Perioperative Nursing Care Flashcards

A client is scheduled for elective surgery in 2 hours. The PN notes the client drank a full glass of water 30 minutes ago. What is the most appropriate action?

Answer: Notify the surgeon and anesthesiologist immediately

NPO (nothing by mouth) status is critical to prevent aspiration during anesthesia. Any oral intake within the pre-operative window must be reported to the surgeon and anesthesiologist immediately, as the case may need to be postponed.

During the pre-operative checklist, the PN confirms the client has signed the surgical consent form. Which of the following best describes the PN's role regarding informed consent?

Answer: Obtain the signature once the surgeon has explained the procedure

Informed consent is the surgeon's legal responsibility to explain. The PN's role is to witness the signature after the surgeon has already obtained informed consent, and to notify the surgeon if the client has unanswered questions or expresses doubt.

A client returns from the operating room following general anesthesia. The PN notes oxygen saturation of 91% and the client is difficult to arouse. What is the priority action?

Answer: Reposition the client to a semi-Fowler's position and apply supplemental oxygen

Airway and oxygenation are the priority in the post-anesthetic period. Repositioning to semi-Fowler's opens the airway and applying supplemental oxygen addresses the desaturation. Obtundation and low O2 sat warrant immediate intervention and escalation.

Which of the following pre-operative findings should the PN report to the surgeon before the scheduled procedure?

Answer: Serum potassium of 2.9 mEq/L

Hypokalemia (K+ < 3.5 mEq/L) increases the risk of serious cardiac dysrhythmias under anesthesia. This is an abnormal lab finding that must be reported and may result in surgery being delayed until corrected.

A post-operative client reports pain of 8/10 and is prescribed morphine 2–4 mg IV q4h PRN. The PN checks vital signs and finds RR 10/min, SpO2 93%, and BP 110/70 mmHg. What should the PN do?

Answer: Withhold the morphine, reposition the client, apply oxygen, and notify the physician

A respiratory rate of 10/min and SpO2 of 93% indicate opioid-induced respiratory depression. Administering more opioid is contraindicated. The PN should withhold the dose, stimulate and reposition the client, apply oxygen, and notify the prescriber immediately.

Which nursing intervention is the highest priority in preventing post-operative pulmonary complications such as atelectasis and pneumonia?

Answer: Encouraging early ambulation and deep breathing exercises

Early ambulation and deep breathing exercises (including incentive spirometry) promote lung expansion, clear secretions, and prevent atelectasis. These are the cornerstone interventions for post-operative pulmonary complication prevention.