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Monitor intake and output. Monitor color and amount of fluid drained from NG tube. Ask patient if he or she is passing any flatus rectally or having bowel movement.

Quiz
1. Donna is a healthy, 46-year-old female scheduled for elective surgery next week. You would include in her preoperative preparation: (a) a pulmonary function test and chest x-ray. (b) a CBC, chemistry panel, and pregnancy test. (c) urine culture, thyroid panel, and cortisol level. (d) glucose tolerance test, ankle-brachial index, and electrocardiogram (EKG). 2. Lucinda is a 37-year-old with a history of asthma who is scheduled for an appendectomy later today. Because of her asthma, you would include as part of her preoperative teaching her need to perform postoperatively: (a) coughing and deep breathing exercises. (b) leg exercises. (c) wound dressing changes. (d) all of the above. 3. Josie is the mother of a healthy 19-year-old having surgery tomorrow. After the surgeon discusses the surgery, risks, and benefits with the patient and her mother, the mother wants to sign the consent form. The most appropriate response to this would be: (a) Of course she can sign the consent form; after all the patient is her daughter. (b) No, she cant sign the form. (c) While you appreciate her concern for her daughter, the patient is a consenting adult and legally has to sign her own consent form. (d) Why dont both the patient and her mother sign the form?

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Perioperative Care

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4. Which member of the surgical team does not scrub into the operating room? (a) The surgeon. (b) The circulating nurse. (c) The scrub nurse or surgical tech. (d) The holding area nurse. 5. Suzette is having a minor procedure performed. Which type of anesthesia is most likely to be used? (a) General. (b) Epidural. (c) Regional. (d) Conscious sedation. 6. 65-year-old Dominic is being transferred into the PACU from the OR. Once there, initial assessment will focus on: (a) airway, breathing, circulation, and wound site. (b) intake, output, and intravenous access. (c) abdominal sounds, oxygen setting, and level of consciousness. (d) pulse oximeter, pupil responses, and deep tendon reflexes. 7. Denise is recovering from an open cholesystectomy. You know that because of the location of the surgery, she has an increased risk of postoperative: (a) myocardial infarction. (b) respiratory complications. (c) deep vein thrombosis. (d) wound infection. 8. Three days after surgery, Mark notices that the wound site is more painful now than it was the day before. When you inspect the surgical site you are looking for redness or inflammation. Other indicators of infection would include: (a) elevated RBC and elevated respiratory rate. (b) elevated WBC and elevated temperature. (c) elevated erythrocyte sedimentation rate and decreased pulse. (d) decreased platelets and decreased blood pressure.

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9. Paralytic ileus may occur as a postoperative complication. Which of the following patients would cause you the greatest concern about the development of paralytic ileus? (a) Kim, a 27-year-old postlaparscopic appendectomy. (b) Joyce, a 39-year-old postopen right hemicolectomy. (c) Nancy, a 56-year-old postmediastinoscopy. (d) John, a 47-year-old posttotal joint replacement.

10. Steve has developed pneumonia following intrathoracic surgery performed last week. Treatment for postoperative pneumonia would most likely include: (a) a cephalosporin, such as cefazolin. (b) a penicillin, such as amoxicillin. (c) a fluoroquinolone, such as levofloxacin. (d) a tetracycline, such as doxycycline.