MedSurg III Ch 18 – Flashcards
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After teaching a class about agents commonly associated with the development of malignant hyperthermia, the instructor determines that additional teaching is needed when the students identify which drug as a possible cause?
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Morphine Explanation: Morphine is not associated with malignant hyperthermia.
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The nurse understands that the purpose of the "time out" is to:
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maintain the safety of the client. Explanation: Verification of the identification of the client, procedure, and operative site are essential to maintain the safety of the client.
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The OR personnel responsible for maintaining the safety of the client and the surgical environment is the:
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Circulating nurse Explanation: The circulating nurse is responsible for maintaining the safety of the client and the surgical environment
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As a circulating nurse, what task are you solely responsible for?
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Keeping records.
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The nurse positions the client in the lithotomy position in preparation for
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perineal surgery
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Which of the following is often the earliest sign of malignant hyperthermia?
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Tachycardia Explanation: The initial symptoms of malignant hyperthermia are related to cardiovascular and musculoskeletal activity. Tachycardia (heart rate >150 bpm) is often the first sign. In addition to tachycardia, sympathetic nervous system stimulation leads to ventricular arrhythmia, hypotension, decreased cardiac output, oliguria, and later, cardiac arrest
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A patient undergoing coronary artery bypass surgery is subjected to intentional hypothermia. The patient is ready for rewarming procedures. Which of the following actions by the nurse is appropriate?
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Apply a warm air blanket, gradually increasing body temperature. Explanation: A warm air blanket can be used to treat hypothermia.
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During the surgical procedure, the client exhibits tachycardia, generalized muscle rigidity, and a temperature of 103°F. The nurse should prepare to administer:
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dantrolene sodium (Dantrium) Explanation: The client is exhibiting clinical manifestations of malignant hyperthermia. Dantrolene sodium, a skeletal muscle relaxant, is administered.
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A 70-year-old patient who is to undergo surgery arrives at the operating room (OR). The nurse, when reviewing the patient's medical record, understands that this patient will require a lower dose of anesthetic agent because of which of the following?
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Decreased lean tissue mass Explanation: Elderly patients require lower doses of anesthetic agents because of decreased tissue elasticity and reduced lean tissue mass.
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The nurse is teaching the client about usual side effects associated with spinal anesthesia. Which of the following should the nurse include when teaching?
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Headache
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A nurse who is part of the surgical team is involved in setting up the sterile tables. The nurse is functioning in which role?
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scrub role
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What is the priority action by the scrub nurse when the surgeon is starting to close the surgical wound?
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obtain a sponge count
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The scrub nurse is responsible for:
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Preparing the sterile instruments for the surgical procedure Explanation: The scrub nurse is responsible for preparing the sterile instruments for the surgical procedure.
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A patient is scheduled for surgery with spinal anesthesia. When explaining this type of anesthesia to the patient, which body area would the nurse describe as being affected first?
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Perineum Explanation: After induction of spinal anesthesia, anesthesia and paralysis affect the toes and perineum, then gradually the legs and abdomen.
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Nursing students are reviewing information about agents used for anesthesia. The students demonstrate understanding when they identify which of the following as an inhalation anesthetic?
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Halothane Explanation: Halothane is an example of an inhalation anesthetic
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Which nursing diagnosis is most important for the client who is undergoing a surgical procedure expected to last several hours?
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Risk for perioperative positioning injury related to positioning in the OR Explanation: Pressure ulcers, nerve and blood vessel damage, and discomfort are risks associated with prolonged, awkward positioning required for surgical procedures
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Which stage of surgical anesthesia is also known as excitement?
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II Explanation: Stage II is the excitement stage that is characterized by struggling, shouting, and laughing.
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Which stage of anesthesia is termed surgical anesthesia?
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III
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The surgical client has been intubated and general anesthesia has been administered. The client exhibits cyanosis, shallow respirations, and a weak, thready pulse. The nurse recognizes that the client is in which stage of general anesthesia?
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Stage IV
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Hypothermia may occur as a result of
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open body wounds. Explanation: Inadvertent hypothermia may occur as a result of a low temperature in the OR, infusion of cold fluids, inhalation of cold gases, open wounds or cavities, decreased muscle activity, advanced age, or the pharmaceutical agents used.
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Which of the following would be included as a responsibility of the scrub nurse?
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Handing instruments to the surgeon and assistants
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When integrating the principles for maintaining surgical asepsis during surgery, which of the following would be most appropriate?
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Ensuring gown sleeves remain sterile 2 inches above the elbow to cuff Explanation: In the operating room, the sleeves of a gown are considered sterile from 2 inches above the elbow to the stockinette cuff.
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Monitored anesthesia care differs from moderate sedation in that monitored anesthesia care:
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may result in the administration of general anesthesia. Explanation: Monitored anesthesia care may require the anesthsiologist to convert to general anesthesia.
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A nurse is administering moderate sedation to a client with chronic obstructive pulmonary disease (COPD). The nurse bases her next action on the principle that:
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it may be necessary to raise the head of this client's bed. Explanation: The nurse should consider positioning when caring for a client who has COPD and difficulty breathing. Elevating the head of the bed assists these clients in breathing.
