The nurse is reviewing the informed consent form with a client who is scheduled for surgery with regional anesthesia. Which of the following statements by the client indicates a need for further teaching? (Select all that apply.)

"I will not be able to move or feel anything below my waist.”

"I will have to stay awake during the surgery.”

"I will need someone to drive me home after the surgery.”

"I will have less risk of nausea and vomiting than with general anesthesia.”

"I will have to fast for at least 8 hours before the surgery.".

Answer and Explanation

Correct Answer : B,C

Choice A reason:

This statement is correct. Regional anesthesia blocks the sensation of pain and other sensations from a specific part of the body, such as below the waist for spinal or epidural anesthesia. The client will not be able to move or feel anything in the affected area during the surgery.

Choice B reason:

This statement is incorrect. Regional anesthesia does not require the client to stay awake during the surgery, unless the client prefers to do so. The client can also receive sedation or general anesthesia along with regional anesthesia, depending on the type and duration of the surgery and the client's preference.

Choice C reason:

This statement is incorrect. Regional anesthesia can have residual effects on the client's motor and sensory function, as well as blood pressure and heart rate, for several hours after the surgery. The client will need someone to drive them home after the surgery and monitor them for any signs of complications.

Choice D reason:

This statement is correct. Regional anesthesia has some advantages over general anesthesia, such as less risk of nausea and vomiting, less blood loss, less stress response, and better postoperative pain control.

Choice E reason:

This statement is correct. Regional anesthesia does not affect the client's ability to swallow or protect their airway, unlike general anesthesia. However, the client will still have to fast for at least 8 hours before the surgery to prevent aspiration of stomach contents in case general anesthesia or sedation is needed or administered.

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Correct Answer is D

Explanation

Choice A reason:

Removing dentures, glasses, contact lenses, jewelry and nail polish is part of the physical preparation of the client before surgery. These items can interfere with the anesthesia, cause injury, or be lost during the procedure.

Choice B reason:

Administering a sedative or anxiolytic medication as prescribed is part of the preoperative medication of the client before surgery. These medications can help reduce anxiety, pain, nausea, and vomiting, and facilitate induction of anesthesia.

Choice C reason:

Marking the surgical site with an indelible marker is part of the patient identification and verification process before surgery. This helps prevent wrong-site, wrong-procedure, or wrong-person surgery by ensuring that the correct site is marked and confirmed by the client, surgeon, and nurse.

Choice D reason:

All of the above. All of these items should be completed before transferring the client to the operating room as part of the preoperative checklist. The checklist ensures that necessary documentation, admission assessment, physical preparation, and client education have been completed before the client enters the surgical suite.

A. Placing a pillow under the dependent axilla. B. Flexing both knees at a 90-degree angle. C. Aligning the shoulders directly over each other. D. Elevating the dependent arm on an arm board.

Correct Answer is A

Explanation

Choice A reason:

Placing a pillow under the dependent axilla is a proper technique for lateral positioning because it helps to prevent brachial plexus injury by reducing the pressure on the neurovascular structures in the axilla. It also helps to maintain the alignment of the shoulder and prevent shoulder drop.

Choice B reason:

Flexing both knees at a 90-degree angle is not a proper technique for lateral positioning because it can cause excessive pressure on the knees and ankles, leading to nerve injury or skin breakdown. It can also impair venous return and increase the risk of deep vein thrombosis (DVT) Only the dependent leg should be flexed at the hip and knee, while the upper leg should be straight and supported by pillows between the legs.

Choice C reason:

Aligning the shoulders directly over each other is not a proper technique for lateral positioning because it can cause compression of the dependent shoulder and compromise the blood supply to the arm. It can also cause shoulder drop and brachial plexus injury. The lower shoulder should be pulled slightly forward and supported by a pad under the chest wall.

Choice D reason:

Elevating the dependent arm on an arm board is not a proper technique for lateral positioning because it can cause excessive abduction of the arm and stretch the brachial plexus. It can also interfere with surgical access to the thorax or kidney. Both arms should be supported on parallel arm boards with abduction less than 90 degrees.

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The nurse is reviewing the informed consent form with a client who is scheduled for surgery with regional anesthesia. Which of the following statements by the client indicates a need for further teaching? (Select all that apply.)

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