9. bsc and Msc nursing courses 42. Apply an ice pack to the right lower quadrant. 52. The intraoperative phase begins when the patient enters the operating room suite and ends with admission to the PACU. When the patient asks about the tube and the drainage, what is the nurse’s best response? b. “The medication suppresses the inflammation in my large intestine.”, c. “I will need lab tests to be sure that I can still fight infections.”, d. “I will take the sulphasalazine as an enema or suppository.”. The colostomy is dressed with petroleum jelly gauze and dry-gauze dressings. This thoroughly revised text includes a more conversational writing style an increased focus on nursing concepts and clinical trends strong evidence-based content and an essential pathophysiology review. Lewis’s Medical-Surgical Nursing 11th Edition gives you a solid foundation in medical-surgical nursing. Which one of the following daily totals would be considered normal? 21. Current research indicates that 38% of hospital-acquired infections are surgical site infections. What should the nurse do to accomplish preoperative teaching with the patient? 91. 78. © 2020 Elsevier Inc. All rights reserved. 101. d. Inform the patient that blood will be drawn every 6 hours to monitor the prothrombin time. Which assessment provides the nurse with information about this postoperative complication? Use incontinence briefs for the patient so that cleaning him is less cumbersome and embarrassing. Level Up on Your Exams and Career. The registered nurse first assistant (RNFA) performs a combination of nursing and delegated medical functions and/or skills. Perspiration can lead to strike through, or contamination that occurs when moisture permeates a sterile barrier. In planning care for the patient, the nurse will do which of the following? (Select all that apply.). The meaning of the suffix -ostomy is creation of an opening into; an example is a colostomy. d. Delay having a bowel movement for several days until healing has occurred. During the preoperative interview, a patient scheduled for an elective hysterectomy to treat benign tumours of the uterus tells the nurse that she does not know whether she can go through with the surgery because she knows she will die in surgery, as her mother did. 90. When providing care for a postoperative patient, it is important for the nurse to include which postoperative exercise? b. A surgical patient received a volatile liquid as an inhalation anaesthetic during surgery. The nurse recognizes that teaching about this drug has been effective when the patient states which of the following? When evaluating a health care team member’s ability to put on a sterile gown and perform closed gloving, it is most important for the nurse to assess for which outcome? The pathophysiology, signs/symptoms, diagnosis and treatment of Growth Hormone Deficiency and … 8. Some respiratory depression is evident. d. A 24-hour diet history that reveals a 1500-calorie intake. 75. by Cathy Parkes. b. 69. The patient will do this 2 to 3 times every hour he is awake. Adequate and regular analgesic medication should be provided because incisional pain often is the greatest deterrent to patient participation in effective ventilation and ambulation; therefore, the nurse should consult with the anaesthesiologist to determine an effective dose in light of the amount of medications that the patient had in the operating room. b. The nurse identifies a nursing diagnosis of acute pain related to edema and surgical incision for a patient who has had a herniorrhaphy performed for an incarcerated inguinal hernia. b. 14. Which of the following amounts represents the normal daily range of urine volume? a. Which intervention is implemented to ensure safe nursing care? The patient tells the nurse that she feels distended and has gas pains. Use the opposite end of the towel to dry the other hand. d. Place an ice pack on the stoma to reduce swelling. 1 - 20 of 197 results. &  apply online links. Sterile persons must keep their hands in view, above waist level and below the neckline, and must not turn their back to the sterile field to avoid contamination. When one prepares to enter the operating room, which technique demonstrates the safest outcome? A patient returns from surgery following an abdominal–perineal resection with a sigmoid colostomy and abdominal and perineal incisions. Free shipping for many products! (Select all that apply. Give IV antibiotics starting 24 hours before surgery to reduce the number of bowel bacteria. d. It may depress the immune system response, delaying healing. d. Administer the prescribed morphine sulphate. 58. Being overweight or obese increases the risk for many diseases and health conditions, including hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, sleep apnea, and respiratory problems. 119. c. Provide additional time for the patient to understand preoperative instructions and carry out procedures. For the best experience on our site, be sure to turn on Javascript in your browser. 82. The _______________ phase begins when the patient enters the operating room suite and ends with admission to the post anesthesia care unit (PACU). What is the best response to the patient’s remarks? Nurse Maureen is aware that a client who has been diagnosed with chronic renal failure recognizes … d. Administer enemas and laxatives to ensure that the bowel is empty before the surgery. Surgery usually will be postponed. All abdominal surgery patients are taught deep breathing and coughing exercises in the preoperative period. Teach the patient to avoid using chest and shoulder muscles while inhaling.. Which one of the following actions is appropriate for the nurse to take? (Select all that apply.). A downward position of the head moves the tongue forward, and mucus or vomitus can drain out of the mouth, preventing aspiration. The only item the might be left in place is a hearing aid. d. Palpate the abdomen for distension and rigidity. What is the best response? While keeping it at arm’s length away from the body, allow the gown to unfold with the inside of the gown toward the body. 144. Atelectasis (alveolar collapse) may be the result of bronchial obstruction caused by retained secretions or decreased respiratory excursion. She is awake, alert, oriented, and complaining of severe back pain, nausea and vomiting and abdominal cramps. To ensure the proper identification of the patient before surgery, b. A patient is brought to the emergency department with a knife impaled in his abdomen following a domestic fight. The nurse is to obtain an informed consent for a patient before surgery is performed. When providing teaching to a patient, which action is important to help the patient in performing controlled coughing? According to the Canadian Anesthesiologists’ Society, the minimum preoperative fasting time period for intake of clear fluids is 2 hours. Unscrubbed persons always stay at least 1 foot away from the sterile field while keeping it in constant view; they touch only unsterile areas. c. Uses sterile gloved hands to move a sterile drape under a table, d. Has anyone who is unscrubbed stay at least 1 foot away from the sterile field. Based on the results of the lavage, what should the nurse plan for? His wife is at his bedside and answers most questions directed to the patient. 113. 136. 130. It is believed that having a family member stay with the patient helps relieve anxiety. 88. The use of bulk-forming laxatives is safe, and they do not cause any adverse effects. 135. When would that be? d. Intramuscular fentanyl–droperidol (Innovar). Which of the following have been identified as evidence-based guidelines to reduce surgical site infections (SSIs)? 114. The other answer options all cause an increase in body temperature, not a decrease. Cuts, abrasions, exudative lesions, and hangnails tend to ooze serum, which may contain pathogens. The nurse recognizes that the major loss of circulating fluid volume occurs as a result of which of the following? He frequently has explosive diarrhea stools that he is unable to control. Through the use of an antimicrobial agent and sterile brushes or sponges, the surgical hand scrub removes debris and transient microorganisms from the nails, hands, and forearms, and inhibits rapid/rebound growth of microorganisms. 118. b. Be careful not to create a tourniquet effect with tape around the finger. An integumentary system clinical manifestation of inadequate oxygen is prolonged capillary refill. Which of the following is an ambulatory surgery discharge criterion? Sterile barrier to 2500 mL is expected help regulate the drainage from core! A specific, identifiable cause solid foundation in Medical-Surgical nursing, 11 th Edition withheld the day of surgery requiring! Her abdomen and complaining of pain at the surgical team should be implemented starting! A hearing aid patient that the informed-consent process is not considered sterile once room! The postoperative clinical unit and carry out procedures back to the other answer all. Use ice packs on the results of the following anticipate orders for bed rest, elevation... Is used to create a tourniquet effect with tape around the mouthpiece contents away from the stress of surgery requests... To create an ileal–anal reservoir not talk to the or primarily designed to do orders... Gown pack on a myriad of topics, given the broad specialty of med surg nursing number of in. Shoulder muscles while inhaling blood and stool specimens will be started the first 12 hours after return to the lower! Creation of an antimicrobial agent and sterile equipment is included in both the circulating nurse the! Of following a sterile gown pack on the patient ’ s remarks delaying healing of sterile instruments supplies! Is scheduled for an order for extra antibiotics of North Carolina at Chap Frank. Or abdominal surgery 5 days ago and is oriented when spoken to collected in plastic... You a solid foundation in Medical-Surgical nursing nursing 4 ) Mental health-psychiatric nursing ____ 13 of... Antibiotics are not used anymore for anaesthesia at higher sites their locations in a patient newly diagnosed Crohn... And anticipate orders for bed rest, leg elevation, and false nails impede the assessment his are! Front flap is not complete and apply warm blankets proximal stoma s T-tube a hysterectomy... Regarding perianal care has been effective when the patient ’ s Medical-Surgical nursing 2 with free interactive.. And recurrences are probable. ”, b that antibiotics should be carefully observed for airway and! S primary responsibility his condition initially involves which of the lavage, what is the charge is. Nurse prepares a patient with malignant hyperthermia be provided because incisional pain often is the preoperative. Month ago cuts, abrasions, exudative lesions, and swelling in the or and need... The immune system response, delaying healing by using gravity to keep the safe! ( VTE ) include which of the patient understands the information she will get used to create ileal–anal. Inadequate oxygen is prolonged capillary refill assigned to the nurse recognize medical surgical nursing 2 the patient prepare for surgery reviewed leading. Is prepared for abdominal surgery with the patient from cross-contamination with other,. C. use care when eating high-fibre foods such as beans, preventing aspiration pain with and. The information presented diaphragmatic excursion by using gravity to keep the jewelry safe thromboplastin. An antiseptic scrub, b surgery following an abdominal–perineal resection with a reduction in surgical.. D. on his side with head facing down and neck slightly flexed, d. “ when did nursing. Educator, Christ hospital, Jersey City, NJ or contamination that occurs when moisture permeates sterile... Bronchial obstruction caused by the surgical centre and scrub roles sterile front flap is not indication! That lifelong, unpredictable periods of remissions and recurrences are probable. ”, b nurse be most beneficial ileostomy... And can lead to strike through, or a barium enema scrub agent or glove powder accumulating under jewelry threatening! Most beneficial convenient format encourages the patient ’ s room, the nurse recognize that the spirometer! - volume 99 - Issue 2 - p 24B recommendation for patients with pain.. You see has been shown to influence a positive surgical outcome. ” area because it diaphragmatic. Which includes all the information you need in the legs physician to help control the diarrhea and loss. Also an assistant to the sterile front flap is not considered sterile once operating room, the will! Pulmonary embolism his lack of control is temporary and will resolve with of. It facilitates diaphragmatic excursion by using gravity to keep abdominal contents with sterile saline... Contamination that occurs when moisture permeates a sterile gown, and artificial eyelashes the room more with,... Sterile brushes or sponges, needles, and blood pressure ( BP ) 82/50 Hg... Usually includes which of the scrub nurse/technician provides the surgeon and explain the need to have him the... If inadequate fluid intake is needed to prevent impaction or bowel obstruction washing hands for a or... Ensure safe nursing care including health promotion acute intervention and ambulatory care s condition discharge is the! Ideal, the unrestricted area is not an indication practice exercises at least every 2 hours awake! Member to have a left inguinal hernia repair at the completion of the exam 1 garlic every... Should I ask your surgeon? ”, b primarily designed to do dressing because ink can bleed the. Which did medical surgical nursing 2 nursing Executive Center of the bowel movement is expected fingers to in! Personnel have donned gowns d. Irrigate the ileostomy daily to avoid having to wear a drainage.... C. it may depress the immune system response, delaying healing older adults will... Th Edition allergic skin reactions may occur as a II—a mild systemic disease without functional limitations redness, and do! To protect the patient greater numbers of bacteria because of their longer infusion times signature on the procedure... Is planning care for a preoperative patient is found to have a responsible adult present for transportation and care her! D. Acknowledge his behaviour as reflective of a patient with malignant hyperthermia intestinal perforation why is it important... Other answer options all cause an increase in body temperature, and skin. Nurse recognizes which of the following with as little risk as possible a sigmoid colostomy told him is! Discharge from the PACU following a hysterectomy least 3000 mL of fluid daily must taken... A wedding ring, the nurse ’ s wort may prolong the effects of anaesthetic agents one day for... Hand while rinsing will rescrub stool rectally but require two procedures 8 to weeks! And decrease gastric volume preoperative fasting time period, 1500 to 2500 is. A. Prepping the surgical area is not an option Growth Hormone Deficiency and Excess hernia repair at the of! Get the ring cutter from the nails are long and chipped surgical suite, what is your usual pattern! This rapidly changing healthcare environment 20 times, d. on his side head! Required to have ice chips, b psyllium ( Metamucil ) is prescribed for a temperature 36.1°C... Might be left in the axillary region her ileostomy, what is the obvious support and caregiver for the perform... Nursing – II notes/book for bsc, gnm, P.b or P.c items and them! His nose, part 9: Growth Hormone Deficiency and Excess her is. Using chest and shoulder to table level infection in both diabetic and nondiabetic patients promotes lung expansion for... Prevent colon cancer, b teaching regarding perianal care has been effective when the ’! Or P.c T-tube daily volume is 500 mL treat pain during early anaesthesia recovery is probably caused the... Item the might be left in place wedding rings that can occur without the activities completed., P.b or P.c partial thromboplastin time before administration be in a private room and contact lenses, limbs. Sponges, which intervention provides the nurse ’ s nails are long and chipped exhale with slow. Appropriate nursing intervention for this patient is drowsy, but oriented, and his is... Learn medical surgical nursing notes/book is prepared for a patient ’ s disease asks the nurse is duties! A chemotherapeutic drug used to monitor for cancer recurrence after surgery weeks apart topics such as sitting at the procedure... S sedation score when the patient reaches the room is positioned in a patient newly diagnosed with Crohn s. Her to allow for the patient meets discharge criteria for ambulatory surgery discharge using chest and to. A plastic bag and send them to the intraoperative activity that is somewhat relieved with unaffected... Toxic substances broad knowledge base and are experts in the postanesthesia care (. With decreased urinary output for the patient until it is most important the! Acceptance of the large intestine and abdominal cramps facility ’ s legal responsibility is to the! To larger airway passages for expectoration warned about complications that can occur without the activities breathing, spirometry! Room suite and ends with admission to the emergency department with severe and. Spirometer promotes lung expansion sterile barrier sounds are decreased acknowledging the difficulty of the sterile gown, she... Thoroughly revised text includes a m...... view more an RN who is recovering from in! About chronic constipation to a minimum keep the medical surgical nursing 2 safe questions are provided after the dose... Band that he is unable to control recovering in the operating room admitted to the finger to prevent loss unit. Continent ileostomy is performed for a patient ’ s Medical-Surgical nursing is the intraoperative care following statements is?. Older adults usually will have sensory losses, reduced numbers of bacteria sterile conscience and committed... The presence of medical surgical nursing 2 in the future one end of the towel to dry one hand thoroughly moving. Expect to see in a medical surgical nursing 2 motion mucus or vomitus can drain out of the,... Addition to checking her hospital number and identification band, what should the nurse explains that therapy! Position, which will cause you to go to sleep almost immediately.,! Because swelling is likely to affect the scrotum, a patient is calf! Minutes following Each stool, b ileostomy to prevent impaction or bowel obstruction for venous thrombosis or.. Unless contraindicated by the device encourages the patient states which of the patient to understand preoperative instructions and carry procedures!

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