Surgery is always a very difficult and stressful situations for patients and families. Creating a physical and psychological problems for patients and families. Providing support is always important, listen to their fear and anxiety. Do your best without jeopardizing their concerns.
The time before surgery is called PERIOPERATIVE PERIOD.
The time in the surgery is called INTRAOPERATIVE(from the time in operating room until after surgery and transported out of operation room)And the time after surgery is called POSTOPERATIVE(from recovery to the floor)Postoperative teaching continues. So it is divided into three phases.There are patient teaching in each phase.
Patient will agree to surgery and sign the consent after the doctor has explained the surgical intervention to patient.
Anesthesia is general or local(regional anesthesia)
(1).An older adult had a surgical intervention. Which action if taken by the nurse demonstrate understanding of normal physiological changes of older adult.
(A).Encourage patient to eat three balanced meal a day.
(B).Monitor vital signs Q4hours.
(C).Turn ,reposition, cough and deep breath every 4hours.Use incentive Spirometry.
(D). Monitor intake and output.
Correct answer C.
Rationale: Having the patient to turn, cough and deep breathing every 4 hours will help to prevent increased risk of respiratory complications including pneumonia and atelectasis.The use of incentive Spirometry inflates alveoli and promotes venous return. It is done 10 times while awake for the first 5 days postoperatively .
(2). Jenifer is scheduled for surgery but she is so worried and afraid. She said tell me daughter that I love her.But nurse what if I did not make it alive with this surgery?. What will be the best response for this patient by her nurse.
A.Tell me how you are feeling. Let us talk about how are are feeling.
B. Your doctor is a miracle worker. So don’t worry or be afraid.
C. My grandmother is 98years old.She woke up from surgery and you are only 45years old.
D.You will be glad that you did this surgery. What kind of insurance do you have?.
Correct answer A.
Rationale: It is therapeutic to allow the patient to talk about her fears and feelings. It is important to understand patient concerns and fears,and to provide correct information and emotional support.
(3).One of the common symptoms of postoperative discomfort is gas pain.What will be the best action taken by the nurse to help patient relieve gas pains?.
(A).Encourage early and frequent ambulation.
(B).Patient to call frequently for pain medication.
(C).Maintain normal vital signs.
(D). Encourage adequate fluid intake.
Correct answer A.
Rationale: Frequent ambulation is necessary because it stimulates peristalsis activity and relieves gas pain.
(4).Bowel elimination is a natural process in which the body excretes the waste products of digestion.
(A) This is essential component of healthy body function.
(B).Excretion is bad for the body.
(C). Elimination is discrimination.
(D).All of the above.
Correct answer A.
Rationale: A is the correct answer B,C,D are all wrong. Problem with the bowel elimination will affect the electrolytes, nutrition and fluid in the body.
(5).What food has a laxative effect.
(A).Chicken and rice.
(B).Cheese.
(C). Prunes.
(D).Hamburger with fries.
Correct answer C.
Rationale: Prunes are natural remedies for constipation.
(6).The PCP known as patient controlled analgesia pump allows the postoperative patient to do what?.
(A). Allow the patient to administer his or her own analgesic.
(B ) Be free and happy without pain.
(C).Happy time patient can over medicate his or herself as much as possible.
(D).Get it when you can.
Correct answer A.
Rationale:Patient controlled analgesics pump will allow the patient to administer his or her own medication. It does not allow the patient to have unlimited access to the narcotic. B,C,D are all wrong.
7. After a car accident mrs Rabbit has a ruptured spleen .The doctor performed a major emergency surgery why?.
A.The surgery must be done immediately to preserve the patient life. This surgery involves a major organ, has tendency for complications and must be done in hospital settings.
(B).Doctors like money. Get money from them.
(C).Patient don’t need that surgery.
(D).It should be a minor surgery.
Correct answer A.
Rationale: A is correct, the spleen is a very important organ in the body. It keeps blood circulation in your body clean and functioning. It will recognize old or damaged blood in your body and remove them. B,C,and D are all wrong.
Nurses You Move Me 