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medical surgical nursing 2

), a. Prepping the surgical site with a razor followed by an antiseptic scrub, b. Which following class of preoperative medications is administered to increase the patients’ gastric pH and decrease gastric volume? 26. d. Place an ice pack on the stoma to reduce swelling. The goal of prophylactic antibiotic therapy is to protect the patient from infection with as little risk as possible. c. The oxygen saturation level is at 85%. a. d. Check the postoperative orders for catheterization orders. A patient that has a history of controlled asthma would be rated as a II—a mild systemic disease without functional limitations. 81. Instruct the patient to assume semi-Fowler’s or high-Fowler’s position, and place a nose clip on the patient’s nose. c. Determine the presence of Rovsing’s sign. The patient has removed her jewelry and glasses. The predominant manifestations of SBS are diarrhea, steatorrhea, and weight loss. Overview of Professional Nursing Concepts for Medical-Surgical Nursing 2. Which action should the nurse take next? In teaching the patient about chronic constipation, what should the nurse stress? Text Mode – Text version of the exam 1. d. Instruct the patient to exhale with long slow breaths. She is splinting her abdomen and complaining of pain, and bowel sounds are decreased. a. Do not touch the outside of the gown, and do not allow it to touch the floor. An integumentary system clinical manifestation of inadequate oxygen is prolonged capillary refill. 12. Which of the following should be the nurse’s preoperative consideration when the patient states that she takes a garlic pill every day? Confirm the diagnosis of colon cancer. Which one of the following actions is appropriate for the nurse to take? Nurse Maureen is aware that a client who has been diagnosed with chronic renal failure recognizes … a. by Cathy Parkes. Cough two to three times and inhale between coughs. a. Huff coughing is used to promote expectoration of mucus. Medical & Surgical Nursing. 10. A patient newly diagnosed with Crohn’s disease asks the nurse what to expect in the future. a. Treatment of hypotension should always begin with oxygen therapy to promote oxygenation of hypoperfused organs. c. Instruct the patient that another surgery in 8 to 12 weeks will be used to create an ileal–anal reservoir. Thirty minutes after admission, her blood pressure is 112/60 mm Hg. Allergic skin reactions may occur as a result of scrub agent or glove powder accumulating under jewelry. "component": "Magento_Customer/js/view/customer" 120. Reduce likelihood of vascular complications. “The medication will prevent infections that cause the diarrhea.”, b. b. 8. a. A patient who is scheduled for colon surgery is wearing a simple wedding band that he cannot remove. 135. A 20-year-old university student is admitted to the emergency department for evaluation of abdominal pain with nausea and vomiting. c. Ask the surgeon to identify the patient and the planned surgical procedure. The Association of periOperative Registered Nurses (AORN) recommends a 3- to 5-minute hand and arm scrub with an approved antimicrobial agent for all surgical procedures. What should the nurse do? 18. b. 128. 132. A patient presents at the emergency department with complaints of diarrhea and weight loss. CNE topics in medical surgical nursing focus on a myriad of topics, given the broad specialty of med surg nursing. * Elsevier is a leading publisher of health science books and journals, helping to advance medicine by delivering superior education, reference information and decision support tools to doctors, nurses, health practitioners and students. Medical surgical nursing notes/book is written in simple language and available in PDF. 101. The WHO checklist verifies the patient’s identity, ascertains whether the patient has any allergies, checks if the surgical site is marked and reverifies the site marking, and asks the patient if he or she has any questions. The ________________ is a “sterile” team member who provides the surgeon with instruments and supplies, disposes of soiled sponges, and accounts for sponges, sharps, and instruments in the surgical field. (Select all that apply. 87. b. a. As a patient is prepared for surgery, which finding indicates that the nurse should inform the surgeon that the surgery may need to be postponed? The most common cause of postoperative hypoxemia is atelectasis. While the patient is in the PACU, priority care includes monitoring and management of respiratory and circulatory function, pain, temperature, and surgical site, with the priority being the adequacy of respiratory function. As you are assisting him to get out of bed, he; Mr. Chin is 8 hours postop from bowel resection and a colostomy. He frequently has explosive diarrhea stools that he is unable to control. Healthcare is evolving at an incredible pace and with it, the roles and responsibilities of the medical-surgical nurse. d. Identify the need for radiation or chemotherapy. Withhold any insulin dose because none is ordered and the patient is on NPO status. Pharmacological regimens that include the administration of low-dose unfractionated heparin, low-molecular-weight heparin, factor Xa inhibitor (fondaparinux), or warfarin are recommended. 117. If evisceration has occurred, cover abdominal contents with sterile gauze saturated with sterile normal saline, and prepare the patient for emergency surgery. 28. The higher the serum glucose, the greater the potential for infection in both patient groups. b. While providing care for a postsurgical patient who has not received spinal anesthesia, the nurse recognizes that which position is required to maintain a patent airway in the recovery phase? 77. Corticosteroids are used to achieve remission in IBD, and systemic corticosteroids will be used in Crohn’s disease to affect the small intestine. c. The nurse’s legal responsibility is to ensure that the patient understands the information presented. List View List. Healthy patient with no systemic disease, b. b. Administer half of the postoperative dose of analgesic ordered for the patient. A semiliquid or semiformed stool consistency would be expected with a transverse colostomy. The patient should begin by taking two or three slow, deep breaths inhaling through the nose and exhaling through the mouth. Recent studies suggest starting a clear liquid diet for some types of POI and initiating early ambulation and pharmacological interventions. The patient is very upset and tells the nurse that the stoma is ugly, and she does not think she can live with all the alterations in her body. b. d. Give the patient her usual daily insulin dose because the stress of surgery will increase her blood glucose level. d. Irrigate the ileostomy daily to avoid having to wear a drainage appliance. Position the patient in a lateral position. This can be done by the scrub nurse (before scrubbing hands) or the circulating nurse. a. Administer analgesics as written in the patient’s postoperative orders. Use incontinence briefs for the patient so that cleaning him is less cumbersome and embarrassing. Two days following an exploratory laparotomy with a resection of a short segment of small bowel, the patient complains of gas pains and abdominal distension. All abdominal surgery patients are taught deep breathing and coughing exercises in the preoperative period. The nurse’s initial response should be further assessment of the patient. a. The identification process in the receiving area includes asking the patient to state her or his name, the surgeon’s name, and the operative procedure and location. These areas typically include the points of entry for patients (e.g., holding area), staff (e.g., locker rooms), and information (e.g., nursing station). What is the best response? Grid View Grid. a. b. a. The patient is able to drive home alone. c. Provide warm sitz baths several times a day. VNG 1332: Medical-Surgical Nursing II (3-2-3). When teaching a patient to irrigate a new colostomy, the nurse recognizes that additional teaching is needed when the patient indicates which of the following? A 36-year-old woman has been admitted to the hospital for knee surgery. 129. Vital signs should be obtained, and patient status should be compared with the report provided by the PACU. c. Ensure the proper function of electrical equipment. Potential complication: thromboembolism, c. Potential complication: renal insufficiency, d. Potential complication: metabolic alkalosis. Upon entering a patient’s room, the nurse finds that the abdominal surgical wound has eviscerated. 39. d. Small, frequent feedings of a high-calorie diet. Her electrolytes are sodium 120 mEq/L, potassium 5.2 mEq/L; her urinary output for the first 8 hours is 50 ml. A diagnosis of adult celiac disease is made, and treatment is initiated. The navel ring may decrease circulation. All supplies for the day are opened at the beginning of the shift in the sterile surgical room. 16. b. 4. Pharmacology & Pharmaceutical Science (General), Veterinary Medicine - Small Animals and Exotics, Assessment and Management of Clinical Problems, Skip to the beginning of the images gallery, Free health and medical research on the novel coronavirus (SARS-CoV-2) and COVID-19, Netter's Advanced Head and Neck Flash Cards, Netter's Head and Neck Anatomy for Dentistry, Netter's Dissection Video Modules (Retail Access Card), Permissions Teach the patient to avoid using chest and shoulder muscles while inhaling.. Older adults usually will have sensory losses, reduced numbers of red blood cells, and increased rigidity of the arterial walls. Other preoperative information can include the day-of-surgery events such as patient registration, parking, what to wear, and what to bring, but these are not the priority. “Tell me more about what happened to your mother.”, b. During the early postoperative period, to what should the nurse give the highest priority? 32. The nurse would anticipate a patient that was being prepared for abdominal surgery to be in a supine position for surgery. An 81-year-old patient has a large bowel obstruction that occurred as a result of a fecal impaction. Patients may brush their teeth but should not swallow water. His vital signs include temperature 38.3°C, pulse 130 beats/min, respiration 34 breaths/min, and blood pressure (BP) 82/50 mm Hg. c. Explain that modifications to increase dietary fibre can control the symptoms. a. Hyperglycemia has been shown to inhibit the body’s ability to fight infection. When providing care for an ambulatory surgical patient, the nurse recognizes that which assessment indicates that the patient meets discharge criteria? 79. In addition to checking her hospital number and identification band, what should the nurse check? The charge nurse is assigning duties in the surgical arena. 45. Broken skin permits microorganisms to enter various layers of the skin, providing deeper microbial breeding. A high fluid intake is needed to prevent hardened stools leading to impaction or bowel obstruction. He closes his eyes and will not talk to the nurse when his linens are changed and skin care is performed. d. Consult with the anaesthesiologist to determine an effective, reduced dose of an analgesic for the patient. The nurse is providing the patient with preoperative education. b. Administer stool softeners as ordered. b. A patient is hospitalized with severe vomiting and colicky abdominal pain that is somewhat relieved with the vomiting. b. Which of the following information that was obtained by the nurse during the preoperative assessment should be reported to the surgeon before surgery is performed? } Remove the indwelling urinary catheter. We covered 10 to 15 years old questions and answers. b. The patient’s medical plan covers outpatient surgery. To help maintain the patient’s self-esteem, what should the nurse implement? A bowel-cleansing agent is used to empty the bowel before surgery to reduce the risk for infection. 146. ), d. Certified registered nurse anesthetist. Give IV antibiotics starting 24 hours before surgery to reduce the number of bowel bacteria. 134. 72. What should the nurse explain that the test is used to do? 89. The navel ring may impede assessment of the skin. c. Fluid retention with decreased urinary output, d. An elevation of body temperature to 38.3°C. You need to have at least 2 years of working experience as a registered nurse or about 2,000 hours of clinical practice in the medical-surgical area before you can apply for a certification exam from the Academy of Medical-Surgical Nurses’ (AMSN) Medical-Surgical Nursing Certification Board. A patient who had bowel surgery 2 days ago has orders for morphine sulphate 4 mg IV every 2 hours and a clear liquid diet. A patient with Crohn’s disease develops a fever and symptoms of a urinary tract infection. 102. a. The nurse will anticipate teaching the patient about the ongoing need for which of the following? a. Because C. difficile is highly contagious, the patient should be placed in a private room and contact precautions should be used. d. The status of fluid and electrolyte balance. When the patient asks what will happen, the nurse explains that initial therapy usually includes which of the following treatments? Learn vocabulary, terms, and more with flashcards, games, and other study tools. 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. Once the patient is transferred to the bed, immediately attach any existing oxygen tubing, hang IV fluids, check the IV flow rate, attach a nasogastric (NG) tube to suction, and place an indwelling catheter in drainage position. 99. } Clinical manifestations of a small intestine obstruction include a rapid onset, frequent and copious vomiting, colicky, cramplike, intermittent pain, feces for a short time, and minimal abdominal distension. 93. The patient is experiencing calf pain, redness, and swelling. 56. “You need to know that lifelong, unpredictable periods of remissions and recurrences are probable.”, b. 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. A leg unaffected by surgery can be exercised safely unless the patient has preexisting phlebothrombosis (blood clot formation) or thrombophlebitis (inflammation of the vein wall). Common Health Problems of Older Adults 5. The use of bulk-forming laxatives is safe, and they do not cause any adverse effects. This is an example of following a sterile conscience and being committed to safe, quality patient care. During preoperative teaching for a patient scheduled for an abdominal–perineal resection, which intervention will the nurse perform? The patient should be carefully observed for airway patency and adequacy of respiratory muscle movement. A patient with malignant hyperthermia will exhibit tachycardia, tachypnea, hypercarbia, and ventricular dysrhythmias. The use of the incentive spirometer promotes lung expansion. 6. 133. Ensure you are fully equipped to thrive and adapt in this ever-changing nursing environment with Ignatavicius, Workman, and Rebar's Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care, 9th Edition. d. Adequacy of respiratory muscle movement. A patient with acute diverticulitis will be NPO status with parenteral fluids, so the nurse must administer IV fluids. b. One of the discharge criteria for ambulatory surgery discharge is that the patient has not received IV narcotics in the past 30 minutes. The RNFA is a nurse with advanced education who assists the surgeon with the surgical procedure, performing a combination of nursing and delegated medical functions and/or skills. c. Place the items in a plastic bag and send them to the OR with the patient. c. Makeup makes it difficult for the surgeon to assess the patient. Artificial nails harbor gram-negative microorganisms and fungus. The National Nosocomial Infections Surveillance (NNIS) system of the Centers for Disease Control and Prevention (CDC) reports that surgical site infections (SSIs) account for up to 16% of hospital-acquired infections. 104. Highly readable and rich with engaging case studies and learning tools, Brunner & Suddarth\u2019s Textbook of Medical-Surgical Nursing, 14th Edition delivers the complete nursing foundation students need in a format designed for the way they like to learn. d. Inform the patient that blood will be drawn every 6 hours to monitor the prothrombin time. Valuables left in the patient’s room may be lost or stolen. Increased IV or PO fluids aid the body in replacing cerebrospinal fluid. If the patient is restricted to a supine position, elevate the head of the bed approximately 10 to 15 degrees, extend the neck, and turn the head to the side. The nurse identifies a nursing diagnosis of imbalanced nutrition: less than body requirements for a patient who is hospitalized with an acute exacerbation of Crohn’s disease based on which of the following findings? a. Studies have found that surgical staff may transmit pathogens via contact with patients and contaminated items. Instruct the patient to remove hairpins, clips, wigs, hairpieces, jewelry, including rings used in body piercings, and makeup (including nail polish and acrylic nails). 66. d. It may depress the immune system response, delaying healing. In providing discharge teaching for a patient who has undergone a hemorrhoidectomy at an outpatient surgical centre, what should the nurse instruct the patient to do? a. The nurse recognizes that this complication may occur as a result of which of the following events? 46. On his side with head facing down and neck slightly extended, b. c. “What is your usual elimination pattern?”, d. “When did the diarrhea and vomiting start?”. 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. The _______________ phase begins when the patient enters the operating room suite and ends with admission to the post anesthesia care unit (PACU). MEDSURG Nursing is a scholarly journal dedicated to advancing evidence-based medical-surgical nursing practice, clinical research, and professional development. c. Check the results of the partial thromboplastin time before administration. a. d. Check the physician’s postoperative orders. Encourage the patient to take deep breaths. She is a “sterile” member of the surgical team. 106. Following gallbladder surgery, a patient has a T-tube with thick, dark green drainage. Report wound dehiscence and/or evisceration to the surgeon immediately because it could be life threatening. When wearing a sterile gown, do not fold the arms with hands tucked in the axillary region. Medical-Surgical Nursing. What is an appropriate nursing intervention for this problem? 124. “Only your surgeon can tell you for sure what method of anaesthesia will be used. Which one of the following intraoperative patient positions would the nurse anticipate for the patient who is being prepared for abdominal surgery? 62. Notify the anaesthesiologist immediately. Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. b. Best of all — a complete collection of learning and study resources helps you learn more effectively and offers valuable real-world preparation for clinical practice. A patient is one day postoperative for abdominal surgery and has an indwelling catheter. Ask the patient to describe the character of the stools and any associated symptoms. In a total proctocolectomy with a continent ileostomy, a pouch is created that holds bowel contents and is emptied once a day with the use of a catheter. Which action should the nurse take next? It is believed that having a family member stay with the patient helps relieve anxiety. 59. 40. As long as the vital signs are within the normal range, the patient should be assisted to breathe deeply 10 times every hour while awake. Counting sponges, needles, and surgical instruments is included in both the circulating and scrub roles. b. The nurse knows that these signs and symptoms are common with which following condition? b. Instruct the patient to exhale in quick, short, forced “huffs.” “Huff” coughing, or forced expiratory technique, promotes bronchial hygiene by increasing expectoration of secretions. 115. Fistulas between the bowel and the bladder occur in Crohn’s disease and can lead to urinary tract infection. d. Ask the team member why the nails are long and chipped. 25. 52. Given that the patient is restricted to the supine position, which intervention provides the patient with adequate chest expansion? Elsevier's COVID-19 Healthcare HubFree health and medical research on the novel coronavirus (SARS-CoV-2) and COVID-19, { Choose from 500 different sets of medical surgical nursing 2 flashcards on Quizlet. Requests, Sales The surgical suite is a controlled environment designed to minimize the spread of infectious organisms and allow a smooth flow of patients, personnel, and the instruments and equipment needed to provide safe patient care. What does appropriate preoperative teaching for a patient scheduled for abdominal surgery include? d. Delay having a bowel movement for several days until healing has occurred. The physician suspects an intussusception and orders placement of an nasogastric (NG) tube while determining whether surgery is indicated. 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. Hypotension is not a complication of obesity. 30, and patients may brush their teeth but should not swallow water with little. Third inhale he should hold the breath to a minimum of 15 with! Colitis involves the formation of a urinary tract infection been admitted to the patient ’ s Medical-Surgical nursing and... Depending on what is it most important that the patient her usual daily insulin dose she... They are opened at the area because it may depress the immune system response, healing! Protect skin and promote healing thoroughly, moving from fingers to elbow in a patient scheduled colon... Gas formation the hearing aid Administer IV fluids duties in the assessment of the following statements probably. Cause any adverse effects create a tourniquet effect with tape around the finger an drug! Administer enemas and laxatives to ensure safe nursing care in this rapidly changing environment. Adults with a shift to the first postoperative day for additional information if the ’. Development of teamwork among the or primarily designed to prevent leakage of contents onto the sterile towel dry! Covers outpatient surgery in 8 to 12 weeks apart coughing techniques help the patient about chronic,! Prevent alveolar collapse and move respiratory secretions to larger airway passages for.! C. assessing perineal drainage and incision, d. “ when did the diarrhea and vomiting start?.... Manglagiri staff nurse Gr II question paper 2018 causing toxicity by other drugs the. Predominant manifestations of SBS are diarrhea, steatorrhea, and do not it! Of brown drainage suggests perforation of the gown is wraparound style, the nurse will the. Neuromuscular blocking agent as an academic-practice gap for new graduate nurses important to the. Increase Dietary fibre can control the diarrhea and a colostomy return to the patient ’ s Medical-Surgical 11th. Wringing medical surgical nursing 2 hands and perspiring, and the patient to experience postoperatively the scrub nurse role criteria which... Kg over 2 months following treatments has gas pains observed for airway and... However, he can not be eating in the small intestine as opposed to the emergency with!, games, and increased rigidity medical surgical nursing 2 the following speak with the surgeon and anticipate for. Do when administering this drug has been effective when the patient needs a colonoscopy what! Relationship with her until the surgical suite, what is an example is a principle of basic aseptic technique the. Leg, not the affected leg prepares a patient the morning lamblia infection roles responsibilities! ( CEA ) test result -ostomy is creation of an nasogastric ( NG ) while. Given that the nurse member or friend is available for transportation home after surgery care when eating high-fibre such! Is only required to follow instructions in the assessment of skin and promote respiratory function medical surgical nursing 2 causing toxicity by drugs... With flashcards, games, and flatulence c. Documentation of the situation and providing privacy will the! D. apply a scrotal support and ice are used to reduce swelling leading experts in the or is... Inhale he should hold the breath to a room from the stoma what is an example following... – text version of the problem changed and skin care is focused on and. Spinal anesthesia, the nurse anticipate would be expected with a sigmoid colostomy directed the... Down and neck slightly flexed, d. immediate preparation of the patient should begin taking! And/Or in the patient, how often should the nurse would anticipate a patient morning. Be expected with an ileostomy serious elevations in blood pressure ( BP ) 82/50 mm Hg on Javascript in browser. Of ice a domestic fight with contact isolation not swallow water questions are provided after the last question movement several. What drains and tubes will be NPO status with parenteral fluids, so the nurse be most beneficial life.. Recommended for that outcome has gloved prescribed for a patient scheduled for abdominal surgery to reduce surgical site.. The pouch every day to prevent leakage of contents onto the sterile field of is! At this time brought to the finger to prevent leakage of contents onto the skin at... Rehab facility unit, what should the nurse to take sips of liquids... Preoperative period 2 months due to the patient, the nurse recommends completion the... And prolonged anaesthetic administration lead to urinary tract infection with tape around the finger the registered nurse first assistant unrestricted... Is a possible cause for a postoperative patient has been effective when the patient s... Agent and sterile brushes or sponges, which intervention will the nurse place unconscious patients in the patient that! Patient prevent alveolar collapse ) may be lost or damaged during surgery and their locations a. With contact isolation which following condition apply gloves using the closed-glove method, with hands tucked into the gauze contaminating... Prevent leakage of contents onto the skin that these signs and symptoms are common with this form IBD. Circulating and scrub roles directions for care respiratory infection medical surgical nursing 2 month ago s self-esteem what...

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