Medical-Surgical Nursing Exam #1
What Are the 2017 Hospital National Patient Safety Goals? - ANS-- Identify patients
correctly
- Improve staff communication
- Use medicines safely
- Use alarms safely
- Identify patient safety risks
- Prevent Infection
- Prevent mistakes in surgery
What Are the Purposes of Surgery? - ANS-- Diagnosis (Yes or No)
- Exploration (Find Problem)
- Cure (Remove/Fix)
- Prevention (Early Stages)
- Palliation (Dying, Hospice, Comfort, No Cure)
- Cosmetic Improvement (Burns, Mastectomy, Reconstruction)
What Are the Three Surgical Phases? - ANS-1.) Preoperative (Until the OR)
2.) Intraoperative (Inside OR)
3.) Postoperative (PACU)
What is Elective Surgery? - ANS-A planned surgery
Ex: Knee replacement
What is An Emergency Surgery? - ANS-Unplanned
Ex: Burst appendix
Inpatient vs. Outpatient - ANS-Inpatient
- Same day admission
Outpatient (Ambulatory)
- Leave hospital when recovered and awake
Nursing Management of the Surgical Client - ANS-- Knowledge of the nature of the
disorder
- Determine the client's response to the stress of surgery
- Assess the results of preoperative diagnostic tests (Look at lab tests)
*What does the patient know, why are they here*
, Preoperative:
Client Interview - ANS-1.) Purpose: Where is the patient at mentally, most anxious, take
vitals after a little while, reassurance
2.) Check documented information prior to the interview (Avoids repetition; see how
nervous)
3.) Occurs in advance or on day of surgery
Preoperative:
Client Assessment - ANS-1.) Health Hx
2.) Medication Hx (Prescription and OTC)
3.) Diagnostic Testing
4.) Psychosocial Factors (Spiritual/Cultural)
*Stop taking Ibuprofen before, stop smoking, when they last ate, etc*
What Subjective Information is Important from the Preoperative Client Interview? -
ANS-- Psychosocial Assessment (Age, Current health)
- Influencing Factors
Fears: Past experiences, death, complications, disfigurement, disruption of life,
disability, viruses, needles, etc.
Pain: Pain medication and management
Hope: To be cured, do not take away hope
*Stress raises glucose levels; always ask about pain*
*Identify caregivers, also the patient must know what is happening*
Anxiety & Nursing Assessment - ANS-Anxiety can arise from:
- Lack of knowledge (More they know the better, use layman's terms)
- Unrealistic expectations (I will have this surgery and be fine)
- Information lessens anxiety
Preoperative Nursing Assessment - ANS-- Health Hx
- Family Diseases (Anesthesia problems/malignant hypothermia)
- Previous and Current Diagnoses medical conditions
- Previous surgeries or problems
- Menstrual/Obstetric History (Pregnant?)
- Current Medications
- Drug Intolerance (Allergies/Adverse Rxn)
What Are the 2017 Hospital National Patient Safety Goals? - ANS-- Identify patients
correctly
- Improve staff communication
- Use medicines safely
- Use alarms safely
- Identify patient safety risks
- Prevent Infection
- Prevent mistakes in surgery
What Are the Purposes of Surgery? - ANS-- Diagnosis (Yes or No)
- Exploration (Find Problem)
- Cure (Remove/Fix)
- Prevention (Early Stages)
- Palliation (Dying, Hospice, Comfort, No Cure)
- Cosmetic Improvement (Burns, Mastectomy, Reconstruction)
What Are the Three Surgical Phases? - ANS-1.) Preoperative (Until the OR)
2.) Intraoperative (Inside OR)
3.) Postoperative (PACU)
What is Elective Surgery? - ANS-A planned surgery
Ex: Knee replacement
What is An Emergency Surgery? - ANS-Unplanned
Ex: Burst appendix
Inpatient vs. Outpatient - ANS-Inpatient
- Same day admission
Outpatient (Ambulatory)
- Leave hospital when recovered and awake
Nursing Management of the Surgical Client - ANS-- Knowledge of the nature of the
disorder
- Determine the client's response to the stress of surgery
- Assess the results of preoperative diagnostic tests (Look at lab tests)
*What does the patient know, why are they here*
, Preoperative:
Client Interview - ANS-1.) Purpose: Where is the patient at mentally, most anxious, take
vitals after a little while, reassurance
2.) Check documented information prior to the interview (Avoids repetition; see how
nervous)
3.) Occurs in advance or on day of surgery
Preoperative:
Client Assessment - ANS-1.) Health Hx
2.) Medication Hx (Prescription and OTC)
3.) Diagnostic Testing
4.) Psychosocial Factors (Spiritual/Cultural)
*Stop taking Ibuprofen before, stop smoking, when they last ate, etc*
What Subjective Information is Important from the Preoperative Client Interview? -
ANS-- Psychosocial Assessment (Age, Current health)
- Influencing Factors
Fears: Past experiences, death, complications, disfigurement, disruption of life,
disability, viruses, needles, etc.
Pain: Pain medication and management
Hope: To be cured, do not take away hope
*Stress raises glucose levels; always ask about pain*
*Identify caregivers, also the patient must know what is happening*
Anxiety & Nursing Assessment - ANS-Anxiety can arise from:
- Lack of knowledge (More they know the better, use layman's terms)
- Unrealistic expectations (I will have this surgery and be fine)
- Information lessens anxiety
Preoperative Nursing Assessment - ANS-- Health Hx
- Family Diseases (Anesthesia problems/malignant hypothermia)
- Previous and Current Diagnoses medical conditions
- Previous surgeries or problems
- Menstrual/Obstetric History (Pregnant?)
- Current Medications
- Drug Intolerance (Allergies/Adverse Rxn)
