FRANU NURS 3730 FINAL CUMULATIVE EXAM QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED LATEST
UPDATE GRADED A++
Preop Phase
Begins when Pt is sch for surgery till transfer to surgical suite
Surgical Care Improvement Plan (SCIP)
Decreases postOp complications & Cardiac Events
Infection Prevention:
-Antibiotics before incision
-Hair Removal (electric razor)
-Urinary Catheter (remove postop day 1-2)
-Control CBG in cardiac Pt's
Cardiac Event Prevent:
-Beta Blockers
VTE/DVT Prevent:
-VTE Prophylaxis (hose, SCD, Lovenox, ambulate)
ASA Classifications
ASA 1: Healthy
ASA 2: mild systemic disease:
-Well controlled DM, Smoker, Prego, Mild COPD
ASA 3: Severe Systemic Disease
,-Poorly controlled DM/HTN/COPD & > 3month MI/CVA/TIA/CAD/Stent placement
ASA 4: Systemic Disease Life Threat
-<3 month MI/CVA/TIA/CAD/Stent Placement
ASA 5: Will Die w/o Surgery
-Emergency surgery pt, massive trauma
ASA 6: Brain dead
Preoperative Pt & Fam Education
-NPO 6hr prior
-Meds (take Cardiac/Bp meds)
-Preop preps
-Breathing/incentive spirometry
-Coughing & splinting
-DVT prevention (Hose, SCD Lovenox, Ambulate)
-Autologous donations
-Explain tubes, drains, vascular access
-Consent (provider gets it nurse likes to watch)
Roles of the IntraOp Team
Surgical Assistant:
-another surgeon or resident helps with suturing
CRNA:
-Meds, IV drugs, IV fluids, Vitals, I&O's
Scrub Nurse/Nurse Tech:
,-set up surgical field, passes instruments to surgeon, assist circ nurse in instrument
counts
Circulating Nurse:
-Preps OR/Supplies
-Assist anesthesia with vitals & meds
-Foley/I&O/VS
-Anticipates Needs
-Privacy
-Maintains Sterile Field
-Talks to Fam
-Documents
Consent for pt who can't write
-Pt signs with an X
-Need 2 witnesses
Ped consent Info
-Guardian signs
-Ped can sign if they are Preg, emancipated, or married
Peds can receive treatment without guardian consent if
-STD's
-MH
-Contraceptives
-Abortions (blue states)
Preoperative pt Prep
, -Provider marks site & verifies w pt
-Get pt naked then gown them, keep underwear unless foley (no bra bc metal)
-No metal bc burn risk
-Valuables w caregiver or security
-Apply Ted/SCD before surg (document this)
-IV 18g
-Ensure pt is wearing all pertinent bands (blood, allergy, fall risk etc...)
Preoperative Pt scenarios
-Pt has fever (call MD)
-Pt has abn Labs (call MD)
-Pt has DM (get CBG and what meds they on/last time taking them)
-Pt is a hard stick (call CRNA)
-Fam want a DNR (call MD)
Preoperative Pt Teaching Scenarios
Surgery is emergent:
-Teach them postop
Pt is 2yr old:
-Teach right before
Pt is 6yr old:
-Teach day before
Pt is 15yr old:
-Treat like adult
Pt has dementia:
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED LATEST
UPDATE GRADED A++
Preop Phase
Begins when Pt is sch for surgery till transfer to surgical suite
Surgical Care Improvement Plan (SCIP)
Decreases postOp complications & Cardiac Events
Infection Prevention:
-Antibiotics before incision
-Hair Removal (electric razor)
-Urinary Catheter (remove postop day 1-2)
-Control CBG in cardiac Pt's
Cardiac Event Prevent:
-Beta Blockers
VTE/DVT Prevent:
-VTE Prophylaxis (hose, SCD, Lovenox, ambulate)
ASA Classifications
ASA 1: Healthy
ASA 2: mild systemic disease:
-Well controlled DM, Smoker, Prego, Mild COPD
ASA 3: Severe Systemic Disease
,-Poorly controlled DM/HTN/COPD & > 3month MI/CVA/TIA/CAD/Stent placement
ASA 4: Systemic Disease Life Threat
-<3 month MI/CVA/TIA/CAD/Stent Placement
ASA 5: Will Die w/o Surgery
-Emergency surgery pt, massive trauma
ASA 6: Brain dead
Preoperative Pt & Fam Education
-NPO 6hr prior
-Meds (take Cardiac/Bp meds)
-Preop preps
-Breathing/incentive spirometry
-Coughing & splinting
-DVT prevention (Hose, SCD Lovenox, Ambulate)
-Autologous donations
-Explain tubes, drains, vascular access
-Consent (provider gets it nurse likes to watch)
Roles of the IntraOp Team
Surgical Assistant:
-another surgeon or resident helps with suturing
CRNA:
-Meds, IV drugs, IV fluids, Vitals, I&O's
Scrub Nurse/Nurse Tech:
,-set up surgical field, passes instruments to surgeon, assist circ nurse in instrument
counts
Circulating Nurse:
-Preps OR/Supplies
-Assist anesthesia with vitals & meds
-Foley/I&O/VS
-Anticipates Needs
-Privacy
-Maintains Sterile Field
-Talks to Fam
-Documents
Consent for pt who can't write
-Pt signs with an X
-Need 2 witnesses
Ped consent Info
-Guardian signs
-Ped can sign if they are Preg, emancipated, or married
Peds can receive treatment without guardian consent if
-STD's
-MH
-Contraceptives
-Abortions (blue states)
Preoperative pt Prep
, -Provider marks site & verifies w pt
-Get pt naked then gown them, keep underwear unless foley (no bra bc metal)
-No metal bc burn risk
-Valuables w caregiver or security
-Apply Ted/SCD before surg (document this)
-IV 18g
-Ensure pt is wearing all pertinent bands (blood, allergy, fall risk etc...)
Preoperative Pt scenarios
-Pt has fever (call MD)
-Pt has abn Labs (call MD)
-Pt has DM (get CBG and what meds they on/last time taking them)
-Pt is a hard stick (call CRNA)
-Fam want a DNR (call MD)
Preoperative Pt Teaching Scenarios
Surgery is emergent:
-Teach them postop
Pt is 2yr old:
-Teach right before
Pt is 6yr old:
-Teach day before
Pt is 15yr old:
-Treat like adult
Pt has dementia:
