NUR 425 - MedSurg 2 Exam 1
Priority order - answer1. Pt bleeding
2. Bt decreased LOC
3. Pt increased BP
4. Pt is coughing (stable)
5. Pt in pain
6. Pt preoperative
7. Pt discharging
Pt getting general anesthesia – answer Ensure intubation, oxygen, and suctioning at
bedside
What is an post removal epidural issue? - answer Spinal fluid headache
Fluid may leak out during an? – answer Epidural removal
Epidural treatment? - answer1. Lay pt flat (take pressure off spine)
2. Administer medication for headache
3. Call anesthesia
How much time do you have between giving medication and intubating? - answerAbout
1 minute
Priority for post-op regarding breathing? - answerEnsure open airway (monitor
breathing)
Resuscitation equipment? - answer1. Oxygen
2. Suctioning
3. Intubation
4. Ventilator
5. Bag
Postop positioning can cause? - answerNerve pinching
Pt has been removed from intubation, pt wants to eat? - answerCall speech therapy.
Make sure that pt has swallowed
Pt done with surgery and acetylcholine is wearing off? - answerRemove intubation
Who marks surgical sites? - answerSurgeon and patient
, Who is responsible for obtaining consent? - answerSurgeon
Why do patients have to remove jewelry? - answerSafety for surgery due to equipment
used
Why do patients remove denture and lose teeth? - answerPt can choke on them
Why do patients remove hearing aids? - answerThey can fall out and they're too
expensive to replace
Nursing responsibilities preop? - answer1. Education
2. Check vitals/labs
3. Shaving
4. Premedicate
o Antibiotics
o PPI
o Chlorhexidine mouth rinse
5. May start fluids
6. Place IV (large gauge)
Preop required for all female patients? - answerPregnancy test
Preop pt: · If pt is anxious, give therapeutic communication? - answerTell them it is
normal to be nervous
What medication do you hold before surgery? - answerblood thinners
Blood thinner medication patient education - answer1. Stop 24-48hrs before
2. Takes 7-10 days for aspirin to wear off
3. Warfarin, Heparin, Lovenox
Labs for bleeding: - answer1. PT
2. PTT
3. INR
4. CBC
5. Hg
6. Hct
What if prelab work shows Hg 9? - answerNotify surgeon.
- May recommend pretreatment or ensure blood is on the floor
Treatments for excessive bleeding (can be due to medications): - answer1. Vitamin K
2. Protamine Sulfate
Nursing responsibilities for bleeding before surgery? - answerTypes & cross
o Cross match pts blood type to avoid infusion reaction
Priority order - answer1. Pt bleeding
2. Bt decreased LOC
3. Pt increased BP
4. Pt is coughing (stable)
5. Pt in pain
6. Pt preoperative
7. Pt discharging
Pt getting general anesthesia – answer Ensure intubation, oxygen, and suctioning at
bedside
What is an post removal epidural issue? - answer Spinal fluid headache
Fluid may leak out during an? – answer Epidural removal
Epidural treatment? - answer1. Lay pt flat (take pressure off spine)
2. Administer medication for headache
3. Call anesthesia
How much time do you have between giving medication and intubating? - answerAbout
1 minute
Priority for post-op regarding breathing? - answerEnsure open airway (monitor
breathing)
Resuscitation equipment? - answer1. Oxygen
2. Suctioning
3. Intubation
4. Ventilator
5. Bag
Postop positioning can cause? - answerNerve pinching
Pt has been removed from intubation, pt wants to eat? - answerCall speech therapy.
Make sure that pt has swallowed
Pt done with surgery and acetylcholine is wearing off? - answerRemove intubation
Who marks surgical sites? - answerSurgeon and patient
, Who is responsible for obtaining consent? - answerSurgeon
Why do patients have to remove jewelry? - answerSafety for surgery due to equipment
used
Why do patients remove denture and lose teeth? - answerPt can choke on them
Why do patients remove hearing aids? - answerThey can fall out and they're too
expensive to replace
Nursing responsibilities preop? - answer1. Education
2. Check vitals/labs
3. Shaving
4. Premedicate
o Antibiotics
o PPI
o Chlorhexidine mouth rinse
5. May start fluids
6. Place IV (large gauge)
Preop required for all female patients? - answerPregnancy test
Preop pt: · If pt is anxious, give therapeutic communication? - answerTell them it is
normal to be nervous
What medication do you hold before surgery? - answerblood thinners
Blood thinner medication patient education - answer1. Stop 24-48hrs before
2. Takes 7-10 days for aspirin to wear off
3. Warfarin, Heparin, Lovenox
Labs for bleeding: - answer1. PT
2. PTT
3. INR
4. CBC
5. Hg
6. Hct
What if prelab work shows Hg 9? - answerNotify surgeon.
- May recommend pretreatment or ensure blood is on the floor
Treatments for excessive bleeding (can be due to medications): - answer1. Vitamin K
2. Protamine Sulfate
Nursing responsibilities for bleeding before surgery? - answerTypes & cross
o Cross match pts blood type to avoid infusion reaction
