Which of the following postoperative patients is at greatest risk for respiratory complications?
A 36-year-old male who had a minimally invasive appendectomy. The patient had community-acquired pneumonia a year ago.
A 58-year-old female with a history of type 1 diabetes. The patient had an incision and drainage of an abscess with procedural sedation.
A 19-year-old male having arthroscopic knee surgery under regional anesthesia. The patient has a history of exercise-induced asthma.
A 65-year-old female who has a BMI of 32 and a long history of tobacco use. The patient had upper abdominal surgery under general anesthesia.
The Correct Answer is D
Choice A reason:
A 36-year-old male who had a minimally invasive appendectomy and a history of community-acquired pneumonia a year ago is at relatively low risk for postoperative respiratory complications. Minimally invasive surgeries typically have fewer complications, and a past episode of pneumonia does not significantly increase the risk unless there are ongoing respiratory issues.
Choice B reason:
A 58-year-old female with type 1 diabetes who had an incision and drainage of an abscess with procedural sedation has some risk factors for complications, such as diabetes, which can impair healing and immune response. However, the procedure was minor and performed under sedation, which poses less risk compared to general anesthesia.
Choice C reason:
A 19-year-old male undergoing arthroscopic knee surgery under regional anesthesia with a history of exercise-induced asthma has a low risk of respiratory complications. Regional anesthesia does not affect the respiratory system as much as general anesthesia, and exercise-induced asthma is generally well-controlled and less likely to cause complications in this context.
Choice D reason:
A 65-year-old female with a BMI of 32 and a long history of tobacco use who underwent upper abdominal surgery under general anesthesia is at the greatest risk for respiratory complications. Factors such as advanced age, obesity, smoking history, and the type of surgery (upper abdominal) significantly increase the risk of postoperative pulmonary complications. General anesthesia further exacerbates this risk due to its effects on respiratory function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Reducing rebreathing of exhaled air is not a primary characteristic of a Venturi mask. This feature is more associated with non-rebreather masks, which have a one-way valve to prevent exhaled air from being inhaled again.
Choice B reason:
Delivering high percentages of oxygen at flow rates of 10 to 15 L/min is not specific to Venturi masks. Non-rebreather masks are typically used for high oxygen flow rates. Venturi masks are designed to deliver precise oxygen concentrations at lower flow rates.
Choice C reason:
Providing a precise amount of oxygen is the key characteristic of a Venturi mask. Venturi masks are equipped with color-coded adapters that allow for the delivery of specific oxygen concentrations, regardless of the patient’s breathing pattern.
Choice D reason:
Working independently of client breathing factors and flow of oxygen is not entirely accurate. While Venturi masks do provide a consistent oxygen concentration, they still depend on the flow of oxygen set by the healthcare provider.
Correct Answer is A
Explanation
Choice A reason:
Hemoglobin, 8.0 g/dL: Hemoglobin is a critical component of red blood cells, responsible for carrying oxygen throughout the body. Normal hemoglobin levels typically range from 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women1. A level of 8.0 g/dL is significantly below the normal range, indicating anemia. Severe anemia can increase the risk of perioperative complications, including poor wound healing, increased risk of infection, and cardiovascular stress. Therefore, this result should be reported to the surgeon as it may necessitate postponing the surgery until the anemia is addressed.
Choice B reason:
Serum creatinine, 0.8 mg/dL: Creatinine is a waste product produced by muscles and filtered out of the blood by the kidneys. Normal serum creatinine levels range from 0.74 to 1.35 mg/dL for men and 0.59 to 1.04 mg/dL for women. A level of 0.8 mg/dL falls within the normal range, indicating normal kidney function. Therefore, this result would not typically cause surgery to be postponed.
Choice C reason:
Platelets, 210,000/mm³: Platelets are essential for blood clotting. Normal platelet counts range from 150,000 to 400,000/mm³. A count of 210,000/mm³ is within the normal range, indicating adequate clotting ability. Thus, this result would not be a reason to postpone surgery.
Choice D reason:
Sodium, 144 mEq/L: Sodium is an essential electrolyte that helps regulate fluid balance, nerve function, and muscle contractions. Normal sodium levels range from 135 to 145 mEq/L. A level of 144 mEq/L is within the normal range, indicating normal electrolyte balance. Therefore, this result would not typically cause surgery to be postponed.
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