Perioperative Care

Question 1

List five variables that increase surgical risk.

Answer 1

1. Age: very young and very old
2. Obesity and malnutrition
3. Preoperative dehydration/hypovolemia
4. Preoperative infection
5. Use of anticoagulants (aspirin) preoperatively

Question 2

Why is a client with liver disease at increased risk for operative complications?

Answer 2

Impairs ability to detoxify medications used during surgery; impairs ability to produce prothrombin to reduce hemorrhage

Question 3

Preoperative teaching should include demonstration and explanation of expected postoperative client activities. What activities should be included?

Answer 3

Respiratory activities: coughing, breathing, use of spiromoter; exercises: range of motion, leg exercises, turning; pain management: medications, splinting; dietary restrictions: NPO evolving to progressive diet; dressings and drains; orientation to recovery room environment.

Question 4

What items should the nurse assist the client in removing before surgery?

Answer 4

Contact lenses, glasses, dentures, partial plates, wigs, jewelry, prosthesis, makeup, and nail polish

Question 5

How is the client positioned in the immediate postoperative period, and why?

Answer 5

Usually on the side or with head to side to prevent aspiration of any emesis

Question 6

List three nursing actions that prevent postoperative wound dehiscence and evisceration.

Answer 6

1. Teaching client to splint incision when coughing
2. Encouraging coughing and deep breathing in early postoperative period when sutures are strong
3. Monitoring for signs of infection, malnutrition, and dehydration
4. Encouraging high-protein diet

Question 7

Identify three nursing interventions that prevent postoperative urinary tract infections.

Answer 7

1. Avoiding postoperative catheterization
2. Increasing oral fluid intake
3. Emptying bladder every 4 to 6 hours
4. Early ambulation

Question 8

Identify nursing/medical interventions that prevent postoperative paralytic ileus.

Answer 8

• Early ambulation
• Limiting use of narcotic analgesics
• NG tube decompression

Question 9

List four nursing interventions that prevent postoperative thrombophlebitis.

Answer 9

1. Teaching performance of in-bed leg exercises
2. Encouraging early ambulation
3. Applying antiembolus stockings
4. Teaching avoidance of positions and pressures that obstruct venous flow

Question 10

During the intraoperative period, what activities should the OR nurse perform to ensure safety during surgery?

Answer 10

Ascertain correct sponge, needle, and instrument count; position client to avoid injury; apply ground during electrocautery use; apply strict use of surgical asepsis.