Acute Care Exam #3 - Pre/Intra/Post-Operative Care, Musculoskeletal Trauma/Management, Biliary Disorders (Q & A) Latest (100%)

Acute Care Exam #3 - Pre/Intra/Post-Operative Care,
Musculoskeletal Trauma/Management, Biliary Disorders (Q &
A) Latest (100%)

Quiz:> If an infection is present in an extremity that is about to be amputated, what must
first be prescribed?
{{{Answer}}} (Prophylactic antibiotics to clear up infection followed by more definitive
surgery)

Quiz:> What type of assessment needs to be performed on both the affected and
unaffected extremity before amputation is considered?
{{{Answer}}} (Neurovascular assessment - 5 P's)

Quiz:> This type of pain is felt at the site post amputation of an extremity
{{{Answer}}} (Phantom limb pain)

Quiz:> Nursing alert: If the elastic dressing falls off on stump (amputation site) what is
the nurses immediate next action?
{{{Answer}}} (Wrap the limb with an elastic compression bandage ASAP, if not, edema
will develop; Notify physician if edema develops)

Quiz:> What types of drugs are given to treat phantom pain?
{{{Answer}}} (BB, anti-epileptics and TCA's)

Quiz:> What is the HALLMARk sign of peritonitis?
{{{Answer}}} (Board like abdomen (extremely rigid))

Quiz:> In what instances will pain perception be diminished? (think meds & comorbid
conditions)
{{{Answer}}} (Patients taking corticosteroids, analgesic agents

Patients with diabetes (advanced neuropathy), patients with cirrhosis (experiencing
ascites))

Quiz:> Defined as a complication of trauma or perforation of bowel; Extremely serious;
IV antibiotics and surgery may be required
{{{Answer}}} (Peritonitis)

Quiz:> What nursing interventions/assessments are required for peritonitis?
{{{Answer}}} (Position patient side-lying or semi-fowlers position (position for comfort)
Monitor respiratory status
Maintain patient NPO
Monitor pulse ox

,Monitor temperature)

Quiz:> What are the s/s associated with cholecystisis?
{{{Answer}}} (Pain
Tenderness
Rigidity of RUQ that may radiate to shoulder)

Quiz:> Defined as stones in gallbladder
{{{Answer}}} (Cholelithiasis)

Quiz:> If pus develops in the gallbladder due to infection, what complication can this
lead to?
{{{Answer}}} (Empyema)

Quiz:> When are ERCP and PTC procedures used?
{{{Answer}}} (For cholelithiasis --> Removal of gallstones)

Quiz:> What type of sedation is used for ERCP and PTC interventions?
{{{Answer}}} (Moderate sedation)

Quiz:> During acute pancreatitis, what should the nurse monitor for specifically?
{{{Answer}}} (HYPOXIA)

Quiz:> During assessment of suspected pancreatitis, what are positive signs of
diagnosis?
{{{Answer}}} (Cullen's sign - ecchymosis around umbilicus
Turner's sign - ecchymosis on flanks)

Quiz:> What diagnostic tests are used to confirm diagnosis of pancreatitis?
{{{Answer}}} (Amylase and lipase ("Ases are high"))

Quiz:> In this typeof pancreatitis, the benchmark of pain is met and the patient is able to
more easily cope with the pain; "Burnout."
{{{Answer}}} (Chronic pancreatitis)

Quiz:> Under moderate sedation, what does the nurse need to monitor?
{{{Answer}}} (RR, temp and BP)

Quiz:> After epidural anesthesia, what will be continuously monitored along with
continuous o2 sat monitoring?
{{{Answer}}} (End tidal co2 - little bubble underneath nasal cannula; monitors co2 levels
& recirculates the co2 the patient breaths out. Ensures that their levels are between 35-
45)

Quiz:> In a patient with chronic lung disease, what is the highest priority post-op for this
patient?

,{{{Answer}}} (Respiratory status

-Depth, rate and characteristics of respirations, use of accessory muscles, identifying
respiratory distress early)

Quiz:> If a wound is dehiscing post-operatiely, what is the nurse's first action?
{{{Answer}}} (IMMEDIATELY put sterile soaked gauze on the open wound & notify
physician because this patient will need to go back to the OR)

Quiz:> What lab values need to be specifically examined pre-op? If these lab values are
off, is surgery postponed?
{{{Answer}}} (PT/INR --> Monitoring for coagulation problems

CBC --> WBC count need to be examined to monitor for contraction of infection

If any of these values are off, surgery will be postponed)

Quiz:> For patients with a PCA pump, what does the nurse need to continuously
monitor?
{{{Answer}}} (RR, level of consciousness, pain level)

Quiz:> If a patient becomes suddenly dizzy upon ambulation post-op, what is the
nurse's first action?
{{{Answer}}} (Stabilize patient, sit them down ASAP to reduce risk of falls)

Quiz:> If a patient becomes suddenly restless in the PACU post surgery, what is the first
thing the nurse should examine?
{{{Answer}}} (PULSE OX - lack of o2 can cause confusion and restlessness)

Quiz:> What are the s/s of hypovolemia and hypovolemic shock?
{{{Answer}}} (Drop in BP
Weak, rapid, thready pulse
Altered LOC
Cool, clammy skin)

Quiz:> How does the nurse prevent post-op atelectasis/pneumonia?
{{{Answer}}} (Encouraging deep breathing/coughing
Encourage use of incentive spirometer
Encouraging ambulation day 1 post-op
Encouraging position changes)

Quiz:> A score of what or higher on the Aldrete test indicates that the patient is ready to
be discharged from the PACU?
{{{Answer}}} (8 or higher)

, Quiz:> When a nurse suspects compartment syndrome, how should they keep the
extremity positioned?
{{{Answer}}} (Keep extremity aligned and DO NOT elevate)

Quiz:> For patients with a spica cast (typically children) what does the nurse need to
assess for concerning bowel movements/constipation?
{{{Answer}}} (Need to assess for a paralytic ileus - auscultate bowel sounds)

Quiz:> How often does the nurse need to inspect the pin sites for patients in traction?
{{{Answer}}} (q8hr)

Quiz:> What is important for the nurse to do in the post-op period?
{{{Answer}}} (Treat pain
Treat constipation due to opiate pain medication
Positon patient for comfort (depending on surgical procedure)
Encourage deep breathing techniques (coughing, incentive spirometer)
Prevent infection)

Quiz:> What is the emergency management of fractures?
{{{Answer}}} (IMMOBILIZATION, followed by reduction via surgical procedure)

Quiz:> Defined as preparing the patient for every step of a surgical experience as a
whole
{{{Answer}}} (Peri-operative care)

Quiz:> This type of surgery would be necessary for a patient that came into the ER post
a traumatic accident; Life would be threatened if surgery was not performed
{{{Answer}}} (Emergent surgery)

Quiz:> How can a nurse evaluate empirical knowing for a patient potentially needing a
colostomy?
{{{Answer}}} (The patient may experience body image disturbances & depression and
the nurse will need to address these concerns)

Quiz:> What are nursing considerations associated with older adult patients going under
anesthesia?
{{{Answer}}} (They have:
- Ineffective temperature control
- Decompensating physiologically
- Do not tolerate anesthesia well (Anesthesia binds to protein in which they lack))

Quiz:> Why do older adult patients not tolerate anesthesia well? (Think body make up)
{{{Answer}}} (Due to older adults not having lower protein concentrations in the body &
higher fat, the anesthesia binds to protein molecules)