*NURSING > QUESTIONS & ANSWERS > Lesson 18 VCE_Care of the Surgical Patient. 32 QnA With all the Correct Answers Indicated. (All)

Lesson 18 VCE_Care of the Surgical Patient. 32 QnA With all the Correct Answers Indicated.

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Lesson 18 - Care of the Surgical Patient Attempt History  Question 1 0.4 / 1 pts Exercise 1 - Writing Activity • This exercise will take approximately 15 minutes to complete. Exercise 1 - ... Question 1 Below, match each type of surgery with the corresponding definition. (A) Performed to restore function that was lost or reduced as a result of congenital anomalies (B) Necessary for patient's health; may prevent additional problems from developing (C) Excision or removal of a diseased body part (D) Exploration allowing for the confirmation of a diagnosis (E) Performed to reduce intensity of disease symptoms You Answered Urgent B Correct! Diagnostic Correct! Palliative You Answered Constructive A D E A You Answered Ablative C Question 2 0 / 1 pts Exercise 1 - Question 2 A patient reports taking large doses of ibuprofen during the preoperative period. For which of the complications is the patient at an increased risk for developing? Increased bleeding Postoperative infection You Answered Electrolyte imbalance Hypotension Question 3 0 / 1 pts Exercise 1 - Question 3 C B After surgery, it is recommended that the patient have at least kcal/day for nutritional maintenance. Answer 1: You Answered600 1500 Question 4 0 / 1 pts Exercise 1 - Question 4 True or False: Antiembolitic stockings must be worn around the clock during the first 2 days of the postoperative experience. You Answered True False Question 5 1 / 1 pts Exercise 1 - Question 5 anesthesia involves loss of sensation to a specific body site. Answer 1: Correct!Local Question 6 1 / 1 pts Exercise 1 - Question 6 Surgeries requiring extensive invasion and manipulation of the body require anesthesia. Answer 1: Correct!general 600 Local general Question 7 1 / 1 pts Exercise 1 - Question 7 During the postoperative period, urinary output less than _____ warrants contacting the physician. 100 mL/hour 75 mL/hour 50 mL/hour Correct! 30 mL/hour Question 8 0 / 1 pts Exercise 1 - Question 8 Handling of the bowel during surgery may result in a nonmechanical obstruction known as a(n) . Answer 1: You Answeredileus paralytic ileus Question 9 1 / 1 pts Exercise 1 - Question 9 A nurse is planning education for a patient who has just had abdominal surgery. The nurse should recommend the practice of diaphragmatic breathing exercises with what frequency while the patient is awake? ileus Correct! Every hour Every 2 hours Every 4 hours Every 6 to 8 hours Question 10 Not yet graded / 1 pts Exercise 2 - Virtual Hospital Activity • This exercise will take approximately 45 minutes to complete. • Sign in to work at Pacific View Regional Hospital on the Medical-Surgical Floor for Period of Care 1. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) • From the Patient List, select Piya Jordan (Room 403). • Click on Get Report; review the report and then click on Go to Nurses' Station. • Click on Chart and then on 403. • Click on and then review the Nursing Admission. Exercise 2 - Question 1 Review and discuss the factors that led Piya Jordan to undergo surgery. Your Answer: Nausea vomitting Patient doesnt seem fully aware of disease. Psych consult order, Piya Jordan had been experiencing gastrointestinal concerns including nausea, vomiting, and ribbonlike stools. She has had surgery to manage an intestinal obstruction. Question 11 0.25 / 1 pts Exercise 2 - Question 2 Based on the Nursing Admission data, choose the surgical risk factors that apply to Piya Jordan. Select all that apply. You Answered Obesity Correct! Heart disease Fever Nutritional imbalance Chronic pain Correct! Age Liver disease Question 12 Not yet graded / 1 pts Exercise 2 - Question 3 Identify two alterations of the cardiovascular system that may apply to Piya Jordan because of her age. Your Answer: Cardiovascular changes of aging that may affect Piya Jordan’s risks during surgery include the following: degenerative changes reducing cardiac reserve, rigidity of arterial walls and reduction in the innervation to the heart, and increased arterial deposits, which may result in clot formation. UnansweredQuestion 13 0 / 1 pts • Click on and then review the History and Physical and Laboratory Results. Exercise 2 - Question 4 The History and Physical noted the need to correct Piya Jordan’s electrolytes and reverse anticoagulation before surgery. Which preoperative laboratory values were abnormal in Piya Jordan’s case? Select all that apply. Red blood cell count (RBC) International normalized ratio (INR) Potassium (K+) Sodium (Na) Hemoglobin (Hgb) Creatinine Question 14 Not yet graded / 1 pts Exercise 2 - Question 5 Why do you think Piya Jordan’s Hgb and RBC values were lower than normal before surgery? Why are changes in these lab values significant? Your Answer: Piya Jordan had blood in her stool, resulting from the mass in her colon. This blood loss creates a potential for oxygenation problems during surgery. UnansweredQuestion 15 0 / 1 pts Exercise 2 - Question 6 What is the most likely reason that Piya Jordan's INR is higher than normal? Inflammation of her knee joints Warfarin therapy at home Irregular nature of her heart rate Blood in her stool UnansweredQuestion 16 0 / 1 pts Exercise 2 - Question 7 Because of the elevated INR, Piya Jordan would be at risk for which of the following complications during surgery? Urinary retention Pneumonia Paralytic ileus Hemorrhage Question 17 0 / 1 pts • Still in the chart, click again on Nursing Admission and review the summaries for Perception and Cognition, Self-Perception, Role Relationships, and Coping and Stress Tolerance. • Now review the Nurse's Notes from Tuesday 0330 to Tuesday 0900. Exercise 2 - Question 8 The nurse’s assessment should identify factors that will have an effect on the patient's ability to receive and understand preoperative instruction. Listed below are numerous factors identified in Piya Jordan's assessment. Complete this exercise by indicating whether each factor would facilitate instruction (positive effect) or would be a barrier to instruction (negative effect). (A) Positive (B) Negative You Answered Patient reports a pain score of 8 out of 10. B You Answered Patient expresses being anxious about husband's welfare. B You Answered Daughter is supportive of mother. A You Answered Patient is fearful of cancer diagnosis. B You Answered Patient speaks English and has a college education. A You Answered Patient reports feeling nauseated. B Question 18 Not yet graded / 1 pts Exercise 2 - Question 9 Based on information from the Nurse's Notes and Nursing Admission, what would be the best time to teach Piya Jordan about deep breathing and coughing exercises? Give a rationale. Question 19 Not yet graded / 1 pts Exercise 2 - Question 10 After surgery, it is important to turn patients frequently. What factor in Piya Jordan’s history might make turning difficult for her?. Question 20 Not yet graded / 1 pts Exercise 3 - Virtual Hospital Activity • This exercise will take approximately 30 minutes to complete. • Sign in to work at Pacific View Regional Hospital on the Medical-Surgical Floor for Period of Care 1. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) • From the Patient List, select Piya Jordan (Room 403). • Click on Get Report; and then click on Go to Nurses' Station. • Click on Chart and then on 403. • Click on and then review the Nurse's Notes, Surgical Reports, and Physician's Notes. Exercise 3 - Question 1 For each of the interventions listed below, give a rationale for its use in Piya Jordan’s case. • Jackson-Pratt drain • Sequential compression device (SCD) • Nasogastric (NG) tube • Abdominal dressing Question 21 Not yet graded / 1 pts Exercise 3 - Question 2 Based on your review of the clinical summary and the Nurse's Notes, for what common postoperative complication might Piya Jordan be at risk, unless the nurse more actively intervenes? Give a rationale and explain the interventions required. Question 22 Not yet graded / 1 pts • Click on Return to Nurses' Station. • Click on 403 at the bottom of the screen. • Click on Patient Care and then on Physical Assessment. • Click on Abdomen (yellow buttons) and review the findings of the abdominal assessment, specifically the subcategories of Integumentary and Gastrointestinal (green buttons). Exercise 3 - Question 3 What type of dressing does Piya Jordan have over her abdomen? How is it secured? Your Answer: Piya Jordan has a large gauze dressing secured with a set of Montgomery ties. UnansweredQuestion 23 0 / 1 pts Exercise 3 - Question 4 Which of the following best describes the type of healing that will result with Piya Jordan's surgical wound? UnansweredQuestion 24 0 / 1 pts Exercise 3 - Question 5 What is the most critical time for healing of a surgical wound? First 24 hours postoperative 7 days postoperative Question 25 Not yet graded / 1 pts Exercise 3 - Question 6 As the nurse caring for Piya Jordan postoperatively, you would want to do a focused assessment when you begin your care. On which assessment categories would you choose to focus postoperatively? (Hint: Do not forget to assess equipment.) • When you have completed your focused assessment, click on Leave the Floor. • From the Floor Menu, choose Look at Your Preceptor's Evaluation. • Next, click on Examination Report to see how you did. UnansweredQuestion 26 0 / 1 pts Exercise 4 - Virtual Hospital Activity • This exercise will take approximately 30 minutes to complete. • Sign in to work at Pacific View Regional Hospital on the Medical-Surgical Floor for Period of Care 2. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) • From the Patient List, select Piya Jordan (Room 403). • Click on Get Report; review the report and then click on Go to Nurses' Station. • Click on Chart and then on 403. • Click on and then review the Nursing Admission and Surgical Reports. Exercise 4 - Question 1 Take into consideration the type of anesthesia that Piya Jordan received preoperatively. Which complication is she at risk for developing as a result of the type of anesthesia she received? Question 27 Not yet graded / 1 pts • Click on Nurse's Notes and review the notes for Wednesday at 1115. • Click on Return to Nurses' Station. • Click on 403 at the bottom of the screen. • Review the Initial Observations. • Click on Patient Care and then on Nurse-Client Interactions. • Select and view the video titled 1115: Interventions—Nausea, Blood. (Note: Check the virtual clock to see whether enough time has elapsed. You can use the fast-forward feature to advance the time by 2-minute intervals if the video is not yet available. Then click again on Patient Care and on Nurse-Client Interactions to refresh the screen.) Exercise 4 - Question 2 Piya Jordan is complaining of nausea. What is the likely source of the nausea? Question 28 Not yet graded / 1 pts Exercise 4 - Question 3 Identify three assessments necessary to determine the source and nature of Piya Jordan’s nausea. UnansweredQuestion 29 0 / 1 pts Exercise 4 - Question 4 If patency of Piya Jordan's NG tube is in question, what is the appropriate action? Remove the tube from suction and call the physician. Question 30 Not yet graded / 1 pts • Click on Physical Assessment. • Click on Chest (yellow buttons) and then on the appropriate subcategories (green buttons) to complete a focused assessment of Piya Jordan's chest. • Click on Abdomen and the related subcategories to review the abdominal assessment. • Click on Take Vital Signs at the top of the screen. Exercise 4 - Question 5 In reviewing the data available for Piya Jordan, clusters of data are revealed from the assessment. One data cluster for this patient is listed below: Chest expansion decreased Decreased aeration, both lower lobes Has had acute pain Abdomen tender to palpation Has not used incentive spirometer What potential problem/nursing diagnosis is indicated by this data cluster? Question 31 Not yet graded / 1 pts Exercise 4 - Question 6 A nurse who has cared for Piya Jordan tells you that one of her nursing diagnoses is Risk for infection. Give a rationale for why this diagnosis would apply to Piya Jordan. Your Answer: Piya Jordan is at risk for infection for several reasons. She has a surgical wound, she has penetration of the skin as a result of an IV site, she has a Foley catheter in place, and she is not using the incentive spirometer or deep breathing exercises to keep her airways clear of secretions. Question 32 Not yet graded / 1 pts Exercise 4 - Question 7 Complete a plan of care for the nursing diagnosis Ineffective Breathing Pattern by completing the areas listed below. • Goal • Expected Outcomes • Interventions (provide 4) • Evaluation Measures (provide 3) [Show More]

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