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Medsurg 102 Final Exam IVY TECH questions with
answers
Diagnostic Surgery - CORRECT ANSWERS ✔✔- determines origin and cause of a disorder or cell type of cancer (Breast biopsy, exploratory laparotomy, arthroscopy) curative surgery - CORRECT ANSWERS ✔✔- performed to resolve a health problem by repairing or removing cause (Cholecystectomy, appendectomy, hysterectomy) Transplant Surgery - CORRECT ANSWERS ✔✔- replacing malfunctioning structures (Kidney transplant, heart transplant, liver transplant) Restorative Surgery - CORRECT ANSWERS ✔✔- performed to improve a patient's functional ability (Total knee replacement, finger reimplantation) Palliative Surgery - CORRECT ANSWERS ✔✔- performed to relieve symptoms of a disease but does not cure (Colostomy, nerve root resection, tumor debulking, ileostomy) Cosmetic Surgery - CORRECT ANSWERS ✔✔- performed primarily to alter or enhance personal appearance
(Liposuction, revision of scars, rhinoplasty, blepharoplasty) Elective Surgery - CORRECT ANSWERS ✔✔- planned for correction of nonacute problem (Cataract removal, hernia repair, hemorrhoidectomy, total joint replacement) Urgent Surgery - CORRECT ANSWERS ✔✔- requires prompt intervention; may be life threatening if treatment is delayed 24-48 hrs (Intestinal obstruction, bladder obstruction, kidney stones, bone fracture, eye injury) Emergent Surgery - CORRECT ANSWERS ✔✔- requires immediate intervention because of life-threatening consequences (Gunshot wound, severe bleeding, abdominal aortic aneurysm, compound fracture) Simple Surgery - CORRECT ANSWERS ✔✔only most overtly affected areas involved with surgery Minimally invasive surgery - CORRECT ANSWERS ✔✔in body cavity or body area through 1+ endoscopes Radical Surgery - CORRECT ANSWERS ✔✔extensive surgery beyond the area obviously involved general anesthesia Stage 1 - CORRECT ANSWERS ✔✔1(analgesia and sedation, relaxation): begins with induction & ends with loss of consciousness
Moderate anesthesia - CORRECT ANSWERS ✔✔- IV delivery of sedative, hypnotic, opioid drugs to reduce sensory perception but allow pt to maintain airway
- Reduces LOC
- Nurse monitors pt and performs evaluation of consciousness during and after moderate sedation o Airway, LOC, SPO2, CO2 level, ECG, VS monitored every 15-30 min o Uses Ramsay Sedation Scale (RSS) to score/evaluate LOC Consent - CORRECT ANSWERS ✔✔- Surgeons responsibility to provide complete explanation of surgical procedure including o Nature & reason for surgery o Who is performing & if other will be present o All available options & benefits or risks with those o Risks associated with procedure and its potential outcomes o Risks associated with anesthesia o Risks, benefits, and alternatives to use blood products during procedure
- Surgeons responsibility to get consent signed before any sedation
- Nurse will just clarify facts and verifies consent had been signed or serve as witness o If pt has any difficulties associated with signing, must have 2 witnesses Emergency Consent - CORRECT ANSWERS ✔✔- In emergency when trying to contact medical power of attorney consent is desired but not required o Surgeon may request written consultation by at least 2 physicians who are not associated with case to legally support surgery decision until appropriate individual can sign consent form
Site markings - CORRECT ANSWERS ✔✔- TJC requires site is marked by licensed independent practitioner and involves patient to ensure correct site o Surgeon is accountable and should be present for this o Use "time-out" to verify correct site, pt, and procedure, nure implements this Immediate post op (PACU) assessments - CORRECT ANSWERS ✔✔-patent airway and adequate gas exchange -VS, LOC -Surgical site for bleeding -every 5-15 minutes, time between increases as they progress
- Priority collaborative problems in immediate postop care - CORRECT ANSWERS ✔✔-potential decreased gas exchange -potential for infection and delayed wound healing -acute pain due to surgical incision/ positioning/ ET tubing -decreased peristalsis Determine readiness for discharge from PACU by recovery score of at least 9-10 - CORRECT ANSWERS ✔✔-Score based on activity, respiration, circulation, consciousness, O2 sat -Also need stable VS, normal T, no overt bleeding, return of gag & cough & swallow reflexes, ability to take liquids, and adequate urine output After discharge from PACU a comprehensive initial assessment is completed - CORRECT ANSWERS ✔✔-airway -breathing
§ Splinting § Pain management Nursing care pre-op minimize anxiety - CORRECT ANSWERS ✔✔o Assess level of anxiety continually o Preop teaching: assess knowledge, allow time for questions o Encourage communication by having pt state feelings, fears, and concerns o Promote rest, urge to continue normal relaxation techniques o Distraction: music, TV, reading, visiting o Teaching family members: increases support & involvement in care Nursing care pre-op prep - CORRECT ANSWERS ✔✔o Remove clothing and wear gown o May apply antiembolism stockings or pneumatic compression devices before surgery o Leave valuables at home o Must wear ID band with first & last name, hospital #, surgeon, birthdate o Red bracelet for any allergies o Dentures may need to be removed & placed in labeled cup, prevents aspiration o Prosthetic devices removed & contacts, wigs, glasses, toupees o Remove fingernail polish and artificial nails (effects SPO2 readings) o Have pt empty bladder Fluid overload cause - CORRECT ANSWERS ✔✔- Excess fluid replacement
- Kidney failure
- Heart failure
- Long term corticosteroid use
- Syndrome of inappropriate antidiuretic hormone (SIADH)
- Psychiatric disorders
- Water intoxication
- Excess Na
- Burns
- Cirrhosis fluid overload symptoms/ assessment - CORRECT ANSWERS ✔✔- Hypertension
- Tachycardia
- Tachypnea
- Bounding pulses
- Weight gain
- Edema
- Abd distention
- Dyspnea & crackles
- Distended neck & hand veins
- Decreased labs Fluid overload intervention - CORRECT ANSWERS ✔✔- Priority: ensure pt safety, restore fluid balance, provide supportive care, prevent future overload
