Preoperative care quiz

C: One of the major reasons that older adults need increased time preoperatively is the presence of impaired vision and hearing that slows understanding of preoperative instructions and preparation for surgery._x000D_Thought processes and cognitive abilities may also be impaired in some older adults. The older adult’s decreased adaptation to stress because of physiologic changes may increase surgical risks, and overwhelming surgery-related losses may result in difficulty coping that is not directly_x000D_related to time needed for preoperative preparation. The involvement of caregivers in preoperative activities may be appropriate for patients of all ages.

D: Blood urea nitrogen (BUN), serum creatinine, and electrolytes are used to assess renal function and should be evaluated before surgery. Other studies are often evaluated in the presence of heart or respiratory disease, or bleeding tendencies.

C: Risk factors for latex allergies include a history of hay fever and allergies to foods, such as avocados, kiwi, bananas, potatoes, peaches, and apricots. When a patient identifies such allergies, the patient should be further questioned about exposure to latex and specific reactions to_x000D_allergens._x000D__x000D_A history of any allergic responsiveness increases the risk for hypersensitivity reactions to drugs used during anesthesia, but the hay fever and fruit allergies are specifically related to latex allergy. After the nurse identifies the allergic reaction, the anesthesia care provider (ACP) should be notified, the allergy alert wristband should be applied, and the note in the record will include the allergies and reactions as well as the nursing actions related to the allergies.

A: The Health Care Procedure (HCP) is ultimately responsible for obtaining informed consent._x000D_However, the nurse may be responsible for obtaining and witnessing the patient’s signature on the consent form. The nurse must be a patient advocate during the signing of the consent form, verifying that consent is voluntary and that the patient understands the implications of consent, but the primary legal action by the nurse is witnessing the patient’s signature.

B: The rationale for use of preoperative checklists is to ensure that the many preparations and precautions performed before surgery have been completed and documented. Patient identification, administration of preoperative medications, voiding, and instructions to the family may be documented on the checklist, which ensures that no details are omitted.

D, E: Hysterectomy and herniorrhaphy are done to eliminate and repair pathologic conditions. Gastroscopy is for the purpose of diagnosis. Rhinoplasty is done for a cosmetic improvement. A tracheotomy is palliative.

A: Excessive anxiety and stress can affect surgical recovery and the nurse’s role in psychologically preparing the patient for surgery is to assess for potential stressors that could negatively affect surgery. Specific fears should be identified and addressed by the nurse by listening and explaining planned postoperative care. Ignoring her behavior, falsely reassuring the patient, and telling her not to be anxious are not therapeutic.

A, B, C, D, E: All of these are actions that are needed to ensure that the patient is ready for surgery. In addition, the nurse should verify that the identification band and allergy band (if applicable) are on; the patient is not wearing any cosmetics; nail polish has been removed; valuables have been removed and secured; and prosthetics, such as eyeglasses, have been_x000D_removed and secured.

A: The preoperative fasting recommendations of the American Society of Anesthesiology indicate that clear liquids may be taken up to 2 hours before surgery for healthy patients undergoing elective procedures. There is evidence that longer fasting is not necessary

A: Obesity, as well as spinal, chest, and airway deformities, may compromise respiratory function during and after surgery. Dehydration may require preoperative fluid therapy. An enlarged liver may indicate hepatic dysfunction that will increase perioperative risk related to glucose_x000D_control, coagulation, and drug interactions. Weak peripheral pulses may reflect circulatory problems that could affect healing.

D: The elevated white blood count (WBC) count may indicate an infection. The surgeon will probably postpone the surgery until the cause of the elevated WBC count has been found. The other values are within normal limits.