What are some complications for obese pt. in surgery?

Dumping syndrome, Bowel or gastric outlet obstruction, Dysphagia, Bile reflux

What happens during the compensatory stage of shock? (ch. 14)

B/P is normal, drop in MAP, increased HR

What is the action of an anticoagulants? (ch. 48)

Interfere with clotting cascade and thrombin formation

Vena Cava filter, Anticoagulant therapy, Fibrinolytic therapy

What position can help manage hypovolemic shock? (ch. 14)

Modified trendelenburg (no bent knees)

What are diagnostics tests for all types of shock? (ch. 14)

CBC, CMP, ABG, Urine specific gravity, osmolality

time of decision for surgery until pt. is in operating room

What is a "spinal headache"? (ch. 27)

Increase pressure in brain, Spinal leak

What are clinical manifestations of PE?

Dyspnea, pleuritic chest pain, sense of impending doom, Diaphoresis, hemoptysis, tachycardia, crackles or wheezes

What happens during the Progressive stage of Shock? (ch. 14)

B/P and MAP decreases, increased HR and respiratory

What is the action of Urokinase? (ch. 48)

Activates plasminogen to plasmin, Breaks fribin clots

Why are NMJ blocking agents used? (ch. 28)

As an adjunct to general anesthetic during surgery, To facilitate mechanical intubation by preventing resistance, To cause paralysis

Surgeries for DVT (ch. 30)

Filters, Venous thrombectomy, Vein ligation

Indications for Epinephrine (Adrenalin)

Prolongs effects for regional anesthetic, Glaucoma, Shock

What are the test(s) for a DVT? (ch. 30)

Ascending contrast venography, D-dimer

slows down GI and urinary, dries up secretion

What does SCIP stand for? (ch. 17)

Surgical Care Improvement Project

What is the function of Heparin? (ch. 48)

Inhibit the conversion of prothrombin to thrombin

What are the stages of Shock? (ch. 14)

Compensatory, Progressive, Irreversible

What is fibrinolysis initiated by? (ch. 48)

Tissue plasminogen activator (tPA)

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RN (transition): Exam 1

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Questions 99

Answers

1
What is the onset of Methohexital (Brevital)?
Slow onset of action
Rapid onset of action
2
What is an antiplatelet drug? (ch. 48)
Urokinase
Aspirin
Heparin
Warfarin
3
What are some complications for obese pt. in surgery?
Dumping syndrome
Bowel or gastric outlet obstruction
Dysphagia
Bile reflux
4
Malignant hyperthermia is...(ch. 18)
inherited muscle disorder
respiratory complication
allergic reaction
infection
5
What is a semirestricted zone in a surgical environment? (ch. 18)
Changing room, walk in with street clothes
Full surgical attire
Scrubs, cap
6
What % of fluid loss is considered hypovolemic shock? (ch. 14)
15% or greater
5%
10%
7
What should you not give orally?
Aspirin
Epinephrine, Dopamine
Acetaminophen
Albumin
8
What happens during the compensatory stage of shock? (ch. 14)
B/P is high, drop in MAP, increased HR
B/P is normal, drop in MAP, increased HR
B/P is low, drop in MAP, increased HR
9
What is the action of an anticoagulants? (ch. 48)
Interfere with clotting cascade and thrombin formation
Break down the thrombus
Alter the formation of the platelet plug
10
What is a barbiturate anesthetic? (ch. 27)
Midazolam
Propofol
Methohexital
11
What are tx for PE?
Vena Cava filter
Anticoagulant therapy
Thrombectomy
Fibrinolytic therapy
12
What position can help manage hypovolemic shock? (ch. 14)
Modified trendelenburg (bent knees)
Sims position
Prone position
Modified trendelenburg (no bent knees)
13
What is a volatile liquid? (ch. 27)
Urokinase
Desflurane
Dantrolene
Albumin
14
What is a low-molecular weight heparins? (ch. 48)
Antihemophilic factor
Urokinase
Warfarin (coumadin)
Lovenox (enoxaparin)
15
What kind should you give malnourished or obese clients? (ch.19)
Carbs
Fats
Proteins
Leafy greens
16
What should you ask the pt. to do before your give Midazolam?
Use the restroom
Take deep breaths
Stretch
17
What are diagnostics tests for all types of shock? (ch. 14)
CBC, CMP, ABG
CT scan
Urine specific gravity, osmolality
CXR, ECG
18
Preop phase (ch. 17)
pt. admitted to PACU to eval in clinical setting or at home
time of decision for surgery until pt. is in operating room
pt. is transferred from op. room to admission to PACU
19
What is a "spinal headache"? (ch. 27)
Decrease pressure in the brain
Headache as a result in a hit in the back
Increase pressure in brain
Spinal leak
20
Back of a surgical gown is sterile. (ch. 18)
False
True
21
Movement at least 1-foot distance from sterile field must be maintained. (ch. 18)
True
False
22
What are clinical manifestations of PE?
Dyspnea, pleuritic chest pain, sense of impending doom
Asymptomatic
Bradycardia, high-grade fever, dry skin
Diaphoresis, hemoptysis, tachycardia, crackles or wheezes
23
What happens during the Progressive stage of Shock? (ch. 14)
B/P and MAP decreases, decreased HR and respiratory
B/P and MAP decreases, increased HR and respiratory
24
Systolic B/P <90 needs to be reported. (ch. 19)
True
False
25
What drug is an thrombolytic agent? (ch. 48)
Antihemophilic factor
Urokinase
Warfarin
Heparin
26
When is discharge education taught? (ch. 19)
Intraop
Preop
In the office
Postop
27
What is the action of Urokinase? (ch. 48)
Activates plasminogen to plasmin
Deactivate plasminogen to plasmin
Breaks fribin clots
Build fribin clots
28
How will corticosteroids affect the surgical experience? (ch. 17)
Affect pain receptors
Delay healing
Stop bleeding
Slow GI
29
Who goes to get supplies during surgery, if needed? (ch. 18)
Patient
Circulating nurse
RN first assistant
Scrub role
30
Nitrous Oxide causes severe CNS depression (ch. 27)
False
True
31
What type of pt. should get Urokinase? (ch. 48)
Stroke
DVT
Pulmonary emboli
Hemorrhage
32
Malignant hyperthermia is induced by...(ch. 18)
IV anesthetic
inhaled anesthetic
pain medication
33
Why are NMJ blocking agents used? (ch. 28)
As an adjunct to general anesthetic during surgery
To facilitate mechanical intubation by preventing resistance
To cause paralysis
For altered fluid and electrolyte imbalance
34
Surgeries for DVT (ch. 30)
Bypass
Filters
Venous thrombectomy
Vein ligation
35
The initial nurse is still responsible for charting even after pt is transferred to ICU (shock)
False
True
36
What are the 2 drug-to-drug interactions with Lidocaine (local anesth.) (ch. 27)
Naloxone
Dopamine
Succinycholine
Epinephrine
37
Which medications are anesthetic gases? (ch. 27)
Halothane
Nitrous Oxide
Midazolam
38
Antihemophilic factor temporarily replaces clotting factors to prevent bleeds (ch. 48)
False
True
39
How many stages are there to the PACU unit? (ch. 19)
3
4
1
2
40
What is a restricted zone in a surgical environment? (ch. 18)
Changing room, walk in with street clothes
Full surgical attire
Scrubs, cap
41
Indications for Epinephrine (Adrenalin)
Prolongs effects for regional anesthetic
Tx for cardiac arrest
Glaucoma
Shock
42
Nitrous oxide is not flammable (ch. 27)
True
False
43
What are the test(s) for a DVT? (ch. 30)
CBC
CT
Ascending contrast venography
D-dimer
44
Anticholinergics...
produce secretion
slows down respiratory
slows down GI and urinary
dries up secretion
45
What does SCIP stand for? (ch. 17)
Sterilize Care Improvement Project
Stationary Care Improvement Project
Surgical Care Improvement Project
46
Indications for Dopamine (Intropin)
Tx for cardiac arrest
Shock
Glaucoma
Prolongs effects of regional anesthetic
47
What is the function of Heparin? (ch. 48)
Inhibit tPA
Coagulates blood
Inhibit the conversion of prothrombin to thrombin
48
How do you calculate mean arterial pressure (MAP)? (ch. 14)
Systolic + diastolic / 3
Diastolic + systolic / 3
Systolic + 2(diastolic) / 3
Diastolic + 2(systolic) / 3
49
What does CAGE stand for? (ch. 17)
Comply, Assist, Guide, Eval
Catch, Attack, Guard, Elbow
Cut, Annoyed, Guilty, Eye
Care, Assess, Guide, Eval
50
What are the stages of Shock? (ch. 14)
Phase 1, Phase II, Phase III
Compensatory, Progressive, Irreversible
Intubation, maintenance, recovery
51
What is fibrinolysis initiated by? (ch. 48)
Extrinsic pathway
Platelets
Intrinsic pathway
Tissue plasminogen activator (tPA)
52
When should discharge planning take place? (ch. 17)
Postop
Intraop
Preop
53
What does SCIP prevent? (ch. 17)
Pain managment
Surgical Site Infections
Bleeding
Venous thrombolism
54
Preventing DVT...(ch. 30)
Cross legs when sitting
Avoid pillows under knees
Elevate knees with knees bent sharply
Avoid sharply flexed hips, knees
55
Which drug(s) are anticoagulants? (ch. 48)
Heparin
Warfarin
Aspirin
Urokinase
56
For fluid replacement, what type of colloids should be given? (ch. 14)
Hypertonic solutions (3% saline)
Albumin
0.9% saline
Lactated Ringer's
57
What can Desflurane trigger? (ch. 27)
Hypovolemic shock
Malignant Hyperthermia
Pulmonary embolism
58
Thromboemboli is one type of PE. What are other sources of emboli?
Tumors, Fat from bone marrow
IV inject. or air, Foreign substance
Amniotic fluid release
59
What are the Alpha- and Beta-Adrenergic Agonists?
Epinephrine
Dopamine
Succinylcholine
Pancuronium
60
What is the action of normal serum albumin? (ch. 14)
Pulls fluid from the vessels to the interstitial spaces
Pulls fluid from interstitial spaces back into the vessels
61
Antidote for Malignant hyperthermia is...
Dopamine
Digoxin
Desflurane
Dantrolene
62
What are the 3 main clinical manifestations of DVT? (ch. 30)
Swelling, warmth, erythema
Swelling, cyanosis, pallor
Pallor, cyanosis, cold at touch
63
Why is warfarin contraindicated in pts. that have chronic ETOH? (ch. 48)
Alcohol interaction
Esophageal varices
Varicose veins
64
What is the #1 diagnostic test for PE?
D-dimer
Pulmonary angiography
Coagulation studies
Chest CT with contrast
65
What is an unrestricted zone in a surgical environment? (ch. 18)
Full surgical attire
Scrubs, cap
You cannot enter it
Changing room, walk in with street clothes
66
What is a depolarizing NMJ blocker? (ch. 28)
Pancuronium
Acetylcholine (ACh)
Succinylcholine
67
What is a local anesthetic? (ch. 27)
Nitrous oxide
Lidocaine
Dopamine
Aspirin
68
There are 3 stages of general anesthetic. (ch. 27)
True
False
69
To maintain a patent airway, keep HOB 15 to 30 degrees unless contraindicated. (ch. 19)
True
False
70
What is the first sign of hypovolemic shock? (ch. 14)
Hemorrhage
Tachycardia
Diaphoresis
71
Name the risk factors for DVT (ch. 30)
C 60yrs old STOC SOAP
(After surgery)
72
Dantrolene classification
Muscle relaxant
Pain management
Diuretic
73
What are the goals of General anesthetics? (ch. 27)
Unconsiousness
Amnesia
Analgesia
74
What are tx for a spinal headache? (ch. 27)
Give caffeine
Blood patch
Let it relieve itself
Give lots of fluid
75
Those with increased BMI are at greater risk for infection (ch. 18)
False
True
76
At what number does the mean arterial pressure(MAP) needs to be for cells to receive O2?
60
55
50
65
77
Methohexital increase the effectiveness of other drugs.
True
False
78
What are the two types of neuromuscular junction (NMJ) blockers? (ch. 28)
Dopamine, epinephrine
Postsynaptic terminal, synaptic, cleft
Angiotensin I, Angiotensin II
Nondepolarizing, depolarizing
79
Leafy green vegetables is AVOIDED in pts. taking warfarin (ch. 48)
True
False
80
ETOH problem score (ch. 17)
3 or higher
4 or higher
2 or higher
1 or higher
81
Clients may wear SCDs if procedure is 60 minutes or longer. (ch. 18)
False
True
82
The RN nurse is responsible for witnessing the signature on an informed consent. (ch. 17)
False
True
83
What should warfarin be given with to treat DVT? (ch. 30)
IV heparin for 4-5 days
Antihemophilic for 4-5 days
Urokinase for 4-5 days
Lovenox for 4-5 days
84
Assess VS q. 15 mins X 4, then q. 30 mins. X2, then q. hour X2 Postop (ch. 19)
False
True
85
Who changes the first dressing postop? (ch. 19)
RN
CNA
Charge nurse
Doctor
86
What is a nurse's # 1 concern postop?
Respiration status
Cardiac status
GI status
Neuro status
87
What are the 3 kinds of surgery? (ch. 17)
Transplant, palliative, emergent
Diagnostic, curative, constructive
Diagnostic, traumatic, emergency
Elective, traumatic, emergency
88
What is Virchow triad? (ch. 30)
Endothelial damage
DVT
Venous stasis
Altered coagulation
89
Which labs are used to monitor Warfarin? (ch. 48)
CBC
PT
PTT
INR
90
The surgical prep can be damp prior to draping. (ch. 18)
True
False
91
What is fibrinolysis? (ch. 48)
Clot removal
Clot build up
92
How many points must a patient have before they are discharge from PACU? (ch. 19)
8
7
9
6
93
What is the function of Adrenergic agonists?
Stimulates the parasympathetic nervous systm
Stimulates the sympathetic nervous system
94
Irreversible shock is not dictated until all we do do is done (organ damage, low B/P, etc.)
False
True
95
What vitamin inject. should pts. get to prevent malabsorption due to lack of intrinsic factor?
B12
A
K
C
96
Geri. who have cardiac+resp. PREOP problems are at higher risk of morbidity and death POSTOP
False
True
97
What is hypovolemic shock? (ch. 14)
decreased intravascular volume due to fluid loss
severe allergic reaction
impairment or failure of myocardium
loss of sympathetic tone causing relative hypovolemia
98
What are non-barbiturate anesthetics? (ch. 27)
Midazolam
Halothane
Nitrous oxide
Propofol
99
Warfarin interferes with which vitamin dependent clotting factors in the liver? (ch. 48)
K
A
B12
C

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