the preoperative patient asks why the dose of warfarin is being withheld. Which response by the nurse is most accurate? Show a." the medication is contraindicated with he type of anesthesia you are receiving" b.this medication could cause excessive bleeding during surgery if it is not stopped beforehand. c. All unnecessary medications are stopped before surgery to prevent you from vomiting under anesthesia? D. this medication may increase respiratory depression associated with anesthetic agents and must be avoided b.this medication could cause excessive bleeding during surgery if it is not stopped beforehand. A patient taking warfarin and digoxin for treatment of atrial fibrillation is instructed to discontinue the use prior to surgery. The nurse would closely monitor this patient for which complication? A. Pulmonary embolism A. Pulmonary embolism rationale: warfarin is an anticoagulant that is used to prevent mural thrombi from forming on the walls of the atria during atrial fibrillation. which nursing interventions would be included in preoperative assessment and teaching plan for an older adult?select all that apply. A. administer a sedative to relieve fear and anxiety B. help patient walk safely to the operating room c. coordinate assessment with the team of health care providers D. speak slowly when giving preoperative instructions to the patient E. understand that the patient may have sensory and cognitive deficits C,D,E An unconscious patient needs to undergo emergency surgery and has no family members or friends available. Which action would the nurse take regarding obtaining consent for the surgery? a. call the local magistrate to get consent for the surgery. b. obtain consent form a legally appointment representative c. avoid giving any treatment because it is illegal to treat without consent d. proceed with plans for surgery; consent is not required for a true medical emergency. d. proceed with plans for surgery; consent is not required for a true medical emergency. Rationale: a true medical emergency may override the need to obtain consent. which patients would require administration of preoperative antibiotics? select all that apply? a. patients undergoing cataract surgery c,d,e rationale: the nurse is caring for a patient with renal dysfunction who is scheduled for surgery. Which nursing interventions are a priority in this situation? select all that apply. a. obtain renal function test preoperatively A,D which activities would be included in a surgical time-out prior to surgery? select all that apply. a. verify patient identification a,c,d in which surgical area will the patient's skin be prepped for surgery, and which clothing will the person doing the prepping wear? a. surgical suite, wearing a lab coat d. operating room, wearing surgical attire and masks which
type of anesthesia is a nurse able to administer without the presence of an anesthesia care provider (ACP) a. moderate sedation rationale: moderate sedation involves administering sedatives, anxiolytics, or analgesics a patient begins having hallucinations and agitation after receiving dissociative anesthesia. Which anesthetic agent is associated with this complication. a. ketamine a. ketamine rationale: a disadvantage of ketamine is the associated risk of agitation, hallucinations and nightmares. These unwanted effects are not associated with he use of thiopental,halothan, or nitrous oxide. which member of the surgical team would inform the blood bank regarding the need for blood transfusion? a. scrub nurse b. circulating nurse rationale: which area is of special concern for the older adult who is having surgery? a. sterility d. skin integrity which type of anesthesia would be used for a colonoscopy in the endoscopy clinic? a. local anesthesia d.monitored anesthesia care monitored anesthesia care would be used for the patient having a colonoscopy done in endoscopy because it can match the sedation level to the patient needs and procedural requirements. local anesthesia would not be used b/c the area affected by the colonoscopy is larger than loss of sensation could be provided with topical, intracutaneous, or subcutaneous application. Moderate sedation is used for the procedures performed outside the operating room and the patient remains responsive. which member of the intraoperative team remains in the unsterile field? a.scrub nurse B. Circulating nurse rationale: circulating nurse is not gowned and gloved and handles unsterile activities in the unsterile field during the intraoperative period. The scrub nurse is gowned and gloved and remains in the sterile field. The surgeon's assistant and registered nurse first assistant may handle and prepare surgical instruments and therefore remain in the sterile field during the intra op period during surgery, tow home or what does the surgical technologist legally need access at all times? a. surgeon D. RN rationale: depending on the individual state rules and regulations, if the surgical technologist are permitted to perform duties in the operating room, there must be access to an RN at all times. The RN is responsible for supervising the surgical technologist in performance of all delegated nursing tasks. which step occurs in the initial stage when a patient is receiving general anesthesia? a. the patient is intubated immediately B. Induction is performed with an IV agent rationale: routine general anesthesia usually beings with an IV induction agent, which may be a hypnotic ,anxiolytic or dissociative agent. the nurse is preparing to administer flumazenil to a patient having severe respiratory depression. For which reason is the nurse administering this antidote. a. morphine overdose B. lorazepam overdose rationale: lorazepam is a benzodiazepine and flumazenil is the antidote for benzodiazepines, In which phase of general anesthesia are H2 blockers used? A. Induction c. preinduction radtionale: to precent aspiration of gastric contents during surgery, the surgeon administers H2 blockers in the pre induction phase of anesthesia. The induction phase is the period in which medications are given to render the past unconscious. Benzodiazepines, opioids, and barbiturates are administered in the induction phase. which assessment finding is a side effect of ketamine? a. bradycardia d. increased alertness postoperatively rationale: Ketamine is a common dissociative anesthetic. it is a phyla cyclohexyl piperidine (PCP) derivative and can cause hallucinations and nightmares. which intraoperative nursing responsibilities would be performed by the scrub nurse? Select all that apply. a. documenting intraoperative care c. coordinating the flow and activities of members of the surgical team d. passing instruments and supplies to the health care provider by anticipating his or her needs e. performing count of sponges, needles, and instruments used during the surgical procedure B,D,E scrub nurse is responsible for keeping track of irrigation solutions for monitoring of blood loss. Both the scrub nurse and the circulating nurse all participate in counting surgical sponges,needles, and instruments, where asp passing instruments to the surgeons and other sterile activities are the exclusive responsibility of the scrub nurse. which medication is administered at the end of surgery to reverse the action of pancuronium? ne ... which activities would the circulating nurse be responsible for? select all that apply. a.preparing the instrument table B,D,E rationale: which duties are specific to a scrub nurse? select all that apply. a. monitor the draping procedure B, D rationale: a scrub nurse always remains in a sterile environments. scrub nurse duties include:assist in the draping procedure, assist in preparing the operating room, and passing instruments to the surgeons and assistants by anticipating their needs. preparing the instrument table and maintaining a sterile enviornment are also the responsibilities of the scrub nurse. a certified registered nurse anesthetist would be responsible for which functions related to surgery? select all that apply. a.passing instruments to the surgeons and assistants b. managing a patient's airway and pulmonary status c. preparing the operating room and the instrument table d. selecting and initiating the planned anesthetic technique e. monitoring the patient's emergence and recovery from the anesthesia B,D,E which complication will the nurse assess for following spinal anesthesia? a.amnesia b. headache rationale: Post-spinal headache is a common patient complaint following spinal anesthesia. The nurse will assess for this complication. which type of anesthesia places patient in an altered state of consciousness but allows them to respond to verbal cues and maintain there own airways? A. topical anesthesia c which anesthetics provide regional anesthesia? a. spinal A,B,D,E bier block= a type of regional anesthesia, it involves injecting anesthetic agents into the venous circulation and using tourniquets to prevent blood from entering systemic circulatio. which admission assessment is documented accurately by the intra op nurse? a. "no evidence of anxiety. anesthesia induction initiated." D. "Patient placed in supine position on OR table. Assessment per flowsheet." rationale: which assessment finding help assure the nurse of patient safety for general anesthesia following correct positioning on the OR table? A.safety straps tightly fitted C,D,E The circulating nurse is responsible for which assessments during the intraoperative phase of surgery? A. vital signs B,E rationale: the circulating nurse frequently assesses the patient's position during surgery. The patient cannot change positions while anesthetized, but movements of the OR table, surgeon, scrub person, and equipment can cause patient movement. which nursing diagnosis would the nurse select for a patient with a blanched area over the coccyx immediately following surgery? A. altered tissue perfusion r/t blanched coccyx B. preoperative positioning injury related to blanched coccyx rationale: Perioperative Positioning Injury related to blanched coccyx is the nursing diagnosis the nurse would select for the patient. The blanched area over the patient's coccyx is the data that supports this nursing diagnosis. which goal would the nurse add to the intraoperative plan of care for a patient at risk for the ineffective tissue perfusion ? c. Patient will remain hemodynamically stable during surgery. rationale: which goal is correct for a patient at risk for intraoperative positioning injury? a. patient's skin will remain intact d. patient will maintain correct position during surgery rationale: Patient position can change during surgery, not by the patient, but from movements of the surgeon and scrub person, use of equipment, and adjustments in OR table level and angles. Patient position is assessed frequently during surgery. Which action(s) would the nurse take to maintain a patient's body temperature during surgery?select all that apply. a.cover patient in thermal drapes A,B,D,E Which Nursing care measures are useful in the prevention of post operative respiratory complications? Select all that apply A. Monitor her oxygen saturation A,C,D,E A patient is admitted to the post anesthesia care unit after bowel surgery and tells the nurse that he or she is going to throw up. Which statement by the nurse reflects a priority nursing intervention. A. I need to check your vital signs B let me help you turn to your side Two days after
Dominos surgery, the patient reports gas pains in abdominal distention. The nurse plans care for the patient on the basis of the knowledge that these symptoms occur as a result of which condition C- slowed gastric emptying Which occurrence might cause secondary heart dysfunction? B. Certain medications Which surgery requires a sensory level L2-L3 anesthesia? B foot surgery Which position with the nurse place a patient who is still drowsy
from anesthesia and has been vomiting? D lateral recovery position Which criteria must a patient meet in order to be discharged from the post anesthesia care unit to the clinical unit? Select all that apply A. No nausea or vomiting B, c , e Which action what is the nurse take to assess an older adult post operative patient has difficulty with memory and the ability to concentrate? Select all that apply A,C, E Post operative patient has absence of breath sounds on the left lung and an oxygen saturation of 86%. Which interventions would the nurse take to maintain adequate oxygen saturation. Select all that apply. A. Administer diuretic D, E Incentive spirometry helps long expansion and promote removal of secretions. Humidified oxygen therapy helps maintain the oxygen saturation levels. A patients BP increase from 110/76 to 160/90 two hours after surgery. Which action would the nurse take first. A. Assess pain level A. Assess pain level Which actions would the nurse take when administering an analgesic to a post op patient. Select all that apply A,B, E Which Action what is the nurse take to ensure oxygenation and a patient who develops inspiratory strider and sternal retraction upon removal of the endotracheal tube? Select all that apply B, D, E Coarse crackles/ noisy respiration's are caused by....what and how do you treat it? Increased secretions due to use of irritant anesthetic drugs To treat=provide IV hydration / suction airway Tachycardia, tachypnea, dyspnea , agitation , chest pain, hypotension are s/sx of: Pulmonary embolism Ambulatory surgery discharge. Phase I or Phase II? Vital signs stable/at baseline Phase I Phase I or Phase II of PACU discharge criteria? Responsible adult driving patient home Ambulatory surgery discharge. Phase II PACU discharge Which actions with the nurse take for a patient in the post anesthesia care unit to ensure that this patient has a patent airway? Select all that apply Suction airway, In the post anesthesia care unit which position will be the safest place an unconscious postoperative patient immediately after that operation? Lateral A client is admitted to a surgical unit postoperatively with a wound drain in place. Which actions should the nurse take in the care of the drain? Select all that apply. a. .Check the drain for patency. A,B,E A client is admitted to the ambulatory surgery center for elective surgery. The nurse asks the client whether any food, fluid, or medication was taken today. Which medication, if taken by the client, should indicate to the nurse the need to contact the surgeon? A. beta-blocker C. An anticoagulant The nurse is caring for a postoperative client who has just returned from the postanesthesia care unit after having nasal surgery. What priorityaction is essential for the nurse to perform? A. assessing how often the client swallows A. assessing how often the client swallows A client is recovering well 24 hours after cranial surgery but is fatigued. The surgeon advances the client from nothing-by-mouth status to clear liquids. The nurse knows that which information is least reliable in determining the client's readiness to take in fluids? 1.Appetite 1.Appetite The nurse is caring for a 25-year-old client who will undergo bilateral orchidectomy for testicular cancer. Which statement by the nurse would be helpful in exploring the client's concerns about loss of reproductive ability? A. "You must be sad that you won't be able to have children after surgery." B."Can you share with me any concerns about how this surgery will affect you in the future?" If wound dehiscence occurs ..... redress with sterile non adherent dressing ... The nurse has instructed a preoperative client using an incentive spirometer to sustain the inhaled breath for 3 seconds. When the client asks about the rationale for this action, the nurse explains that this action achieves which function? A.Dilates the major bronchi C.Maintains inflation of the alveoli A client returns to the nursing unit following a pyelolithotomy for removal of a kidney stone. A Penrose drain is in place. Which action should the nurse include in the client's postoperative plan of care? A.Positioning the client on the affected side B.Irrigating the Penrose drain using sterile procedure C.Changing dressings frequently around the Penrose drain C.Changing dressings frequently around the Penrose drain rationale: to prevent skin breakdown The nurse is caring for an abdominal surgical client who has a Jackson-Pratt drain in place. Which interventions should the nurse include in the plan of care for this drain? Select all that apply. A.Secure the drain to the sheet. B.
Make sure suction is maintained. The nurse is reviewing the surgeon's prescription sheet for a preoperative client, which states that the client must be NPO (nothing by mouth) after midnight. Which medication should the nurse clarify to be given and not withheld? A. Atenolol A. Atenolol In which way does smoking increase a patient's surgical risk? D. Decreases ability to maintain a clear airway Which age-related characteristic increases surgical risk for infants? A. Increased risk for hemorrhage D. Immature physiological mechanisms Which cultural factor has the potential for increasing surgical risk? A. Need for strong family support C. Disbelief in traditional medications What is the focus during the preoperative phase of surgery? A. Protection of patient privacy during surgery C. Patient assessment and preparation for surgery Which age-related characteristic increases the surgical risk for older adults? ... Lasik eye surgery that corrects vision and eliminates the need for eye glasses is which type of procedure? A.ablative B. constructive Rationale: restores visions When a patient's condition is serious but not life-threatening, which type of procedure will be scheduled? A.urgent A. urgent rationale: Urgent surgery is required when the health condition is not immediately life-threatening. However, the surgery must be performed within 24 hours or the condition can become life-threatening. Difference between urgent and emergency surgery? Urgent: Urgent surgery is required when the health condition is not immediately life-threatening. However, the surgery must be performed within 24 hours or the condition can become life-threatening. Emergency: Emergency surgery is an immediate surgery required for a life-threatening medical condition. The surgery cannot be delayed. In which way does nutrition deficiency increase patient surgical risk? A. Interferes with anesthesia induction B. Vitamin K deficiencies can contribute to poor wound healing, increasing surgical risk. Diuretics increases risk of _______ ? fluid and electrolyte imbalance When the nurse is addressing surgical risk during the preoperative phase of surgery, which cultural factor takes priority? A.Language barrier rationale: The patient's language barrier is the cultural factor that takes priority during the preoperative phase of surgery. The patient's inability to understand teaching and understand what is happening can increase stress and anxiety and thereby increase the patient's surgical risk. What is the focus during the intraoperative phase of surgery? A. Admitting the patient to the surgical unit B. Preventing patient injuries and complications Preventing patient injuries and complications is the focus of all team members during the intraoperative phase of surgery. Which type of surgery is conducted to determine or confirm a diagnosis, such as malignancy. ex. removal of tumor to determine if malignant or benign A. palliative diagnostic Which type of surgical procedure will a patient undergo to restore appearance following breast removal for cancer? A. Reconstructive A. Reconstructive rationale: Which patient admission assessment is documented accurately by the intraoperative nurse? A."No evidence of anxiety. Anesthesia induction initiated." D."Patient placed in supine position on OR table. Assessment per flowsheet." The circulating nurse is responsible for which assessments during the intraoperative phase of surgery? Vital signs Urinary output Which nursing diagnosis would the nurse select for a patient who is scheduled for heart surgery that is projected to last eight hours? Ineffective Tissue Perfusion Risk for Perioperative Positioning Injury rationale: Which actual intraoperative nursing diagnosis is stated correctly? Nausea related to effects from anesthesia Injury from Equipment related to failure of OR table Risk of Ineffective Tissue Perfusion with Risk Factor of Immobility Pain related to tissue injury at the surgical site Injury from Equipment related to failure of OR table rationale: Injury from Equipment is an actual nursing diagnosis for the intraoperative patient. It is correctly stated. A risk intraoperative nursing diagnosis would be selected for a patient with which finding? Abnormal blood gas results Protruding bony prominences Acute surgical site pain after a procedure Nausea and vomiting following anesthesia Protruding bony prominences rationale: A risk intraoperative nursing diagnosis would be selected for a patient with protruding body prominences. The patient is at risk for postoperative injury from positioning but does not yet have an injury. Which special precautions do intraoperative nurses take when positioning intraoperative patients?select all that apply. A.Padding any pressure points A.Padding any pressure points Which action(s) would the nurse take to maintain a patient's body temperature during surgery? a. Cover patient in thermal drapes. A.Cover patient in thermal drapes. throughout the intra-operative phase- ... When is a "time out" called? in the operating room right before the procedure starts. Circulating nurse right patient is in the room, the right surgical site is identified, and the correct procedure is about to be performed what are the 3 types of anesthesia? Regional Moderate sedation patients able to respond to verbal cues and independently maintain cardiac/respiratory function useful for short, diagnostic, or ambulatory surgical procedures. RN can administer under supervision of HCP general anesthesia. *patient at risk for Circulatory and respiratory depression *patient unable to be stimulated, and will need support with ventilation GENERAL ANESTHESIA "balanced anesthesia" - This method involves administering different drugs or anesthetics at different intervals during the anesthesia process to produce temporary loss of consciousness, loss of sensation, amnesia, analgesia, and muscle relaxation. ... 4 stages of general anesthesia stage 1 - analgesia regional anesthesia prevents pain sensation in a specific area of the body through the injection or application of local anesthetics that interrupt the transmission of nerve impulses. patients remains awake and maintain their own airway preferred for patients who are hemodynamically compromised. Regional anesthesia: peripheral nerve block ... The nurse's primary roles during the intraoperative phase of surgery are to protect patient safety and to assess the patient's response to surgery. The circulating nurse must be the patient's advocate because the anesthetized patient cannot speak for him or herself. Patient safety is continually assessed throughout the intraoperative phase of surgery. ... Circulating nurse duties non sterile patient safe positioning calls time out documenting patient care and OR activities in EHR Communicates with anesthesiologist/CRNA about patient physiologic status Coordinates the needs of the surgical team by obtaining supplies and carrying out the nursing care plan During surgery, which patient parameters are continually assessed? Heart rate Heart rate Risk nursing diagnosis labels related to intraoperative patients include: Risk for perioperative positioning injury Risk for imbalanced body temperature Risk for imbalanced fluid volume Risk for infection ... Actual nursing diagnosis labels related to intraoperative patients include: Anxiety Ineffective breathing pattern impaired breathing ... Intraoperative goals: Patient will remain free from injury or signs of skin or tissue injury from surgical positioning. Patient will maintain intraoperative temperature within normal or preoperative temperature range for patient. Patient will remain free of hypervolemia or hypovolemia throughout surgery. Patient will remain free of postoperative wound infection. Patient's airway will remain patent during surgery. ... scrub nurse Prepares the sterile field ... anesthesiologist/CRNA dministers anesthesia ... interventions used to prevent hypothermia and maintain adequate body temperature during surgery: warmed blankets, ... intraoperative phase of surgery ends when the patient is transferred to the post-anesthesia care unit (PACU). ... Which goal is correct for a patient at risk for intraoperative positioning injury? A. Patient's skin will remain intact. B. Patient will maintain tissue perfusion C. Patient will be free of skin breakdown after surgery. D. Patient will maintain correct position during surgery. D. Patient will maintain correct position during surgery. benzodiazepines can cause hypotension, tachycardia and respiratory depression. Monitor ... Which anesthetic drug combination is most appropriate for a patient who requires emergency surgery following a motor vehicle crash? ketamine and midazolam Why? Midazolam reduces/eliminates hallucinations associated with ketamine Transition from intra-op to post op- 1. bedside report from the OR staff, usually the circulating nurse and anesthetist, to the PACU nurse. Vital signs (including pain level) are monitored based on the surgeon's orders, the patient's condition, and facility's policies, or more frequently, the patient's status. ... Post op assessments in the PACU are made every 15 minutes during the first hour and then every 30 minutes for the next 2 hours. ... What is the role of the circulating nurse during surgery?Circulating nurses provide additional supplies and sterile instruments as needed during the operation and assist the other team members in monitoring the status of the patient or helping with the repositioning of the patient during the procedure.
What action during a surgical procedure requires immediate intervention by the circulating nurse?(see full question) What action during a surgical procedure requires immediate intervention by the circulating nurse? Explanation: The scrub nurse is "scrubbed" in and should only come in contact with sterile equipment.
Which action is a circulating nurse responsibility during anesthesia induction?The circulating nurse ensures patient safety, monitors the implementation of sterile technique, documents nursing care, addresses any environmental hazards, ensures the scrub team is appropriately prepared, participates in surgical counts (sponges and instruments), and acts as a liaison between family and perioperative ...
What are the responsibilities of a circulating nurse quizlet?The circulating nurse has several functions, including maintaining client safety and privacy, monitoring traffic in and out of the operating room, assessing fluid losses, reporting findings to the surgeon and anesthesia provider, anticipating needs of the team, and communicating to the family.
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Which action is appropriate for a circulating nurse to perform during a surgical procedure quizlet?
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