NURS 3730 EXAM 1 QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
what are the national patient safety goals?
1. correct procedure on correct patient at correct body positions
2. correct site parking
3. pause before surgery for time out
what to obtain from patient during preoperative phase?
-history with ROS
-medical and surgical hx (including anesthesia hx)
-drug and substance use
^ tobacco increases the risk of pulmonary complications
^ alcohol alters response to anesthesia and pain...withdrawal can cause delirium
tremors
what to assess in the preoperative phase?
baseline VS
CV - HTN, hx of VTE/DVT, etc
,respiratory - baseline
kidney - affects effectiveness of drugs
neurologic - orientation, GCS
musculoskeletal - ROM, etc
nutrition - decr. protein intake can slow recovery
skin - temp, breakdown, etc
psychosocial - anxiety/fear
diagnostic assessments to get in the preoperative phase
urinalysis
blood type and screen
CBC or H&H
* incr. K+ = incr. risk of dysrhythmias
* decr. K+ = slower recovery
clotting studies (PT, INR, aPTT)
,metabolic panel
preg test
CXR
CR/MRI
EKG
how to minimize anxiety during the preoperative phase
encourage communication
promote rest
use distraction
teach the caregiver
how can degenerative changes in myocardium and valves place an older adult at
higher risk during surgery and what can the nurse do about it?
decreased cardiac reserve puts older adults at risk for decreased CO, specially during
times of stress
assess baseline VS for tachycardia, fatigue, and arrhythmias
, how can rigidity of arterial walls and reduction in SNS and PNS innervation to the
heart place an older adult at higher risk during surgery and what can the nurse do
about it?
alterations predispose patient to post op hemorrhage and rise in systolic and diastolic
BP
maintain adequate fluid balance to minimize stress to the heart. ensure that BP is
adequate to meet circulatory demands
how can increased calcium and cholesterol deposits within small arteries as well
as thickened arterial walls place an older adult at higher risk during surgery and
what can the nurse do about it?
predispose patient to clot formation in lower extremities
instruct patient in leg exercises and proper turning. apply elastic stockings or
intermittent pneumatic compression devices. give anticoagulants. provide education
about effects and dietary restrictions
how can decreased SQ tissue and increased fragility of skin place an older adult
at higher risk during surgery and what can the nurse do about it?
prone to pressure injuries and skin tears
assess skin Q4h; pad all bony prominences during surgery; turn or reposition at least
Q2-3h
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
what are the national patient safety goals?
1. correct procedure on correct patient at correct body positions
2. correct site parking
3. pause before surgery for time out
what to obtain from patient during preoperative phase?
-history with ROS
-medical and surgical hx (including anesthesia hx)
-drug and substance use
^ tobacco increases the risk of pulmonary complications
^ alcohol alters response to anesthesia and pain...withdrawal can cause delirium
tremors
what to assess in the preoperative phase?
baseline VS
CV - HTN, hx of VTE/DVT, etc
,respiratory - baseline
kidney - affects effectiveness of drugs
neurologic - orientation, GCS
musculoskeletal - ROM, etc
nutrition - decr. protein intake can slow recovery
skin - temp, breakdown, etc
psychosocial - anxiety/fear
diagnostic assessments to get in the preoperative phase
urinalysis
blood type and screen
CBC or H&H
* incr. K+ = incr. risk of dysrhythmias
* decr. K+ = slower recovery
clotting studies (PT, INR, aPTT)
,metabolic panel
preg test
CXR
CR/MRI
EKG
how to minimize anxiety during the preoperative phase
encourage communication
promote rest
use distraction
teach the caregiver
how can degenerative changes in myocardium and valves place an older adult at
higher risk during surgery and what can the nurse do about it?
decreased cardiac reserve puts older adults at risk for decreased CO, specially during
times of stress
assess baseline VS for tachycardia, fatigue, and arrhythmias
, how can rigidity of arterial walls and reduction in SNS and PNS innervation to the
heart place an older adult at higher risk during surgery and what can the nurse do
about it?
alterations predispose patient to post op hemorrhage and rise in systolic and diastolic
BP
maintain adequate fluid balance to minimize stress to the heart. ensure that BP is
adequate to meet circulatory demands
how can increased calcium and cholesterol deposits within small arteries as well
as thickened arterial walls place an older adult at higher risk during surgery and
what can the nurse do about it?
predispose patient to clot formation in lower extremities
instruct patient in leg exercises and proper turning. apply elastic stockings or
intermittent pneumatic compression devices. give anticoagulants. provide education
about effects and dietary restrictions
how can decreased SQ tissue and increased fragility of skin place an older adult
at higher risk during surgery and what can the nurse do about it?
prone to pressure injuries and skin tears
assess skin Q4h; pad all bony prominences during surgery; turn or reposition at least
Q2-3h
