HESI Med-Surg II
risk factors for surgery
(ANS-
-age: old & young
-nutrition: obese & malnourished
-fluid & electrolyte status: dehydration & hypovolemia
-general health: infections or pathology
what general health condition would be a reason to delay surgery?
(ANS- current upper respiratory infection
what medications can increase surgical risks?
(ANS-
-anticoagulants
-tranquilizers (hypotension)
-heroin (CNS depression)
-antibiotics
-diuretics
-steroids
-OTC\/herbs
-Vitamin E
what post operative plans should a nurse include in her pre-operative teaching?
(ANS-
-respiratory care: ventilator? incentive spirometer?
-activity: ROM? early ambulation?
-pain control: PCA? IM meds?
-dietary restrictions
-ICU or PACU orientation
when is it appropriate for the nurse to mark the operative site on the patient?
(ANS-
-right or left distinctions<\/p>\n\n\n\n
-multiple structures: fingers\/toes
-levels: spinal procedures
what assessments are made immediately of the patient arrival in the PACU?
(ANS-
-vitals
-level of consciousness
-skin color & condition
-dressing location & condition
-IV fluids
-drainage tubes
-position
-o2 sat levels
when is a client moved from the PACU to the floor\/unit?
(ANS- when the client is stabilized
what should be monitored in the immediate post-operative period?
(ANS<\/p>\n\n\n\n
post-op complications: urinary retention
(ANS-
-occurs 8-12 hrs post op
-monitor hydration status
-encourage oral intake
-offer bedpan or assist to commode
post-op complications: pulmonary probs
(ANS-
-atelectasis, pneumonia, embolus
-occurs 1-2 days post op
-assist pt to TCDB
-keep hydrated
-enable early ambulation
-provide incentive spirometer
post-op complications: wound healing probs
(ANS-
-occurs 5-6 days post op
-splint incision when coughing
-monitor for s\/s of infection, malnutrition, dehydration
-provide high protein diet
wound dehiscence
(ANS- the separation of the wound edges that is more likely to occur with vertical
incisions
wound evisceration
(ANS- the protrusion of intestinal contents more likely to occur in older, diabetic,
obese, malnourished, or prolonged paralytic ileus pts
post-op complications: UTI’s
(ANS-
-occurs 5-8 days post op<\/p>\n\n\n\n
-oral fluid intake
-empty bladder q 4-6 hrs
-monitor I & O’s
-avoid catheterization if possible
post-op complications: thrombophlebitis
(ANS-
-occurs 5-8 days post op
-leg exercises q 8 hrs while in bed
-early ambuation
-TED hose or sequential compression devices
-DO NOT raise knee gatch on bed
-DO NOT place pillows beneath knees
-no crossing legs at knees
-low-dose heparin
post-op complications: decreased GI peristalsis
(ANS-
-constipation & paralytic ileus
-occurs 2-4 days post op
-NG tube: decompression
-limit use of narcotic analgesics (dec peristalsis)
-early ambulation
why do we prep the bowels before a surgery involving the intestinal tract?
(ANS-
-to decrease the bacterial count w\/in the intestinal tract
-to empty the intestine of stool
-ultimately: to help reduce the risk of infection in the postoperative period
roles of the circulating nurse
(ANS-
-pt advocate
-obtains necessary supplies for the procedure
-ensures diagnostic studies & bld products are available<\/p>\n","protected":false},"excerpt":{"rendered":"
HESI Med-Surg IIrisk factors for surgery(ANS–age: old & young-nutrition: obese & malnourished-fluid & electrolyte status: dehydration & hypovolemia-general health: infections or pathologywhat general health condition would be a reason to delay surgery?(ANS- current upper respiratory infectionwhat medications can increase surgical risks?(ANS–anticoagulants-tranquilizers (hypotension)-heroin (CNS depression)-antibiotics-diuretics-steroids-OTC\/herbs-Vitamin Ewhat post operative plans should a nurse include in her pre-operative […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-116201","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/116201","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=116201"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/116201\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=116201"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=116201"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=116201"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}