devastating consequences

Answer 8

bariatric

Question 9

patients with anemia, hemophilia, or bloodborne pathogen diseases

Answer 9

hematological disorder

Question 10

patients with diabetes, anorexia, bulimia, liver dysfunctions, and renal dysfunctions requiring dialysis

Answer 10

metabolically impaired

Question 11

patients with neuromuscular disease, paralysis, physical deformities that are congenital in nature or acquired and sensory impairment

Answer 11

physically challenged

Question 12

patients with Down’s syndrome, PTSD, OCD, ADHD, fetal drug or alcohol syndrome

Answer 12

mentally or emotionally challenges

Question 13

patients who have an infectious disease that could spread microorganisms to staff or other patients

Answer 13

isolation

Question 14

patients with physical wound or injury, such as a fracture or blow

Answer 14

trauma

Question 15

includes immunocomprimised patients, such as cancer patients on chemotherapy, patients with AIDS or who are HIV positive, transplant patients on immune-suppression medications, and burn patients

Answer 15

aseptically critical

Question 16

patients who consume a substance in amounts or with methods neither approved nor supervised by medical professionals

Answer 16

substance abuse

Question 17

pregnancies with a greater chance of complications

Answer 17

high-risk pregnancy

Question 18

in this stage, the world becomes meaningless and overwhelming, and life makes no sense. The patient is in a state of shock.

Answer 18

denial

Question 19

Empty feelings present themselves in this stage, and grief enters on a deeper level. This feels as though it will last forever.

Answer 19

depression

Question 20

This stage is marked by calm and acknowledgment. This is not a period of happiness and must be distinguished from depression.

Answer 20

acceptance

Question 21

Patients in this stage may feel guilty or remorse that they did not change their lifestyle or heed warning signs.

Answer 21

anger

Question 22

In this stage, the normal reaction to feelings of helplessness and vulnerability is often a need to regain control or postpone death.

Answer 22

bargaining

Question 23

In this stage, patients experience a reaction to practical implications relating to the illness or loss. Sadness and regret pre-dominate this stage.

Answer 23

depression

Question 24

This stage is often confused with the notion of being “all right” or “OK” with what has happened.

Answer 24

acceptance

Question 25

The first reaction to learning of terminal illness or the death of a cherished loved one is to disallow the reality of the situation.

Answer 25

denial

Question 26

This is the second stage of grieving.

Answer 26

anger

Question 27

Secretly, patients in this stage may make a deal with God or a higher power in an attempt to postpone the inevitable.

Answer 27

bargaining

Question 28

This stage is about acknowledging that an illness is a reality or that a loved one is physically gone and recognizing that this new reality is the permanent reality.

Answer 28

acceptance

Question 29

Aging patients may be mentally confused for a variety of reasons, so it is important to speak ______ and distinctly.

Answer 29

slowly

Question 30

Many aging patients experience problems _____, making it important for you to speak loudly and clearly.

Answer 30

hearing

Question 31

Handle aging patients gently but _____, without rushing them.

Answer 31

firmly

Question 32

Allow patients to be as _____ as possible.

Answer 32

independent

Question 33

Specialized monitoring equipment and temperature control units may be used on aging patients to more closely monitor their _____ _____ and alert the OR team to any emergencies.

Answer 33

vital signs

Question 34

Aging patients are more prone to postoperative complications such as hypotension, _______, cerebral edema, and hypoxemia.

Answer 34

hypothermia

Question 35

Aging patients present special challenges to the anestheologist because fitting a _____ may be difficult due to loss of teeth.

Answer 35

mask

Question 36

Aging patients have a diminished and slower _____ _____; therefore they are more inclined to thrombus formation and my require antiembolic stockings.

Answer 36

heart rate

Question 37

Patients need to be _____, not pulled, during transfer to and from the operating table since skin is thin and sensitive.

Answer 37

lifted

Question 38

Decrease of blood supply to kidneys inhibits _____ and makes patient susceptible to infections.

Answer 38

filtering

Question 39

Blood loss must be monitored and promptly _____.

Answer 39

replaced

Question 40

Aging patients are more prone to _____ infections.

Answer 40

respiratory

Question 41

Positioning an aging patient can be a challenge, not just because their skin is more easily damaged but for reasons of structural integrity. _____ become porous and less dense.

Answer 41

Bones

Question 42

A 36-year-old male Buddhist monk comes in for a same-day hernia repair. Male monks cannot come in contact with a woman, since this can be interpreted as a breaking of vows. Which of the following is NOT an option in caring for this patient? 1) have the patient self-bathe as part of pre-op prep 2) have anestheologist induct the patient early, since there is a mixed gender surgical team 3) observe surgeon's request for an all-male staff 4) all of the above

Answer 42

2) have anestheologist induct the patient early, since there is a mixed gender surgical team

Question 43

A horse tramples a 12-year-old girl, resulting in massive internal injuries. Her parents are out of town, but the camp counselors have spoken with them and they are on a flight home. After being rushed to the hospital, the surgical team discovers pooled blood in her abdomen and significant damage to her kidney. Her medical alert card state that under no circumstances is she to receive blood because of her parents' beliefs. The counselor, the girl's legal guardian, has refused to sign the release at the parents' explicit direction. The tension between the high value placed on life (Hippocratic oath, life devoted to healing) in direct opposition with a religious belief that places an equally high value on the soul and the hereafter. Which of the following is the most defensible position for the surgical team to take? 1) administer a blood transfusion, since the patient's life is at stake. 2) perform all necessary life-saving surgeries without a blood transfusion 3) stop surgery and sew her up 4) coerce the camp counselor into signing a waiver to allow for blood transfusion

Answer 43

2) perform all necessary life-saving surgeries without a blood transfusion

Question 44

A 72-year-old Native American grandmother arrives carrying a dream catcher her young grandson has made for her especially for this surgery. She wants to bring it into surgery. A 5-year-old boy from India is being assisted with his pre-operative routine and the nurse goes to cut several strings ties to each of his wrists. He draws back in fear, crying out that she will cut his soul. Which of the following are other examples of items requiring special exemption or a mutually acceptable compromise? 1) medicine bundles 2) bits of red ribbon 3) special charms on chains, bracelets, bundles, or talismans 4) rosary beads 5) all of the above

Answer 44

5) all of the above

Question 45

A description of those who need special language, cultural, or religious considerations include all of the following EXCEPT: 1) those with cultural or religious practices that vary from the minority of the local population 2) those whose language is not the primary language of the local population 3) those whose religious or cultural customs prevent them from receiving blood transfusions or donated organs 4) those who may not completely understand doctor's orders because they are non-native speakers

Answer 45

1) those with cultural or religious practices that vary from the minority of the local population

Question 46

permanent loss of consciousness, permanent coma, and in a persistent vegetative state (PVS)

Answer 46

higher brain death

Question 47

results from the cessation of heart function

Answer 47

cardiac death

Question 48

irreversible loss of all functions of the brain, including the brain stem

Answer 48

whole brain death

Question 49

A DNR order indicates that the patient and/or the family has made a decision to _____ lifesaving efforts.

Answer 49

decline

Question 50

The official order is charted in the patient's medical records after the DNR document has been _____ by the patient or a family member.

Answer 50

signed

Question 51

DNR orders can be incorporated into a(n) _____ _____, or by informing hospital staff.

Answer 51

advance directive

Question 52

Many types of surgery provide _____ benefits to patients who either will not survive long-term or who do not wish resuscitation in the OR, so the precise procedures that can and cannot be performed should be designed to prevent ambiguity.

Answer 52

pallative

Question 53

Unless instruction for a DNR are in effect, hospital staff will make every effort to help patients whose hearts have stopped or who have stopped _____.

Answer 53

breathing

Question 54

_____ issues may arise if a DNR order is not in place and when the decision is left to the family members.

Answer 54

Ethical

Question 55

Patients who benefit from a DNR order are those who have _____ or other debilitating illnesses.

Answer 55

terminal

Question 56

The decision to become an organ donor is personal. In many states, this decision is verified on the individual's _____ _____ or other identification cards.

Answer 56

driver's license

Question 57

Organ and tissue donation can occur with a decreased donor, who can give kidneys, pancreas, liver, lungs, heart, intestinal organs, and with a live donor, who can give a _____ or a portion of the liver, lung, or intestine.

Answer 57

kidney

Question 58

A donor must be free of _____ _____. At the time of death, the donor's families will be asked to assist in completing a health history of the donor.

Answer 58

infectious disease

Question 59

The process for procurement is organized through tissue and organ procurement agencies who locate _____, register recipients, and organize procurements.

Answer 59

donors

Question 60

A computer program matches donor organs with recipients based on certain characteristics. These include _____ type, tissue type, height, and weight. The length of time the patient has been waiting, the severity of the patient's illness, and the distance between the donor's and the recipient's hospitals also figure into who is the best match for a specific organ.

Answer 60

blood

Question 61

At the hospital, the donor is maintained on _____ support and the condition of each organ is carefully monitored by the hospital medical staff and the procurement coordinator.

Answer 61

life

Question 62

The _____ operation takes place after the transport team arrives t the hospital with the new organ.

Answer 62

transplant