Exam (elaborations)
Perioperative Nursing (Pre, Intra, Post) Questions with Solutions 2024
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Perioperative Nursing (Pre, Intra, Post)
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Perioperative Nursing (Pre, Intra, Post)Priority Care to maintain patient safety - answer Complete preoperative
testing/preparation
•Maintain normal glucose levels
•Ensure informed consent
•Ensure correct surgical site
•Prevent postoperative infection
•Complete preoperative teaching to prevent complications
•Address psychological comfort
Important Key Points for Preoperative Procedures - answer•Assess each patient's risk
factors for threats to SAFETY.
•Communicate to the perioperative team AND PATIENT any physical or laboratory
change that may alter the patient's response to drugs, anesthesia, or surgery.
•Ask the patient to explain in his or her own words which surgical procedure is being
done and why.
•After the patient has received preoperative drugs, keep the side rails up and the bed in
the low position
•Communicate during hand-off to the operating room personnel all care that has been
provided and what care may still be needed.
Health Promotion & Maintenance Preoperatively - answerTeach patients about
preoperative preparations and specific postoperative interventions to prevent
complications (incision splinting, deep-breathing exercises, range-of-motion exercises
[Prevention of respiratory complications]
• Breathing exercises
• Incentive spirometry
• Coughing and splinting
[Prevention of cardiovascular complications]
• VTE (Leg exercises & Mobility)
Preoperative Psychosocial Integrity - answer•Encourage the patient to express his or
her feelings regarding the surgical procedure or its possible outcome(s).
•Explain and provide written information for all diagnostic procedures, restrictions, and
follow-up care to the patient and his or her family. Provide and explain written info on
the procedure, restriction, follow up to PT and family [Ethics]
•Implement appropriate interventions to reduce patient anxiety.
, Preoperative Physiological Integrity - answer•Communicate to the perioperative team
any physical or laboratory change(s) that may alter the patient's response to drugs,
anesthesia, or surgery.
•Apply prescribed antiembolic stockings, sequential compression boots, or other
devices to reduce or prevent vascular complications.
•Ensure that dentures and any other personal items are removed from the patient
before he or she is transferred to the surgical suite.
Pre-surgical screening/tests - answerU/A Urine Analysis - specific gravity, I&O, odor,
color
CBC - RBC, WBC, H&H, creatinine & BUN
BMP Basic Metabolic Panel for electrolytes
PT/PTT/INR
CXR Chest Xray (& XRAY left lower extremity that PRE AND POST OPERATIVELY)
EKG Electrocardiography
hCG for pregnancy testing
Baseline VS
HT/WT
For healthy patients undergoing elective surgery, require a complete history and
physical examination, but no routine preoperative tests unless they fall into the following
categories:
Obtain hemoglobin level for major surgery with significant expected blood loss
Obtain serum creatinine level for people older than 40 years
Perform EKG in patients older than 40 years
Perform CXR in patients older than 60
There is no need to repeat any lab tests if they were normal 4 months (depending on
hospital policy) of the surgery and no change in patient's clinical status noted
Pre-Op Checklist Day of Surgery - answer1. Preoperative education - pain mgt, wound
mgt, complication of surgery, POST OPERATIVE CARE, sedation drugs/anesthesia
2. Informed consent signed - surgeon signs with PT and nurse as a witness, not
coerced
3. NPO - bowel prep, Patient not to ingest anything by mouth for 6 to 8 hours before
surgery, to ensure no vomiting, aspirating, defecating (Break in the skin or shave of hair
increases risk for infection)
4. Skin Prep - use HIBICLENS (little packages of 6 antimicrobial wipes_
5. Documentation/Checklist of valuable - Advanced directive, security holds valuables
6. Pre Op Meds - Given & Charted, allergy bands, sedation drugs (make sure to receive
consent of these drugs and inform the drug effects to the PT)
7. Side rails up after pre op bed in low position
8. Hospital Gown
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