1. You take M.P.'s BP and get 134/82mm Hg. She asks whether these BP readings are okay. On
what do you base your response?
2. List at least three important ways you might help M.P. maintain her success.
CASE STUDY PROGRESS M.P. tells you she was recently at a luncheon with her garden club and that
most of those women take different BP pills than she does. She asks why their pills are different shapes
and colors.
3. How can you explain the difference to M.P.?
4. During the visit, you ask M.P., “When was your last eye examination?” She answers, “I'm not
sure, probably about 2 years ago. What does that have to do with my blood pressure?” What is
your response?
CASE STUDY OUTCOME
M.P. comes in for a routine follow-up visit 3 months later. She continues to do well on her daily BP drug
regimen, with average BP readings of 130/78mm Hg. She
B.A. is hired under the condition that she complies with LTBI therapy and will immediately report any
signs and symptoms of active disease to the clinic. She reports weekly for her medications and finishes
her 12 weeks of therapy without experiencing any significant effects.
Overview
Surgery is the art and science of treating diseases, injuries, and deformities by operation and
instrumentation. The surgical procedure involves an interdisciplinary team of the patient, surgeon,
anesthesia care provider (ACP), other health care team members, and you. Surgery may be performed
for a variety of purposes and in a variety of settings. You play an important role in preparing the patient
and caregiver for the surgical experience, caring for the patient during surgery, and facilitating the
patient's recovery following surgery.
A complete preoperative history and physical assessment is vital to the planning of nursing care.
Preoperative teaching prepares the patient and caregiver for the surgical experience and enhances the
patient's postoperative outcome. As the patient's advocate during the surgical procedure, you are
responsible for maintaining safety and preventing injury. You may assume a variety of functions in the
operating room (OR), including circulating, scrubbing, and/or assisting the surgeon. Postoperatively,
your expertise assists the patient in obtaining maximal recovery in the shortest period of time. Priority
nursing care during the postoperative period focuses on both assessing for and preventing the
occurrence of common postoperative complications such as atelectasis, venous thromboembolism,
infection, postoperative paralytic ileus, and urinary retention.
Objectives




1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Identify relevant preoperative and postoperative assessment data for a patient undergoing
surgery.
Provide appropriate preoperative teaching for a patient scheduled for surgery and the caregiver.
Identify the priority nursing interventions that must be completed before transporting a patient
to the OR.
Compare and contrast responsibilities of the circulating and scrub nurses during the Glasses to
OR with patient
Hairpins and/or wig secured
Hearing aid sent home with family
History and physical on chart
Lab results on chart
Make-up, false eyelashes, and nail polish removed
Consent form signed and on chart
Patient pajamas put on
Preoperative medication given
Situation, background, assessment, recommendation (SBAR) report given to receiving nurse
Skin prep complete, if ordered
Surgical site identified and marked
Vital signs taken
Voided and/or indwelling catheter inserted
7. Just before transferring T.A. to the OR, you administer her preoperative medication. Match the drug
classification with its corresponding preoperative purpose and effect.
Antiemetics
Prevent post-operative infection
Anticholinergics
Decrease respiratory secretions
Benzodiazepines
Prevent nausea and vomiting
Antibiotics
Reduce anxiety and provide amnesia
8. T.A. is now in the OR and under general anesthesia. The perioperative nurse may be responsible for
either circulating or scrubbed functions. Identify the differentiating activities of these two distinct roles.
Place a C (for circulating) or an S (scrub) next to the following lists of tasks.










1.
Accompanies the patient to the post-anesthesia recovery area___
Ensures that supplies and equipment are available, sterile, and in working order ___
Assists with the draping procedure ___
Assists with the induction of anesthesia ___
Assists with transferring patient to the OR bed ___
Checks chart and relates pertinent data ___
Coordinates all OR activities with team members ___
Documents intraoperative care ___
Identifies and assesses the patient ___
Keeps track of irrigation solutions used for calculation of blood loss ___
Minimal nausea and vomiting
16. T.A. arrives on the clinical unit in stable condition. She is drowsy but arouses easily and is oriented
×3. Her lungs are clear and vital signs are stable. She has an abdominal dressing that is dry and intact.
She received morphine sulfate 4 mg IV for pain just before transfer. She currently rates her incisional
pain as a 2 on a scale of 0 to 10. She has a urinary catheter in place draining clear yellow urine. Her
abdomen is soft with hypoactive bowel sounds. An IV is infusing at 125 mL/hr via a peripheral IV site.
Identify which of the following tasks need to be completed by a registered nurse (RN) or can be
delegated to the unlicensed assistive personnel (UAP). Place RN next to the tasks that an RN can
complete. Place UAP next to the tasks that can be completed by the UAP.










Perform a physical assessment. ____
Obtain vital signs. ____
Empty and measure indwelling urinary catheter drainage bag. ____
Assess the patient's understanding of the pain scale. ____
Teach the patient methods to prevent atelectasis. ____
Give the patient an incentive spirometer to use. ____
Teach the patient what to expect during the next 24 hours. ____
Apply sequential compression devices. ____
Provide oral care as needed. ____
Obtain capillary blood glucose as ordered. ____