1
ADULT IV NURSING CARE WITH ADVANCED MEDICAL
SURGICAL ALTERATIONS STUDY GUIDE TIPS 2026 JUST
RELEASED VERSION
Peri-Operative Nursing (≈ 50% of the exam)
Pre-operative risks
- Airway risks
o Obstructive sleep apnea → airway obstruction post-op
o Obesity → difficult intubation, hypoventilation
- Cardiac disease
o CHF, MI, dysrhythmias, pneumonia → ↓ oxygenation
- Metabolic/endocrine
o Diabetes → poor wound healing, glucose instability
o Thyroid disorders → ↑ anesthesia sensitivity
- Renal & liver disease
o Altered drug clearance, bleeding risk
- Bleeding risk
o Coagulopathies, anticoagulant use
- Genetic risk
o Malignant hyperthermia history (patient or family)
Allergies
- Latex allergy
o Banana, kiwi, avocado allergy = latex risk
- Egg or soybean allergy
o Contraindication to propofol
- Iodine/shellfish allergy
o Contrast dye risk
- Medication allergies
o Antibiotics, anesthetics, opioids
o Medical conditions affecting surgery and anesthesia
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Medications that impact surgery
- Anticoagulants: warfarin, Eliquis, Xarelto, Lovenox, Heparin
- Antiplatelets: aspirin, Plavix
- OTC supplements: fish oil, vitamin E, St. John’s Wort, CoQ10
- GLP-1 agonists (Ozempic): must be held 7 days → aspiration
risk
- Beta blockers: usually continued to prevent cardiac events
Understand pre-operative safety and consent
- Patient must:
o Be NPO (6-8 hrs solids, 2 hrs clear liquids)
o Understand the procedure
o Have correct site marked
- Nurse role
o Witness consent
o Clarify information already given
- HCP role
o Explain risks, benefits, alternatives
Describe intra-operative nursing roles
- Circulator Nurse Responsibilities
o Works outside sterile field
o Manages patient safety
o Coordinates the OR
o Documents everything
o Performs counts (laps, sharps, instruments)
o Conducts surgical time-out
- Time-out includes:
o Patient name & DOB
o Procedure
o Correct site
o Allergies
, 3
o Antibiotics
o Special equipment
- Positioning & safety
o Pad bony prominences
o Maintain neutral alignment
o Protect eyes, nerves, airway
o Apply SCDs for VTE prevention
o Use warming devices (Bair Hugger)
ADULT IV NURSING CARE WITH ADVANCED MEDICAL
SURGICAL ALTERATIONS STUDY GUIDE TIPS 2026 JUST
RELEASED VERSION
Peri-Operative Nursing (≈ 50% of the exam)
Pre-operative risks
- Airway risks
o Obstructive sleep apnea → airway obstruction post-op
o Obesity → difficult intubation, hypoventilation
- Cardiac disease
o CHF, MI, dysrhythmias, pneumonia → ↓ oxygenation
- Metabolic/endocrine
o Diabetes → poor wound healing, glucose instability
o Thyroid disorders → ↑ anesthesia sensitivity
- Renal & liver disease
o Altered drug clearance, bleeding risk
- Bleeding risk
o Coagulopathies, anticoagulant use
- Genetic risk
o Malignant hyperthermia history (patient or family)
Allergies
- Latex allergy
o Banana, kiwi, avocado allergy = latex risk
- Egg or soybean allergy
o Contraindication to propofol
- Iodine/shellfish allergy
o Contrast dye risk
- Medication allergies
o Antibiotics, anesthetics, opioids
o Medical conditions affecting surgery and anesthesia
,2
Medications that impact surgery
- Anticoagulants: warfarin, Eliquis, Xarelto, Lovenox, Heparin
- Antiplatelets: aspirin, Plavix
- OTC supplements: fish oil, vitamin E, St. John’s Wort, CoQ10
- GLP-1 agonists (Ozempic): must be held 7 days → aspiration
risk
- Beta blockers: usually continued to prevent cardiac events
Understand pre-operative safety and consent
- Patient must:
o Be NPO (6-8 hrs solids, 2 hrs clear liquids)
o Understand the procedure
o Have correct site marked
- Nurse role
o Witness consent
o Clarify information already given
- HCP role
o Explain risks, benefits, alternatives
Describe intra-operative nursing roles
- Circulator Nurse Responsibilities
o Works outside sterile field
o Manages patient safety
o Coordinates the OR
o Documents everything
o Performs counts (laps, sharps, instruments)
o Conducts surgical time-out
- Time-out includes:
o Patient name & DOB
o Procedure
o Correct site
o Allergies
, 3
o Antibiotics
o Special equipment
- Positioning & safety
o Pad bony prominences
o Maintain neutral alignment
o Protect eyes, nerves, airway
o Apply SCDs for VTE prevention
o Use warming devices (Bair Hugger)
