Test 1 Preparation (Tue.

9/6)

Patient Reviews
Perioperative Nursing:
1. OR: Susan Smith- Left breast biopsy
2. PACU: M. Potter- Inguinal Hernia Repair/ general anesthesia and Mrs. Paul- Hip
fracture/ spinal anesthesia
Perioperative Care: John Hale 1 and John Hale 2: Two different reviews; one a day
surgery and the other an admit the morning of surgery

Maternity: Problems of pregnancy

Lily Larson: Pregnancy Induced Hypertension
A 17-year-old primigravida who develops pregnancy- induced hypertension.
Lily Larson is a 17-year-old primigravida who has come to the prenatal clinic where you
work. She says she is about seven months pregnant. This is her first visit for prenatal
care. She has come to the clinic because she knows "my baby is due soon."
Lily lives with her grandmother in a two-bedroom house near the clinic. She has no
health insurance, and her grandmother receives a small income from Social Security.
Lily says she feels "Okay, but tired." She had been attending the eleventh grade in high
school until she dropped out three months ago. She is currently working part-time in a
drug store, but plans to go back to school after her baby is born. Right now she is
working to "save money for me and my baby."

Case Studies

Pain:
Perioperative Care
Medical-Surgical:
Breast Cancer
Sandra
Breast Self-Examination and Patient Instruction

1. Lie down and place your left arm behind your head. Lying down spreads the
breast tissue evenly and thinly over the chest wall, making it easier to feel
the tissue.
2. Use finger pads of the three middle fingers on your right hand to feel for
lumps in the left breast. Use overlapping dime-sized circular motions to feel
the breast tissue. Use three different levels of pressure to feel the breast
tissue. Light pressure to feel the tissue closest to the skin; medium
pressure to feel a little deeper; and firm pressure to feel the tissue closest
to the chest and ribs. A firm ridge in the lower curve of each breast is
normal.
3. The up-and-down (vertical) pattern is recommended for examining the
entire breast. Move around the breast in an up-and-down pattern starting at
an imaginary line straight down your side from the underarm and moving
across the breast to the middle of the sternum. Examine the entire breast
going down until you feel only ribs and up to the neck or clavicle. Repeat
the procedure while examining your right breast.
4. Stand in front of a mirror. Place your hands firmly on your hips, which will
tighten the pectoral muscles. Look at your breasts for size, shape, redness,
scaliness, or dimpling of the breast skin or nipple.
5. Examine each underarm while standing or sitting with arm slightly raised.
Check for any lump, hard knot, or thickening of tissue.

Answer direct, clear questions directly and clearly (not open-endedly)

Obstetrics:
Pre-eclampsia