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NU 310 Exam 1 Questions with Complete Answers
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NU 310 Exam 1 Questions with Complete Answers
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NU 310 Exam 1 Questions with CompleteAnswers
three phases of Perioperative Nursing - Answer-1.) preoperative phase
2.) Intraoperative phase
3.) postoperative phase
Preoperative phase - Answer-period of time from decision for surgery until patient is
transferred into operating room (OR)
Intraoperative phase - Answer-period of time from when patient is transferred into
operating room to admission to post- anesthesia care unit (PACU)
Postoperative phase - Answer-period of time from when patient is admitted to PACU to
follow-up evaluation in clinical setting or at home
How are surgeries classified? - Answer-by body system, by purpose, by degree of
urgency, by degree of risk
Surgical Classification - Answer-• Aesthetic
• Constructive
• Diagnostic
• Curative
• Rehabilitative
• Exploratory
• Emergent
• Palliative
Aesthetic surgery - Answer-improve or preserve appearance (scar removal after burn)
Constructive surgery - Answer-congenital defect; re-constructive- construct of damaged
area
Diagnostic surgery (biopsy) - Answer-to determine origin of symptoms
Curative surgery - Answer-repair, replace, remove disease
- ex: tumor removal
Rehabilitative surgery - Answer-total joint replacement surgery to correct crippling pain
or progression of degenerative osteoarthritis
Exploratory surgery - Answer-estimate extent of the disease
Palliative surgery - Answer-to decrease symptoms
,Surgical Classification based on degree of Urgency - Answer-• Emergent
• Urgent
• Required
• Elective
• Optional
(Table 17-1)
Emergent surgery - Answer-Patient requires immediate attention; disorder may be life-
threatening
- Without delay
- Examples: Severe bleeding, Bladder or intestinal obstruction, Fractured skull, Gunshot
or stab wounds, Extensive burns
Urgent surgery - Answer-Patient requires prompt attention
- Within 24-30 h
- examples: Acute gallbladder infection, Kidney or ureteral stones
Preoperative Diagnostic Tests - Answer-• Urine analysis
• CBC
• Chemistry
• PT/PTT
• CXR (chest x-ray)
• Urine culture **
• ECG**
• ABGs**
• Type and screen
• Pregnancy test
• Drug levels
• HbA1C
• Pulmonary function tests
• Sleep apnea
• Other blood levels
• Other diagnostic tests specific to surgery
Required surgery - Answer-Patient needs to have surgery
- Plan within a few weeks or months
- Examples: Prostatic hyperplasia without bladder obstruction, Thyroid disorders,
Cataracts
Optional surgery - Answer-Decision rests with patient
- Personal preference
- example: Cosmetic surgery
Before Surgery the nurse will... - Answer-• Initiates initial preoperative assessment
,• Initiates teaching appropriate to patient's needs
• Involves family in interview
• Verifies completion of preoperative diagnostic testing
• Verifies understanding of surgeon-specific preoperative orders
• Discusses, reviews advanced-directive document
• Begins discharge planning by assessing patient's need for postoperative
transportation, care
Elective surgery - Answer-Patient should have surgery
- Failure to have surgery not catastrophic
- Example: Repair of scars, Simple hernia, Vaginal repair
Preoperative Assessment - Answer-• Once the decision to perform a surgical procedure
is established, preoperative assessment is conducted
• Detailed history, physical assessment and diagnostic tests
• Detailed medication history because some if it might need to be stopped or modified
days prior to surgery
• Nutritional, fluid status (hydration, electrolytes, bowels)- Table 17-2
• Dentition (significant for anesthesia and intubation)
• Drug or alcohol use
• Respiratory status, smoking habits
• Cardiovascular status (O2, V/S, HTN..)
• Hepatic, renal function (liver, kidneys)
• Endocrine function (glucose, steroids, thyroid)
• Immune function and allergies- Fig. 17-1
• Previous medication use (prescribes, OCT, herbal agents)- Table 17-3
• Psychosocial factors
• Spiritual, cultural beliefs
What gerontological considerations do we keep in mind during the preoperative phase?
- Answer-• Cardiac and circulatory compromise
• Respiratory compromise
• Renal function
• Confusion
• Fluid and electrolyte imbalances
• Skin
• Comorbidities
• Altered sensory
• Mobility restrictions
• lowered physiologic reserve
physiologic reserve - Answer-the ability of an organ to return to normal after a
disturbance in its equilibrium
Medications that potentially affect the surgical procedure? - Answer-• Corticosteroids
• Diuretics = dehydration
, • Phenothiazines
• Tranquilizers
• Insulin
• Antibiotics
• Anticoagulants
• Antiseizure medications
• Thyroid hormone
• Opioids
• OTC and herbals
What other special considerations should be accounted for during the preoperative
phase? - Answer-• Patients who are obese
• Patients with disabilities
• Patients undergoing ambulatory surgery
• Patients undergoing emergency surgery
An informed consent should be in writing and contains: - Answer-• Explanation of
procedure, risks
• Description of benefits, alternatives
• Offer to answer questions about procedure
• Instructions that patient may withdraw consent
• Statement informing patient if protocol differs from customary procedure
In what circumstances is informed consent necessary? - Answer-- Invasive procedures,
such as a surgical incision, a biopsy, a cystoscopy, or paracentesis
- Procedures requiring sedation and/or anesthesia
- A nonsurgical procedure, such as an arteriography, that carries more than a slight risk
to the patient
- Procedures involving radiation
- Blood product administration
The signed consent form is placed in _____________ and accompanies
_____________. - Answer-a prominent place on the patient's medical record, the
patient to the OR
Informed Consent: Voluntary consent - Answer-• Valid consent must be freely given,
without coercion
• Patient must be at least 18 years of age (unless emancipated minor)
• Consent must be obtained by physician
• Patient's signature must be witnessed by professional staff member
Informed consent: Incompetent patient - Answer-Individual who is not autonomous and
cannot give or withhold consent
• Cognitively impaired
• Mentally ill
• Neurologically incapacitated
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