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    ISPN综合测验 围手术期护理
    日期:2015-03-30 15:40:35    来源:奥医教育
    Perioperative Nursing Care
    围手术期护理
     
     
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    1. A nurse has just reassessed the condition of a postoperative client who was admitted 1 hour ago to the surgical unit. The nurse plans to monitor which of the following parameters most carefully during the next hour?
    1. Urinary output of 20 mL/hr
    2. Temperature of 37.6o C (99.6o F)
    3. Blood pressure of 100/70 mm Hg
    4. Serous drainage on the surgical dressing
    2. A postoperative client asks a nurse why it is so important to deep breathe and cough after surgery. When formulating a response, the nurse incorporates the understanding that retained pulmonary secretions in a postoperative client can lead to:
    1. Pneumonia
    2. Fluid imbalance
    3. Pulmonary embolism
    4. Carbon dioxide retention
    3. A nurse is developing a plan of care for a client scheduled for surgery. The nurse should include which activity in the nursing care plan for the client on the day of surgery?
    1. Have the client void immediately before going into surgery.
    2. Avoid oral hygiene and rinsing with mouthwash.
    3. Verify that the client has not eaten for the last 24 hours.
    4. Report immediately any slight increase in blood pressure or pulse.
    4. A client with a perforated gastric ulcer is scheduled for surgery. The client cannot sign the operative consent form because of sedation from opioid analgesics that have been administered. The nurse should take which appropriate action in the care of this client?
    1. Obtain a court order for the surgery.
    2. Send the client to surgery without the consent form being signed.
    3. Have the hospital chaplain sign the informed consent immediately.
    4. Obtain a telephone consent from a family member, following agency policy.




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