Chapter 35 Caring for the Perioperative Patient

Chapter 35 Caring for the Perioperative Patient

1. The preoperative phase encompasses which period of time?

a. Entry to the operating suite until admission to postanesthesia care

b. Entry into the operating suite until discharge from the hospital

c. The decision to have surgery until admission to postanesthesia care

d. The decision to have surgery until entry to the operating suite

ANS: D

The preoperative phase begins with the decision to have surgery and ends when the patient enters the operating room. The intraoperative phase begins when the patient enters the operating suite and ends when the patient is admitted to the postanesthesia care unit.

Difficulty: Easy

Client Need: Safe and Effective Care Cognitive Level: Comprehension Page 1027

PTS: 1

2. A 2-year-old child is scheduled for a tonsillectomy. When determining the plan of care, the nurse should:

a. Include the parents or caregivers in the plan of care

b. Explain to the child that she will have a sore throat after surgery

c. Tell the child that she can have her favorite foods for the first 24 hours after surgery

d. Prepare the child for discharge from the hospital as soon as she is alert

ANS: A

It is developmentally normal for toddlers to experience anxiety with separation from parents or caregivers. Be sure to include these people in the plan of care. Developmentally, a 2-year- old lives in the “here and now” and wouldn’t grasp an intangible concept, such as pain in the future. The toddler would take liquids and soft foods within the first 24 hours when her throat is sore during swallowing. She should not eat foods that are rough and crunchy because they may scratch her throat and cause bleeding. After a tonsillectomy, the child will need to be monitored for bleeding and stable vital signs; therefore, she will not be discharged as soon as she is alert.

Difficulty: Moderate

Nursing Process: Interventions

Client Need: PSI

Cognitive Level: Synthesis

Page 1036

PTS: 1

3. Which of the following is the most appropriate nursing goal for a 2-year-old who is to have a tonsillectomy?

a. Separation anxiety will be minimal.

b. The child will verbalize understanding of expected pain.

c. The child will tolerate a normal diet 24 hours after surgery.

d. The parent will indicate readiness to assume the child’s care.

ANS: A

The only concrete information in this question is that the child is 2 years old. Therefore, the only problem the nurse can reasonably predict from this would be developmental in nature. It is developmentally normal for toddlers to experience anxiety with separation from parents or caregivers. Minimizing anxiety by involving the parents or caregivers would be the appropriate goal for separation anxiety. A 2-year-old child would not be expected to verbalize understanding of expected pain. The toddler would take liquids and soft foods within the first

24 hours when her throat is sore during swallowing. She should not eat foods that are rough and crunchy because they may scratch her throat and cause bleeding. Nurses should encourage

parental involvement, but parents should not be expected to assume the child’s care.