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Medical-Surgical Nursing
Critical Thinking in Patient Care
Fifth Edition
CHAPTER
4
Nursing Care of
Patients Having
Surgery
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Directory
• NCLEX-RN® REVIEW Test Questions
• Lecture Note Presentation
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
NCLEX-RN® REVIEW
Test Questions
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 1
1. The nurse’s primary responsibility related to
informed consent is which of the following?
1. defining the risks and benefits of the surgery
2. witnessing the patient’s signature on the consent
form
3. explaining the right to refuse treatment or withdraw
consent
4. advising the patient and family about what is
needed for the diagnosis
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 1 Response
1. The nurse’s primary responsibility related to
informed consent is which of the following?
1. defining the risks and benefits of the surgery
2. witnessing the patient’s signature on the
consent form
3. explaining the right to refuse treatment or withdraw
consent
4. advising the patient and family about what is
needed for the diagnosis
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 1 Rationale
The nurse’s primary responsibility to informed
consent is serving as a witness to the patient
signature on the consent form.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 2
2. Given shorter hospital stays for outpatient
surgery, patients require which of the
following?
1.
2.
3.
4.
increased opioid doses
increased information about complications
increased attention to nutrition
increased parenteral hydration
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 2 Response
2. Given shorter hospital stays for outpatient
surgery, patients require which of the
following?
1.
2.
3.
4.
increased opioid doses
increased information about complications
increased attention to nutrition
increased parenteral hydration
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 2 Rationale
When patients are discharged soon after surgery,
they need increased information about
complications so they will recognize abnormal
manifestations as early as possible and report
these to the healthcare provider.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 3
3. Nonsteroidal anti-inflammatory drugs are given
in the postoperative period to do which of the
following?
1.
2.
3.
4.
stimulate appetite
increase amnesia
potentiate analgesia
improve renal function
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 3 Response
3. Nonsteroidal anti-inflammatory drugs are given
in the postoperative period to do which of the
following?
1.
2.
3.
4.
stimulate appetite
increase amnesia
potentiate analgesia
improve renal function
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 3 Rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs)
potentiate analgesia and reduce inflammation
caused from surgery.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 4
4. When reviewing a preoperative patient’s chart,
the nurse notes some abnormal findings.
Which abnormal finding may indicate renal
impairment?
1.
2.
3.
4.
decreased hemoglobin
increased chloride
decreased glucose
increased creatinine
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 4 Response
4. When reviewing a preoperative patient’s chart,
the nurse notes some abnormal findings.
Which abnormal finding may indicate renal
impairment?
1.
2.
3.
4.
decreased hemoglobin
increased chloride
decreased glucose
increased creatinine
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 4 Rationale
Creatinine levels specifically reflect renal
clearance. When creatinine is increased above
normal levels, renal impairment needs to be
considered.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 5
5. In the immediate postoperative period for knee
surgery, neurovascular concern is raised if
which of the following is found distal to the
site?
1.
2.
3.
4.
bounding pedal pulse
muscle cramps in the foot
redness or swelling in the calf
skin that is cool to the touch
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 5 Response
5. In the immediate postoperative period for knee
surgery, neurovascular concern is raised if
which of the following is found distal to the
site?
1.
2.
3.
4.
bounding pedal pulse
muscle cramps in the foot
redness or swelling in the calf
skin that is cool to the touch
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 5 Rationale
Redness or swelling in the calf may be a
manifestation of DVT in the circulatory system
distal to the surgery.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 6
6. What would the nurse do postoperatively about
medications prescribed prior to surgery?
1.
2.
3.
4.
continue after surgery
decrease by half for 36 hours
order anew prior to administration
withhold until evidence of anesthesia is absent
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 6 Response
6. What would the nurse do postoperatively about
medications prescribed prior to surgery?
1.
2.
3.
4.
continue after surgery
decrease by half for 36 hours
order anew prior to administration
withhold until evidence of anesthesia is absent
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 6 Rationale
All orders must be cancelled when the patient is
admitted to surgery and must be re-ordered
following surgery.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 7
7. A nurse is preparing a patient with diabetes
mellitus for surgery. The patient is NPO prior
to surgery. What would the nurse consider
about this patient?
1.
2.
3.
4.
has no risk for hyperglycemia
should receive sliding-scale insulin prescriptions
will benefit from hypoglycemia during anesthesia
will fail to manifest signs of hypoglycemia under
anesthesia
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 7 Response
7. A nurse is preparing a patient with diabetes
mellitus for surgery. The patient is NPO prior
to surgery. What would the nurse consider
about this patient?
1.
2.
3.
4.
has no risk for hyperglycemia
should receive sliding-scale insulin prescriptions
will benefit from hypoglycemia during anesthesia
will fail to manifest signs of hypoglycemia under
anesthesia
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 7 Rationale
Anesthetic agents cause paralysis and block
sympathetic nervous system control. This blocks
manifestations of hypoglycemia and could prevent
recognition of the condition.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 8
8. Acute pain management medications in the
immediate postoperative period generally do
which of the following?
1.
2.
3.
4.
progress from NSAIDs to opioids
progress from oral to parenteral routes
are scheduled rather than p.r.n. to promote control
induce a strong sedative effect to decrease the risk
of nausea
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 8 Response
8. Acute pain management medications in the
immediate postoperative period generally do
which of the following?
1. progress from NSAIDs to opioids
2. progress from oral to parenteral routes
3. are scheduled rather than p.r.n. to promote
control
4. induce a strong sedative effect to decrease the risk
of nausea
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 8 Rationale
Administering analgesics on a regular schedule in
the immediate postoperative period enhances pain
control.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 9
9. What risks for the older adult patient are posed
from lengthy operative procedures?
1.
2.
3.
4.
memory loss due to blood loss
hearing loss due to extended anesthesia
weight loss due to lack of nutritional intake
pressure sores and joint pain from operative
positioning
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 9 Response
9. What risks for the older adult patient are posed
from lengthy operative procedures?
1.
2.
3.
4.
memory loss due to blood loss
hearing loss due to extended anesthesia
weight loss due to lack of nutritional intake
pressure sores and joint pain from operative
positioning
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 9 Rationale
Remaining in a fixed position for a long period of
time impairs circulation, which increases the risk of
pressure ulcers; joint stiffness develops from lack
of flexion so that pain occurs when the joint is
flexed.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 10
10. A nurse working in the PACU would know that
hypothermia in the perioperative period has
what effect?
1.
2.
3.
4.
decreases cardiac ischemia
reduces the risk for wound infection
increases patient comfort and analgesia
is associated with cardiac morbidity and surgical
bleeding
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 10 Response
10. A nurse working in the PACU would know that
hypothermia in the perioperative period has
what effect?
1.
2.
3.
4.
decreases cardiac ischemia
reduces the risk for wound infection
increases patient comfort and analgesia
is associated with cardiac morbidity and
surgical bleeding
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
®
NCLEX-RN REVIEW
Test Question 10 Rationale
Hypothermia is associated with bleeding from the
surgical site and increases cardiac ischemia,
which in turn increases the risk of cardiac mortality
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Lecture Note
Presentation
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Learning Outcome 1
• Compare the differences and similarities
between outpatient and inpatient surgery.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Determinants of Whether Surgery is
Inpatient or Outpatient:
• Complexity of surgery
• Recovery
• Expected needed level of postop care
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Common Outpatient Surgeries:
•
•
•
•
•
•
•
•
Cataract removal
Hernia repairs
Tubal ligations
Vasectomies
D and C
Hemorrhoidectomies
Diagnostic procedures
Biopsies
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Outpatient Surgery
• Advantages:
– Decreased cost
– Reduced risk of hospital-acquired infection
– Less interruption in patient’s routine
– Reduction in time lost from work
– Less physiological stress
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Outpatient and Inpatient
Surgeries
• Physical care provided in same way
• Increased need for teaching and emotional
support for outpatient
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Learning Outcome 2
• Identify the three phases of perioperative
care.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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The Three Phases of
Perioperative Care:
• Preoperative
• Intraoperative
• Postoperative
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Preoperative Phase:
• Decision for surgery is made
• Patient transferred to operating room
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Intraoperative Phase:
• Entry into operating room
• Admittance to recovery room
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Postoperative Phase:
• Admittance to recovery room
• Complete recovery
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Learning Outcome 3
• Identify the significance of diagnostic tests
used in the perioperative period.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Diagnostic Tests
• Provide baseline data
• Detect problems that can create risks
during and after surgery
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Common Preoperative
Laboratory Tests
•
•
•
•
Complete blood counts
Electrolyte studies
Coagulation studies
Urinalysis
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
TABLE 4–3 Laboratory Tests
for Perioperative Assessment
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
TABLE 4–3 (continued) Laboratory Tests for Perioperative Assessment
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Learning Outcome 4
• Explain nursing implications for
medications prescribed for the surgical
patient.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Preoperative Medications
Serve to Achieve:
•
•
•
•
•
Sedation
Reduced anxiety
Induced amnesia
Increased comfort
Reduced gastric acidity, volume, nau-sea,
vomiting, and incidence of aspira-tion
• Increased gastric emptying
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
TABLE 4–4 Examples of
Commonly Used Preoperative
Medications
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
TABLE 4–4 (continued) Examples of Commonly Used Preoperative Medications
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Assessment of all Patient’s
Medications
•
•
•
•
Over-the-counter
Vitamins/herbal medications
Illegal drugs
Aspirin
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Special Considerations for Preoperative
Medication with the Diabetic Patient
• Withholding insulin
• n.p.o. status
• Monitoring plasma glucose
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Medications
• Intraoperative medications
– General or regional anesthesia
– Anesthesiologist or CRNA
– Unconsciousness, analgesia, reflex loss,
muscle relaxation
• Postoperative medications
– Opioid analgesics
– Nonsteroidal anti-inflammatory drugs
– Administered ATC
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Learning Outcome 5
• Identify variations in perioperative care for
the older adult.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Perioperative Risks
for the Older Adult
•
•
•
•
Hypotension, hypothermia, hypoxemia
Joint pain and decubitus ulcer forma-tion
Infection
Confusion
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Keys to Successful Surgical
Outcomes for Older Adults:
• Stabilize nutrition and hydration
• Control chronic conditions
• Provide information
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Table 4-6 Nursing Interventions for Older Surgical Patients
Reprinted from AORN Journal, Vol. 83, No. 3, Judith L. Clayton, “Special
Needs of Older Adults Undergoing Surgery,” p 557–574, © 2008, Association
of periOperative Registered Nurses, with permission from Elsevier.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Older Adults and
Postoperative Pain
• Believe health care providers know best
• Must be coached to report pain candidly
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Learning Outcome 6
• Describe principles of pain management
specific to acute postoperative pain
control.
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Postoperative Pain
• To be expected; unavoidable
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
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Benefits of Postoperative
Pain Relief
• Promotes comfort
• Facilitates coughing, turning, deep
breathing, earlier ambulation, decreased
hospital stays
• Decreases postoperative complications
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Guidelines for Perioperative
Pain Management
•
•
•
•
Education and training
Monitoring of patient outcomes
24-hour availability of anesthesiologists
Use of dedicated pain management
service
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
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Managing Postoperative
Acute Pain
• Medications
• Nonpharmacologic approaches
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Assessing Postoperative
Acute Pain
• Importance of patient input
• Assess regularly
• Change pain relief regimen accordingly
Medical-Surgical Nursing: Critical Thinking in Patient Care, Fifth Edition
Priscilla LeMone • Karen Burke • Gerene Bauldoff
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.