Chapter 20 Postoperative Nursing Management

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Chapter 20  Postoperative Nursing Management

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. You are the recovery room nurse who is admitting a patient from the OR. What is the first assessment you would make on a newly admitted patient?
A) Heart rate
B) Nail perfusion

C) Core temperature
D) Patency of the airway

Ans: D
Chapter: 20
Client Needs: D-3
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Page and Header: 462, Care of the Patient in the Postanesthesia Care Unit

Feedback: The primary objective in the immediate postoperative period is to maintain ventilation and, thus, prevent hypoxemia (reduced oxygen in the blood) and hypercapnia (excess carbon dioxide in the blood). Both can occur if the airway is obstructed and ventilation is reduced (hypoventilation). This assessment is followed by cardiovascular status and the

condition of the surgical site. Nail perfusion is part of the cardiovascular status. The core temperature would be assessed after the airway, cardiovascular status, and wound.

2. Your patient is in the recovery room following chest surgery. The patient complains of severe nausea. What would you do next?
A) Administer an analgesic
B) Apply a cool cloth to the patient’s forehead

C) Offer the patient a small amount of ice chips D) Turn the patient completely to one side

Ans: D
Chapter: 20
Client Needs: D-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Page and Header: 465, Care of the Patient in the Postanesthesia Care Unit

Feedback: Turning the patient completely to one side allows collected fluid to escape from the side of the mouth if the patient vomits. After turning the patient to the side, the nurse can offer a cool cloth to the patient’s forehead. Ice chips can increase feelings of nausea. An analgesic is not administered for nausea and vomiting.

3. You are discharging your patient home from day surgery after a general anesthetic. What instruction would you give the patient prior to the patient leaving the hospital?
A) The patient is not to drive a vehicle
B) The patient should have a glass of brandy the first night home to help him or her sleep C) Eat a large meal at home

D) Do not sign important papers for the first 12 hours after surgery

Ans: A
Chapter: 20
Client Needs: D-3
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 468, Care of the Patient in the Postanesthesia Care Unit

Feedback: Although recovery time varies depending on the type and extent of surgery and the patient’s overall condition, instructions usually advise limited activity for 24 to 48 hours. During this time, the patient should not drive a vehicle, drink alcoholic beverages, or perform tasks that require energy or skill. Eat only as tolerated.

4. Your patient is a 78-year-old male who has had outpatient surgery. You are getting him up for his first walk postoperatively. To decrease the potential for orthostatic hypotension, what should you plan to have the patient do?
A) Sit in a chair for 10 minutes prior to ambulating

B) Drink plenty of fluids to increase circulating blood volume
C) Stand upright for 2 to 3 minutes prior to ambulating
D) Sit upright on the side of the bed for 15 minutes prior to ambulating

Ans: C
Chapter: 20
Client Needs: D-3
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 4
Page and Header: 473, Care of the Hospitalized Postoperative Patient

Feedback: Older adults are at an increased risk for orthostatic hypotension secondary to age- related changes in vascular tone. The patient should sit up and then stand for 2 to 3 minutes before ambulating to alleviate orthostatic hypotension. Therefore options A, B, and D are incorrect.

5. You admit a patient to the PACU who has undergone a surgical procedure that required the use of general anesthesia. What is the patient most at risk for following general anesthesia? A) Atelectasis
B) Anemia

C) Dehydration
D) Peripheral edema

Ans: A
Chapter: 20
Client Needs: D-3
Cognitive Level: Analysis Difficulty: Moderate
Integrated Process: Nursing Process

Objective: 3
Page and Header: 470, Care of the Hospitalized Postoperative Patient

Feedback: Atelectasis occurs when the postoperative patient fails to move, cough, and breathe deeply. With good nursing care, this is an avoidable complication. Anemia occurs rarely and usually in situations where the patient loses a significant amount of blood or if he continues bleeding postoperatively. Fluid shifts postoperatively may result in dehydration and peripheral edema, but the patient is most at risk for atelectasis.

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