NUR 276 exam 3 UPDATED ACTUAL Questions and CORRECT
Answers
How do corticosteroids affect surgery? Abrupt cessation of corticosteroids due to surgery can cause adrenal
insufficiency and possible cardiovascular collapse
Why are steroids given before and after surgery in To prevent adrenal insufficiency and maintain adequate stress response during
patients on chronic corticosteroids? surgery
What is the most commonly used corticosteroid given Dexamethasone
perioperatively?
s/s of dehydration - Dry mucous membranes
- Poor skin turgor
- Decreased urine output/dark concentrated urine
- Hypotension
- Tachycardia
- Elevated BUN
Position for abdominal surgeries Dorsal recumbent
Position for lower abdomen and pelvic surgery Trendelenburg
Position for perineal, rectal, and vaginal surgeries Lithotomy
Position used for renal surgery Sims or Lateral
deaf patient- they may need special positioning during true
surgery
Unrestricted zone street clothes allowed
semi-restricted zone - hospital laundered scrub clothes
- Shoe covers
- Scrub cap
, Restricted zone - Hospital laundered scrub clothes
- Sterile gown
- Shoe covers
- Scrub cap
- Eye protection
- Mask and sterile gloves
Malignant hyperthermia A hereditary condition of uncontrolled heat production that occurs when
susceptible people receive certain anesthetic drugs.
Malignant hyperthermia triggers administration of inhaled Anesthetic agents such as Halothane and Paralytic
medications such as Succinylcholine
Clinical manifestations of malignant hyperthermia - Muscle rigidity
- Hypotension
- Tachycardia
- Hypoxia
- Increased retention of CO2
- Oliguria
- Brown urine (increased CK)
- Elevating temp above 40 C (late sign)
Complications of malignant hyperthermia - Rhabdomyolysis
- Hyperkalemia
- Respiratory acidosis
- Death
Nursing interventions for malignant hyperthermia - Give Dantrolene
- Ice packs
- Cooling blanket
- Chilled cold IV fluids
- Monitor for kidney damage and rhabdomyolysis
Dantrolene Inhibits the heat producing mechanism in the muscles to help stop the
temperature rise
Surgical considerations for bariatric patients - Delayed wound healing & infection
- Skin breakdown
- Respiratory compromise
- Difficult intubation
- Periods of apnea post-op
- Difficult IV placement
Surgical considerations for geriatric patients - Cognitive decline may not understand information
- Hearing loss may make teaching harder
- Poor concentration may get easily distracted
- Memory issues may forget instructions quickly
Answers
How do corticosteroids affect surgery? Abrupt cessation of corticosteroids due to surgery can cause adrenal
insufficiency and possible cardiovascular collapse
Why are steroids given before and after surgery in To prevent adrenal insufficiency and maintain adequate stress response during
patients on chronic corticosteroids? surgery
What is the most commonly used corticosteroid given Dexamethasone
perioperatively?
s/s of dehydration - Dry mucous membranes
- Poor skin turgor
- Decreased urine output/dark concentrated urine
- Hypotension
- Tachycardia
- Elevated BUN
Position for abdominal surgeries Dorsal recumbent
Position for lower abdomen and pelvic surgery Trendelenburg
Position for perineal, rectal, and vaginal surgeries Lithotomy
Position used for renal surgery Sims or Lateral
deaf patient- they may need special positioning during true
surgery
Unrestricted zone street clothes allowed
semi-restricted zone - hospital laundered scrub clothes
- Shoe covers
- Scrub cap
, Restricted zone - Hospital laundered scrub clothes
- Sterile gown
- Shoe covers
- Scrub cap
- Eye protection
- Mask and sterile gloves
Malignant hyperthermia A hereditary condition of uncontrolled heat production that occurs when
susceptible people receive certain anesthetic drugs.
Malignant hyperthermia triggers administration of inhaled Anesthetic agents such as Halothane and Paralytic
medications such as Succinylcholine
Clinical manifestations of malignant hyperthermia - Muscle rigidity
- Hypotension
- Tachycardia
- Hypoxia
- Increased retention of CO2
- Oliguria
- Brown urine (increased CK)
- Elevating temp above 40 C (late sign)
Complications of malignant hyperthermia - Rhabdomyolysis
- Hyperkalemia
- Respiratory acidosis
- Death
Nursing interventions for malignant hyperthermia - Give Dantrolene
- Ice packs
- Cooling blanket
- Chilled cold IV fluids
- Monitor for kidney damage and rhabdomyolysis
Dantrolene Inhibits the heat producing mechanism in the muscles to help stop the
temperature rise
Surgical considerations for bariatric patients - Delayed wound healing & infection
- Skin breakdown
- Respiratory compromise
- Difficult intubation
- Periods of apnea post-op
- Difficult IV placement
Surgical considerations for geriatric patients - Cognitive decline may not understand information
- Hearing loss may make teaching harder
- Poor concentration may get easily distracted
- Memory issues may forget instructions quickly
