Prepare: Perioperative Nursing

Phases of Perioperative Period

• Which phase of the perioperative period is the client (pictured below) in?

Informed Consent

• When a nurse witnesses a client's signature on an informed consent, the nurse is witnessing which of the following?

Developmental Considerations

• Individuals at each end of the age spectrum are at higher risk during surgery due to immature or aging immune systems, inability to regulate body temperature and fragile skin.

Self-Check: Phases of the Perioperative Period

• The client below is being prepared to transfer to the operating room. Which phase of the perioperative period is the client in?

Self-Check: Preoperative Checklist

• The nurse is getting the client ready for surgery and completing the preoperative checklist. Which of the following is not part of the preoperative checklist?

Self-Check: Temperature in Operating Room

• As the client is brought into the operating room suite, the client starts to shiver uncontrollably. What action should the nurse take first?

Self-Check: Postoperative

• The postoperative nurse is focused on which of the following after effects of anesthesia? Select all that apply.

Self-Check: Perioperative Process

• Place the following in the correct order of occurrence.

Reflect: Perioperative Nursing

What is Perioperative Nursing?

The nurse is caring for a surgical client when the client asks what perioperative nursing means. What should the nurse's response be?

Nurses in the Perioperative Setting

• Select which nurse(s) work in the perioperative setting. Select all that apply.

Preoperative phase

• Before surgery, why does the preoperative nurse physically assess the client?

Surgical Attire

• Which of the following is proper attire for the operating room? Click on the correct image below.

Informed Consent

• Which statement is incorrect regarding an informed consent signed by a client?

Pain management

• The nurse is caring for a postoperative client who reports pain. Based on recent evidence-based guidelines, which approach would be best?

Pain Intervention

• A client is crying and grimacing post-surgery but denies pain and refuses pain medication because "my brother is a drug addict and has ruined our lives." What is the priority intervention for this client?

Education

• The nurse is discussing preoperative education with a client. The client asks if a family member can also listen. Which is the best response by the nurse?

Nursing Application for Care of a Surgical Patient

Prepare: Clinical Judgment and Care of the Patient in Surgery

Perioperative Definition

• The Preoperative phase begins with decision to have surgery, lasts until transfer to operating suite. Intraoperative extends from admission to surgical department to transfer to the post-anesthesia care unit (PACU). Postoperative lasts from admission to PACU through recovery which can vary from a day to many weeks depending on the type of surgery.

Operating Room Safety

• A ________ is conducted, right before incision, as a final confirmation of the correct client, procedure, site, and implants.

Empathy in the Perioperative Environment

• The client is very restless and verbalizes being "scared to death" and worried about the surgery. The partner asks the nurse what can be done to help. How can the nurse address the psychological comfort of the client?

Self-Check: Recognizing Cues

• David Egan is a 62-year-old male who arrived in the preoperative area for surgery today. He was identified using two forms of identification and ID bands were applied during pre-admission. He has a history of Type 2 diabetes mellitus, cigarette smoking one pack a day for 43 years, hypertension, coronary artery disease, and peripheral vascular disease. Five weeks ago, he developed a wound on his right heel which measured 3cm by 3cm. Despite intravenous (IV) antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a below the knee amputation of the right lower extremity.

Self-Check: Forming Hypotheses

Forming Hypotheses

• The nurse has created nursing diagnoses based on the data collected. Drag and drop the correct diagnosis that matches the etiology (cause).

Self-Check: Generating Solutions

• Which of the following techniques could the nurse use to decrease pre-operative anxiety prior to obtaining informed consent? Select all that apply.

Self-Check: Implementing

• While David is in the operating room, one of the surgical nurses is stuck with a suture needle. How could needlesticks be prevented? Select all that apply.

Self-Check: Evaluation of Outcomes

• What interventions must the nurse implement to prevent respiratory complications? Select all that apply.

Reflect: Clinical Judgment and Care of the Patient in Surgery

Implementing the Nursing Process/Prior Knowledge

• The nurse is completing a pre-operative checklist for David. Which of the following interventions must be done prior to the patient being sent to the operating room? Click to select all that apply.

Recognizing Cues

• Review the scenario: David Egan is a 62-year-old male who arrives to the preoperative area for a below the knee amputation of the right lower extremity. On the day of surgery, his medication(s) should include which of the following? Select all that apply.

Priority

• Which client’s statements is of most concern to the nurse?

Analyzing Cues

• Match the nursing diagnosis to the cues that support it.

Prioritize Hypotheses/Generate Solutions

• David had the following post-op nursing diagnoses related to loss of limb:
• Which diagnosis should the nurse address first?

Actions

• Match the nursing intervention with the complication it will prevent.

Outcomes

A client arrives to the unit after surgery. Which of the following would the nurse consider an expected outcome of the post-operative period? Select all that apply.

Effective Communication

The nurse is called to the phone for an inquiry about David. The caller identifies herself as David’s sister. She wants to know his condition. What should the nurse tell the caller?