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Fundamentals Test 4

QuestionAnswer
Who is at higher risk for surgical complications? Infants, elderly, immunocompromised
What complication are young and elderly patients at higher risk of? Dehydration
What will the nurse do if there is some drainage on a surgical dressing? Mark the area with a pen and write date and time to enable close monitoring of drainage.
How do wound vacuum devices assist in wound healing? Drawing wound edges together by negative pressure.
Describe how to remove staples from the patient's skin? Place staple remover under the staple, press down on the handle of the tool, and pull outward.
What postoperative complications can develop and what manifestations should the nurse watch for? Infection (fever, rising pulse, redness and warmth), Hemorrhage (restlessness, rising pulse, falling blood pressure), Dehiscence (increased serosanguineous drainage on the dressing)
For which patients would coughing after surgery be contraindicated? Patients who have had brain surgery. These patients will use deep breathing and incentive spirometer.
What interventions will help a postoperative patient that is complaining of gas pains? Walking frequently.
Name the three distinct phases of wound healing. What is the typical timeframe for each phase? Inflammation, proliferation, and maturation. Inflammation begins immediately and lasts 1-4 days. Proliferation begins on Day 3 or 4 and lasts 2-3 weeks. Maturation begins about 3 weeks after injury and can last for 2 years.
Identify factors that affect wound healing. Age, nutrition, lifestyle habits, overall health, diminished lung function, slow metabolism, other diseases (such as diabetes and heart disease)
Identify the basic wound types (abrasion, hematoma, laceration). An abrasion is a scraping away of skin tissue. A hematoma is a pooling of blood under unbroken skin. A laceration is a torn, ragged, or mangled wound.
While you are changing a dressing, what aspects of the wound and dressing should you assess? REEDA (redness, edema, ecchymosis, discharge, and approximation of wound).
What is an example of a wound healing by first intention? A surgical incision that is well-approximated
What is an example of a wound healing by second intention? A laceration with jagged edges that do not approximate.
What is an example of a wound healing by third intention? An abdominal incision that is left open to drain and will be surgically closed at a later time.
What type of dressing would be used for a stage I pressure ulcer? Thin film.
When changing a dressing on a horizontal incision, which direction should the nurse pull to remove the tape from the old dressing? From each of the four sides toward the wound.
What is the main purpose of using a hydrocolloid dressing? Occlude air and promote breakdown of necrotic tissue.
Why would a nurse choose to use a non-adherent dressing? It allows drainage to seep through a barrier and be absorbed on the other side. It does not stick to the wound.
What is the proper method to clean a wound? In a circular motion around the wound, circling to the outside.
Why is it important for the immobilized patient to do frequent deep breathing exercises? Prevention of hypostatic pneumonia
Patients faced with movement restriction may experience which type of emotional response? Depression
Air-fluidized therapy is not recommended for patients with what conditions? Spinal cord injury or unstable spine.
When is a continuous passive motion machine used? Exercise the joint after joint replacement surgery.
What is the nurse's responsibility regarding the continuous passive motion machine? Verify the settings for the prescribed flexion and extension limits.
How do you assess the patient who is in traction? Make sure that the patient's extremity is not touching the bed frame. Ensure that the weights hang freely from the bed frame and do not touch the floor.
Why is Buck's traction used? Reduce muscle spams that accompany fractures.
How should the nurse handle a freshly applied plaster cast? With the palms of the hand and flat part of the fingers (no fingertips!!)
What should the nurse do prior to placing a patient in a mechanical lift? Widen the stance of the lift's base and lock it.
How should a patient using crutches correctly climb the stairs? Bring the good leg up first when going up the stairs.
What important assessment should be done in the patient using a brace, splint, or prostheses? A frequent, thorough assessment of skin integrity.
What are the signs of altered circulation and perfusion to watch for in a patient with a cast? Pale or blue skin, decreased movement of area distal to injury, numbness, decreased pulses, decreased capillary refill.
How do you properly apply an elasticized bandage to a patient's exremity? By overlapping turns of the bandage equally.
What are the major dangers of immobilization? Pressure injuries, loss of bone mass, pneumonia, and permanent loss of function.
Explain complementary therapies. Holistic treatments used in conjunction with other medical treatments.
What is imagery? Using a visual stimulus to produce a particular physiologic change that can decrease stress or promote healing.
What is meditation? Involves focusing attention on a single repetitive stimulus, thereby decreasing all other stimuli
What is the basis of chiropractic therapy? Manipulation of the spine for symptomatic relief and improved functioning.
What is the nurse's role when patients choose to use complementary and alternative therapies? Asking if the patient is taking over-the-counter herbal remedies. Instructing the patient to inform the health care provider when such therapies are being used.
What is an appropriate nursing intervention if an old dressing becomes stuck to a patient's wound? Wet it with normal saline to loosen the dressing.
Why does inflammation occur after an injury or surgery? Blood vessels have dilated and allowed plasma to leak into the wound site.
Why are Montgomery straps used to secure a dressing? To decrease skin irritation from tape when frequent dressing changes are necessary.
How do range-of-motion exercises improve venous circulation? Through compression of muscles on venous walls.
What is a normal finding at the pin sites of a patient in skeletal traction? Drainage of clear fluid.
What is the major advantage of a low-air-loss mattress? Reduction of friction.
What are the normal limits of capillary refill? Three seconds or less for adults. Five seconds or less for the elderly.
What are nursing interventions for evisceration? Place the patient in supine position. Place large sterile dressings over the viscera. Soak the dressings in sterile normal saline. Notify surgeon immediately.
What are the characteristics of a partial-thickness wound? Superficial wounds, heal more quickly by producing new skin cells, Fibrin clot forms framework for growing new cells.
How long should a cold compress be applied to a wound? 20 minutes.
How can a nurse reduce the incidence of edema in an extremity with a plaster of Paris cast on? Elevate the extremity on one to two pillows.
After the removal of a cast, how should the nurse expect the skin to appear? Dry and dirty.
How long does it take for a cast to dry? 30 minutes.
To ensure proper functioning, what action must the nurse take after emptying a Hemovac or Jackson-Pratt drain? Compress the drain prior to inserting the plug.
When applying a pressure bandage, how should the wrap be terminated? Circular turn.
To ensure proper height of a walker, the patient's elbows should be bent to which angle? 15 to 30 degrees
What is a keloid? A large raised scar, commonly found in African-Americans.
What is the maximum weight that can be applied with skin traction? 15 pounds.
Created by: ms_molly