Quiz For The Surgeons - What To Do And Not Do In Pre OP And Post OP?

The incentive spirometer is used to prevent lung collapse. This device helps patients expand their lungs and improve their lung function by encouraging deep breathing and coughing. By using the incentive spirometer regularly, patients can prevent atelectasis, which is the collapse of lung tissue due to shallow breathing or immobility. This can be especially beneficial for patients who have undergone surgery or are at risk of developing respiratory complications.

In the postanesthesia care unit or recovery room, one of the top priorities for the nurse is to ensure the maintenance of a patent airway. This is crucial because after surgery, clients may still be under the effects of anesthesia, which can cause respiratory depression or obstruction. By ensuring a clear and unobstructed airway, the nurse can prevent any potential respiratory complications and ensure adequate oxygenation for the client's recovery.

When a nurse finds that a client's abdominal surgical wound has eviscerated, it means that the organs inside the abdomen are protruding through the wound. This is a medical emergency that requires immediate action. The nurse should cover the site with saline-soaked sterile gauze to prevent infection and further injury to the organs. Calling for help is also important, as the nurse may need assistance in providing further care or transporting the client to the operating room. Sitting the client upright or attempting to replace the organs is not appropriate and can cause further harm.

Voiding before receiving the preoperative medication is an important indicator that the client is prepared for surgery. This is because emptying the bladder before surgery helps prevent complications during the procedure, such as accidental release of urine or injury to the bladder. It also ensures that the client is comfortable and does not have the urge to urinate during the surgery, which can interfere with the procedure. Therefore, voiding before receiving the preoperative medication is a crucial step in preparing a client for surgery.

Auscultating for bowel sounds every 4 hours is the correct answer because paralytic ileus is a condition where there is a temporary paralysis or lack of movement in the intestines. This can occur after surgery due to the effects of anesthesia and manipulation of the intestines during the procedure. By auscultating for bowel sounds, the nurse can assess if there is normal peristalsis and movement of the intestines, which would indicate that paralytic ileus is not present.

In the postanesthesia care unit or recovery room, it is important to closely monitor the client's condition as they recover from anesthesia. Assessing the client every 15 minutes allows healthcare providers to promptly identify any changes in vital signs, pain levels, or overall well-being. This frequency of assessment ensures that any complications or adverse reactions can be detected and addressed in a timely manner, promoting the client's safety and recovery. Assessing the client every 5 minutes may be too frequent and may disrupt the client's rest, while assessing every 30 minutes or hourly may not provide enough monitoring to catch potential issues early on.

Eupnea refers to normal, unlabored breathing. In the postoperative period, it is a positive sign that the client is recovering well if they are experiencing eupnea. This indicates that their respiratory system is functioning properly and there are no complications or respiratory distress. Tachycardia, hypotension, and hyperthermia are all abnormal signs that may indicate complications or distress in the postoperative period. Therefore, the correct answer is eupnea.

The correct answer is that no intravenous (IV) narcotics have been given in the last 30 minutes. This is because the criteria for ambulatory surgery discharge include ensuring that the client is not under the influence of IV narcotics, as they can impair their ability to drive safely. The other statements in the question, such as the client being able to drive home alone, some respiratory depression being evident, and the oxygen saturation level being at 85%, are not valid criteria for ambulatory surgery discharge.

The nurse recognizes that the surgeon should be informed and the surgery may be postponed if the client has calf pain, redness, and swelling. This could indicate a deep vein thrombosis (DVT), which is a blood clot that forms in a deep vein, usually in the leg. Surgery increases the risk of developing a DVT, and if one is present, it could potentially dislodge and travel to the lungs, causing a pulmonary embolism. Therefore, it is important to notify the surgeon and potentially postpone the surgery to further evaluate and treat the client's condition.

The correct answer is "Consent is required by law to protect the client’s rights." This statement accurately reflects the purpose of obtaining informed consent before surgery. Informed consent is a legal and ethical requirement to ensure that the client understands the risks, benefits, and alternatives of the procedure and has the right to make an autonomous decision about their healthcare. By obtaining consent, healthcare providers protect the client's rights to information, autonomy, and self-determination. The other options in the question do not fully capture the significance of informed consent or the nurse's role in providing information and obtaining consent.

The decreased glomerular filtration rate is a change that occurs in the older adult client that places them at risk for surgery. Glomerular filtration rate refers to the rate at which the kidneys filter blood. A decrease in this rate indicates a decline in kidney function, which can lead to complications during surgery such as fluid and electrolyte imbalances. Therefore, a decreased glomerular filtration rate increases the risk for surgery in older adults.

Placing a pillow over the incisional site for splinting helps to support the incision and reduce pain during coughing or deep breathing exercises. This technique provides stability and prevents excessive movement or strain on the surgical site, promoting healing and preventing complications such as dehiscence or herniation.

Performing active range-of-motion exercises to the unaffected extremities helps to maintain joint mobility and prevent muscle atrophy while the client is recovering from surgery. This is important because immobilization and inactivity can lead to stiffness and weakness in the unaffected extremities. Turning every 4 hours helps to prevent pressure ulcers but is not specifically related to postoperative exercises. Completing leg exercises once daily and repeating individual leg exercises 20 times may be too strenuous for the client immediately after surgery and could increase the risk of complications.

During surgery, it is important for the medical team to remove any items that may interfere with the procedure or pose a risk to the patient. However, a hearing aid is a non-invasive device that does not interfere with the surgery and can be safely left on. Unlike an artificial limb, eyeglasses, or contact lenses, a hearing aid does not need to be removed as it does not pose any risk or hindrance to the surgical process. Therefore, a hearing aid is the item that may remain in place during surgery.

When transferring a client from the postanesthesia care unit to a room, the nurse should use a black pen to note the drainage on the dressing. This is important for accurate documentation and monitoring of the client's condition. Removing the indwelling urinary catheter or attaching the nasogastric tube to suction may not be necessary or appropriate at this time. Changing the dressing immediately when the client reaches the room may disrupt the healing process and increase the risk of infection.

A client who has received spinal anesthesia should be positioned supine, with the head flat. This position helps to prevent the pooling of anesthesia in the lower extremities and promotes even distribution of the anesthetic. It also helps to prevent hypotension by maintaining venous return and cardiac output. Lying on the side or in the prone position can increase the risk of complications such as respiratory compromise and impaired circulation. Trendelenburg's position, with the head lower than the feet, is not recommended as it can increase intracranial pressure and is not necessary for spinal anesthesia.

In the usual preparation for general surgery, the client may be given specifically ordered oral medications with small amounts of water. This is because some medications need to be taken before surgery, and a small amount of water is allowed to help swallow the medication. However, the client should not consume any solid food or large amounts of water to avoid complications during surgery.

The presence of tenderness, redness, and swelling in the left calf indicates a potential deep vein thrombosis (DVT), which is a serious complication after surgery. Heparin therapy is commonly used to prevent or treat blood clots, so preparing for heparin therapy would be the appropriate action in this situation. Massaging the lower leg could potentially dislodge a blood clot and worsen the condition. Keeping the leg in a dependent position and having the client exercise the extremity may also increase the risk of clot dislodgement. Therefore, preparing for heparin therapy is the best course of action.