Exam (elaborations)
MSN 277 Exam 1 Questions With Complete Solutions
- Course
- MSN 277
- Institution
- Northern Kentucky University
MSN 277 Exam 1 Questions With Complete Solutions
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MSN 277 Exam 1 Questions WithComplete Solutions
Surgery correct answer: ○ Sometimes surgery might be enough but there are limitations
○ Considered a local therapy
○ Diagnosis
○ Cure
■ Different surgeries to help cure
Palliative correct answer: ■ Option for palliation
■ Max for quality of life and relieving symptoms for those with terminal disease like cancer
■ Ex. large tumor compressing nerve and have chronic name
● Palliative surgery is an option for that patient
Prevention correct answer: ■ Removal of mole or anything that can cause harm later on
Cosmetic improvement correct answer: Exploration correct answer: ■ Figure out what's going on and compare to what is normal, a lot of times in the chest and abdomen
■ Surgeon determines dx and could treat right there
Nursing assessment of the preoperative patient (Subjective, Objective, Past health history, medication, allergies, illicit drugs) correct answer: ○ Subjective data ■ How the patient feels, abstract
■ Psychosocial
■ Anxiety
■ Fear
■ Hope
○ Objective data
■ Data values
● Blood pressure
■ Concrete evidence
○ Past health history
■ We must know what other chronic disorders they have, overweight, diabetes, restrictive lung disease, one kidney, big drinker, all of the past history
○ Medication
■ Asses the medications
■ A lot of different medications used to treat their conditions
■ Nausea, pain medicine
■ Sedatives and antibiotics and a risk for drug interactions
■ Over the counter meds, herbals and see the potential drug interactions
● Aspirin (increases risk for bleeding)
■ Assessing the patients and hoping that they are honest with us
○ Allergies
■ Important aspect of pre op care
■ Can be allergic to anesthesia
■ Tend to give antibiotics pre surgery to limit number of bacteria in body
■ Make sure to assess and document the info in case there are any allergies to meds
■ Weird allergies (bananas, avocado) = immune system is hyperactive and more likely to be allergic to latex ○ Illicit drugs
■ Withdrawal
■ Serious behavioral issues and difficult to take care of and we can plan and assess for that
■ Chronic alcoholic, cirrhosis, drugs stick around in body longer
and anesthesia will stick longer
Cardiovascular system correct answer: ■ Heart surgeon has to clear them and if they are not cleared then they will not perform surgery
■ VTE risk - venous thromboembolism
■ CAD, HTN, MI? Prosthetic heart valve (on blood thinners/ antibiotic)? Agina?
■ Lab work done to find certain diseases
■ EKG
Resp System correct answer: ■ Lungs; organ with most complications after surgery
■ VTE risk - venous thromboembolism
■ Need to know if they have asthma COPD or if they are a chronic smoker
■ Previous surgery? Lung cancer? Sleep apnea (for obese patient)? Heart failure?
Neurological System correct answer: ■ Evaluation of neurologic functioning includes assessing the patient's ability to respond to questions, follow commands, and maintain orderly thought patterns
■ Record the patient's ability to pay attention, concentrate, and respond appropriately to establish a baseline for postoperative comparison. ■ Preoperative assessment of the older person's baseline cognitive function is especially crucial for comparison during and after surgery.
■ In the review of the neurologic system, obtain information about any history of strokes, transient ischemic attacks, or spinal
cord injury. Ask about neurologic diseases, such as myasthenia gravis, Parkinson's disease, and multiple sclerosis, and any treatments used.
GI correct answer: ■ Assess for a history of renal or urinary tract diseases, such as chronic kidney disease or repeated urinary
tract infections.
■ Older male patients may have an enlarged prostate that can interfere with the insertion of a bladder catheter or impair voiding after surgery
■ Immediately tell the surgeon if the patient states that she may be pregnant. Maternal and fetal exposure to anesthetics should be avoided during the first trimester. RULE OUT PREGNANCY BEFORE SURGERY since drugs used can be dangerous to baby
■ Urination is going to be very important to monitor; ileostomy and urine output
Hepatic System correct answer: ■ The liver is involved in glucose homeostasis, fat metabolism, protein synthesis, drug and
hormone metabolism, and bilirubin formation and excretion.
■ The liver detoxifies many anesthetics and adjunctive drugs. The patient with hepatic dysfunction may have an increased perioperative risk for clotting abnormalities and adverse responses to drugs.
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