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1. which of the following should a nurse include when teach outpatient. about up coming surgery |
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Definition
- post-op nursing intervention
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2. who is responsible for all the risks and benefits |
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Definition
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3. what is the greates risk factor to a pt. that undergo the surgery anesthesia |
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Definition
- aspiration
what do we do about that
- NPO for 6 – 8 hrs before surgery
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4. pt. is scheduled for colostomy, and is very nervous; what is the most effective way for you to help this pt. |
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Definition
- encourage him to express his feeling about his greatest fear |
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5. who has the legal capacity to give consent |
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Definition
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6. when pt. signed the consent form, what is the informed consist of |
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Definition
- understanding the nature and the reason for the surgery
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7. you’re giving pt. a pre-op enema, pt. started to cry and said ‘I’m sorry that you have to do this messy thing for me”; what is your best therapeutic answer |
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Definition
- ask and open ended question find out what she is upset about
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8. pt. is going to have an exploratory laparotomy (opening of abdomen and look around) in the morning, what do you need to do first |
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Definition
- Phisohex shower (antibacterial wash)
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9. how should you respond to pt saying ‘what exactly am I going to have done in the surgery, what exactly they are going to do to me’ |
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Definition
- your response is ‘what did the physician tell you’ |
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10. what is the best way to prevent infection on the wound |
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Definition
- preparation of the skin over the surgical site before the surgery
*** preparation of the skin include pHisohex shower, shaving hairs….
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| 11. pt. is going for total knee replacement, how are you going to teach pt. about pain |
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Definition
- teaching the pain scale 1 – 10
- leg exercise to prevent pulmonary embolism
*** pulmonary embolism is the blockage of the main artery of the lung
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| 12. when you are checking pt. in for surgical procedure, what is the most important thing to check |
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Definition
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| 13. what are some of the risk factors for aspiration? Who is at risk? |
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Definition
- obese pt.
- pts eating to close to surgical time (within 8 hrs b4 surgery)
- general anesthesia |
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| 14. what is malignant hyperthermia |
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Definition
- is inherited disease that causes a rapid rise in body temperature (fever) and severe muscle contractions when the affected person receives general anesthesia |
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| 15. who does malignant hyperthermia affect |
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Definition
- strong muscled men
- hereditary factors |
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| 16. what cause malignant hyperthermia |
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Definition
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| 17. math: order = 1.4g IM med. reconstitute with 2.1mL NS after reconstituted the solution = 350mg/mL how much do you get |
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Definition
- 1.4g = 1400mg
1400mg / 350mg/mL = 4mL/2vial (bc 1 vial = 2.1mL) |
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| 18. pt. is receiving conscience sedation for putting back his dislocated shoulder, as a nurse what are you going to assessed this pt |
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Definition
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| 19. who can give anesthesia |
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Definition
- anesthesiologist
- anesthetist (s/b an RN) |
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| 20. what is stage 1 of anesthesia |
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Definition
- is relaxation and analgesic state
- problem with communication, slurred speech, drowsiness |
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| 21. what is the most dangerous stage for most pt. in general anesthesia |
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Definition
- stage 2 (excitement and delirium stage)
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| 22. what stage is the surgical stage of anesthesia |
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Definition
- stage 3
- muscles are relaxed, regular breathing, pt. cannot hear anything |
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| 23. what is stage 4 of anesthesia |
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Definition
- is danger stage
- apnea, BP drops, cardiac arrest , respiratory arrest
- at this stage, pt. is dead on the table |
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| 24. what is post-op period (from beginning to the ending) |
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Definition
- from the completion of surgery to the transferring to unit |
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25. what is inter-operative period |
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Definition
| - is the surgery period (from the time pt. transfer to and leave from the operating table) |
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| 26. what is the purpose of PACU (Post Anesthesia Care Unit) |
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Definition
- continuous critical evaluation, stabilization and maintain airway of the pt. |
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| 27. S/S of compromised airway |
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Definition
- noisy breathing
- pt. is agitated, restless, confused, S/S of hypoxia |
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| 28. how do you treat pt. with stridor, noisy respiration and agitated |
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Definition
- open the airway (head tilt or jaw thrust for head or neck injury)
*** oxygen only works for hypoxia not for obstruction |
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| 29. what is the most common object obstructed the airway that cause stridor |
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Definition
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| 30. what med. do you give to pt. immediately post-of to prevent laryngospasm |
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Definition
- succinylcholine (anectine) (use for relaxing the muscle)
*** laryngosasm: vocal cord disfunction
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| 31. you are monitoring pt. and taking temperature, what is the body temperature reflex of |
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Definition
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| 32. an post-op pt. with hypothemic, what is your best action |
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Definition
- give warm blanket, fluid
- remove wet, bloody clothings from the surgery
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| 33. post-op pt. received general anesthetic, which of the following observations is your priority |
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Definition
- N/V
- mild hypertension
- decrease urinary output
- rising body temperature
why
- due to malignant hyperthermia |
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| 34. what is characteristic of the drainage that you want to write down |
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Definition
- amount
- color
- consistency
- odor
• you would do all that for all body fluid (urine, NG suctioning, wound) |
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35. before the doctor can change the dressing for the first time and the pt.’s dressing is saturated; what do you do |
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Definition
- reinforce the dressing (adding another layer of dressing on top) |
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36. S/S of pt. become hypovolemia |
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Definition
- blood loss of at least 500mL |
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| 37. before you medicate post-op pt. for pain, what information do you want to gather first |
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Definition
- PQRST (Provoke, Quality, Radiates, Severity and Time) |
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38. after the PQRST, what is your next step before giving medication |
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Definition
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39. pt. with appendectomy (abd surgery), has temperature of 100 orally, pulse of 84, RR of 10 and BP of 120/72. which one requies immediate interventions |
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Definition
- respiratory
*** normal respiratory rate = 12 – 20 |
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40. you giving pain med. to pt., you come back about 45min. later pt. still complains about pain on the same place. What should you do |
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Definition
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Definition
- pulse and respiratory elevated and BP can go either way
- diminished lung sound, pallor, chest pain, shortness of breath
*** atelectasis is the partial collapse of a lung can cause breathing difficulty, chest pain, cough, diminished breath sound or no breath sound at all
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42. what is the most common complications of spinal anesthesia |
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Definition
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43. what do we do to prevent headache from spinal anesthesia |
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Definition
- keep pt. flat for 8-12 hrs |
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44. what do you do when pt. started vomiting during the surgery |
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Definition
- turn pt. into the left side |
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45. what electrolyte are we concern about losing during the prolonged surgery |
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Definition
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46. to prevent pulmonary embolism in the post-op pt what do we do |
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Definition
- leg exercise to increase blood circulation to heart |
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| 47. what is the purpose of ted hose |
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Definition
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| 48. pt. is ordered to ambulate, what is the first thing you have to do before ambulation |
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Definition
| - take VS - check for orthostatic (sit up, dangling, standing) |
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49. pt. tell you he feels a POP after his abd surgery and has a lot of pink serous fluid around the his dressing. What is the sign |
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Definition
- it is dehiscence (premature ‘bursting’ open of a wound along surgical suture) |
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50. what do you do with dehiscence |
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Definition
- put him supine
- bend his knee
- apply normal saline on the dressing
- then call doctor
*** do the same with evisceration (the internal organ came out)
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51. what do you do with a full Jackson Pratt (wound drainage system) while assessing pt. |
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Definition
- empty it and before re-attach it, you have to squeeze it in to re-establish the suction |
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52. S/S of infection from the post-op pt. |
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Definition
- pus, redness, smelling and increased pain
- elevated WBC
- fever |
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53. pt. had abd surgery, what do you use to splint the incision |
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Definition
- splint with hand if incision is small
- or with pillow if incision is larger (put right on the incision) |
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54. what is the purpose of splinting incision |
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Definition
- to prevent dehiscence or evisceration |
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55. which of the following is the most important in your pre-op teaching plan as a nurse |
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Definition
- answer any question the pt. might have
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56. when prepare pt. for surgery, what should you ask the pt. regarding of allergy |
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Definition
- check if pt. allergic to the medication and also to iodine and shellfish |
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what position do we often put pt. in after surgery to help train secretion |
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Definition
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