The nurse is reviewing the laboratory results for a preoperative patient. Which test result should be brought to the attention of the surgeon immediately?

Correct Answer: D

Rationale: In this scenario, the correct answer is option D, which is a White Blood Cell (WBC) count of 18,500/µL. An elevated WBC count indicates a potential infection or inflammation in the body, which is crucial information for the surgeon to be aware of before proceeding with surgery. This result should be brought to the surgeon's attention immediately to assess the patient's condition and consider appropriate interventions. Option A, a Serum K+ of 3.8 mEq/L, is within the normal range and does not pose an immediate threat to the patient's preoperative status. Similarly, option B, a Hemoglobin of 15 g/dL, and option C, a Blood glucose of 100 mg/dL, are also within normal limits and do not require immediate attention in this context. From an educational perspective, understanding the significance of abnormal laboratory values in preoperative patients is critical for nurses to provide safe and effective care. This question highlights the importance of recognizing abnormal findings and prioritizing communication with the healthcare team to ensure patient safety and optimal outcomes. Nurses must be vigilant in monitoring and interpreting laboratory results to advocate for their patients' well-being during the perioperative period.

Correct Answer: D

Rationale: The correct answer is D) Patients remain responsive and breathe without assistance. In the context of moderate sedation, it is crucial for the nurse to communicate with the family about what to expect during the procedure. Moderate sedation, also known as conscious sedation, is a controlled state of sedation where the patient is able to maintain their own airway and respond to verbal or tactile stimulation. This allows for procedures such as realignment of fractures to be performed with the patient in a more relaxed state without the need for general anesthesia. Option A) Includes inhalation agents is incorrect because moderate sedation typically involves medications administered intravenously, not through inhalation. Option B) Induces high levels of sedation is incorrect as moderate sedation is meant to keep the patient in a state of reduced consciousness but still able to respond. Option C) Frequently used for traumatic injuries is incorrect because while moderate sedation can be used for various procedures including those for traumatic injuries, it is not specific to this type of situation. Educationally, it is important for nurses to have a clear understanding of different levels of sedation and be able to effectively communicate with patients and their families about what to expect during procedures involving sedation. This information helps in ensuring patient safety and managing the expectations of those involved in the care process.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) When the patient first arrives in the PACU. This timing is crucial for several reasons. When a patient is recovering from anesthesia, they may be disoriented, confused, or agitated due to the effects of the anesthesia wearing off. Providing orientation explanations upon arrival in the Post-Anesthesia Care Unit (PACU) allows the nurse to establish a baseline understanding for the patient before they become fully awake and potentially agitated. This early orientation helps reduce anxiety, fear, and agitation by preparing the patient for their surroundings and the recovery process. Option A) When the patient is awake may not be the best choice because by that time, the patient might already be feeling disoriented and anxious, which could lead to agitation. Option C) When the patient becomes agitated or frightened is reactive rather than proactive and may not effectively prevent agitation. Option D) When the patient can be aroused and recognizes where he or she is might be too late as the patient could already be in a state of distress before reaching that point. Educationally, this question highlights the importance of proactive nursing interventions in preventing patient agitation and promoting a smooth recovery process. It emphasizes the significance of timely communication and patient-centered care in the post-anesthesia setting, where patients are vulnerable and require support to navigate the transition from sedation to wakefulness.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Hypoxemia. When a patient in the PACU exhibits emergence delirium with agitation and thrashing, the nurse's first priority should be to assess for hypoxemia. Hypoxemia can lead to altered mental status, including delirium, so addressing this issue is crucial to ensure the patient's safety and well-being. The nurse should assess the patient's oxygen saturation levels, respiratory rate, and lung sounds to determine if there is any impairment in oxygenation. Option B) Neurologic injury is not the most immediate concern in this situation. While neurologic injury is always a potential risk in any patient, the patient's current symptoms are more indicative of hypoxemia rather than neurologic injury. Option C) Distended bladder and option D) Cardiac dysrhythmias are also important considerations in postoperative patients, but they are not the priority in a patient presenting with emergence delirium and agitation. These issues can be assessed once the patient's oxygenation status has been addressed. In an educational context, this question highlights the importance of prioritizing patient assessments based on the presenting symptoms and potential complications. It emphasizes the need for nurses to quickly identify and address critical issues to ensure patient safety and optimal outcomes. Understanding the rationale behind prioritizing assessments can help nurses make informed clinical decisions in fast-paced and high-stress environments like the PACU.

Correct Answer: D

Rationale: In this question, the correct answer is option D) Indwelling catheter. An indwelling catheter, also known as a Salem Sump or Levin tube, is specifically designed to drain gastric contents. It is inserted through the nose or mouth, down the esophagus, and into the stomach to remove stomach contents, provide decompression, or administer enteral feedings. Option A) T-tube is incorrect as it is typically used for bile drainage after gallbladder surgery, not gastric drainage. Option B) Hemovac is incorrect as it is a closed wound drainage system used to remove blood and other fluids from a surgical site, not gastric contents. Option C) Nasogastric tube is incorrect in this context as it is used for various purposes such as decompression, feeding, or medication administration, but it is not specifically designed to drain gastric contents like an indwelling catheter. Educationally, understanding the purpose and appropriate use of different types of tubes in clinical practice is crucial for nursing students and healthcare professionals. It is essential to differentiate between various tubes to provide safe and effective patient care based on their specific indications and functions. This knowledge helps in preventing complications and ensuring proper treatment interventions for patients requiring tube management.