DON‌‌MARIANO‌‌MARCOS‌‌MEMORIAL‌‌STATE‌‌UNIVERSITY‌‌‌

South‌‌La‌‌Union‌‌Campus‌‌‌
COLLEGE‌‌OF‌‌COMMUNITY‌‌HEALTH‌‌AND‌‌ALLIED‌‌MEDICAL‌‌SCIENCES‌‌‌
Agoo,‌‌La‌‌Union‌‌‌
T
‌ el.‌ ‌072.682.0663‌

Embracing‌‌World‌‌Class‌‌Standards ‌ Care‌‌to‌‌learn,‌
‌Learn‌‌to‌‌care‌
Name: ___Ramos, Andrea_________________________Section:BSN2-C_____
Subject: NUPC 113 Date: September , 2022
ACTIVITY 1

You are caring for a patient who is scheduled for surgery, which must be performed under general
anesthesia, to alleviate pain and stabilize the spinal column. During the preoperative assessment in
which the patient's husband is present, you ask the patient if she has had anything to eat or drink since
midnight. The patient states, “I have not eaten anything since midnight. I only drank a can of soda this
morning before I came to the hospital.” The patient's husband immediately responds, “This won't keep
her from having surgery, will it? I better not have to take off from work another day for this nonsense.”

1. What are the possible implications of the patient's consumption of soda before surgery?

Before receiving anesthesia and having surgery, a patient's stomach has to be empty to lower the risk
of aspiration.

2. What is your response to the patient's disclosure that she has consumed a can of soda on the morning
of the scheduled surgery?

Remind the patient that due to the risk of aspiration, they are not permitted to eat or drink after
midnight.

3. How would you address the husband's response?

Speak to the husband in a professional manner and assure him that every effort will be taken to keep
the patient safe while still trying to fulfill their timetable.

4. Would you tell the surgeon about the patient's consumption of soda? Why or why not?

You should let the surgeon know so that a decision may be made regarding the timing of your
operation and your soda consumption. The surgeon may order the stomach to be drained via a
nasogastric tube or the administration of a dopamine D2 receptor blocker, such as metoclopramide,
even if the procedure may need to be rescheduled.

5. What teaching will you provide at this time?

Whether the operation will be done today on a continuum will determine how the lesson is delivered.
Continue pre-operative education if the surgery is scheduled; if it is postponed, discuss appropriate
dietary limitations.
 DON‌‌MARIANO‌‌MARCOS‌‌MEMORIAL‌‌STATE‌‌UNIVERSITY‌‌‌
South‌‌La‌‌Union‌‌Campus‌‌‌
COLLEGE‌‌OF‌‌COMMUNITY‌‌HEALTH‌‌AND‌‌ALLIED‌‌MEDICAL‌‌SCIENCES‌‌‌
Agoo,‌‌La‌‌Union‌‌‌
T
‌ el.‌ ‌072.682.0663‌

Embracing‌‌World‌‌Class‌‌Standards ‌ Care‌‌to‌‌learn,‌
‌Learn‌‌to‌‌care‌
Activity 2

You are caring for a 70-year-old patient who was alert and oriented to person, place, and time during
the preoperative assessment. At that time, the patient confirmed that she has a current donot-
resuscitate (DNR) order in place and stated that she is “ready to die” if surgery to remove a malignant
tumor “does not go well.” During the surgery, complications arise, and members of the interprofessional
health care team prepare to administer life-saving measures.

1. How do you serve as the patient's advocate at this time?

As a nurse and healthcare professional, I may still engage in the role of a patient's advocate by
supporting patients' choices and, if necessary, helping colleagues make decisions on a patient's behalf.
This is an ethical responsibility.

2. What information do you communicate to the interprofessional health care team?

The DNR order is one of the pieces of information I should give to the multidisciplinary healthcare
teams. Therefore, it is advantageous to use a collaborative approach while making resuscitation
choices, talks about the patient's preferences with the medical team, the patient, and the patient's
family members.

3. Should the DNR order be suspended during surgery, especially if it appears that the patient can be
saved?

No, unless it is explicitly addressed beforehand, a DNR order cannot be suspended and remains in
effect during any operation or treatment.

4. What information will you share with the family when they ask why you did not save their loved one?

I shall inform or provide the patient's family members with the DNR order. Resuscitation efforts
should not be made in the uncommon case of cardiac or pulmonary arrest since a DNR is a medical
order from a licensed independent doctor, according to Donovan (2015). Employees will be educated
to discern between pre-arrest actions and resuscitation attempts since DNR orders are written in
legalese.
 DON‌‌MARIANO‌‌MARCOS‌‌MEMORIAL‌‌STATE‌‌UNIVERSITY‌‌‌
South‌‌La‌‌Union‌‌Campus‌‌‌
COLLEGE‌‌OF‌‌COMMUNITY‌‌HEALTH‌‌AND‌‌ALLIED‌‌MEDICAL‌‌SCIENCES‌‌‌
Agoo,‌‌La‌‌Union‌‌‌
T
‌ el.‌ ‌072.682.0663‌

Embracing‌‌World‌‌Class‌‌Standards ‌ Care‌‌to‌‌learn,‌
‌Learn‌‌to‌‌care‌
PRESTEST 3

Before you start our third lesson, let us check if you are ready to begin our course by answering this
pretest. It is all about Postoperative Nursing Care. Write your answer in a piece of paper. Good luck. Be
honest to yourself.

Identification: Give at least 2 potential problems postoperatively per system.

 Neuropsychologic
- Pain
-Fever
-Hypothermia
 Respiratory
- Aspiration
- Pneumonia
- Hypoxemia
 Gastrointestinal
- Nausea and vomiting
- Hiccups
- Distention and Flatulence
 Cardiovascular
- Hemorrhage
- Hypotension
- Hypertension
 Urinary
- Retention
- Infection

 Integumentary (Injection Site)

- Infection
- Hematoma
 Fluid and Electrolytes
- Fluid overload
- Fluid deficit
- Electrolyte Imbalance
 DON‌‌MARIANO‌‌MARCOS‌‌MEMORIAL‌‌STATE‌‌UNIVERSITY‌‌‌
South‌‌La‌‌Union‌‌Campus‌‌‌
COLLEGE‌‌OF‌‌COMMUNITY‌‌HEALTH‌‌AND‌‌ALLIED‌‌MEDICAL‌‌SCIENCES‌‌‌
Agoo,‌‌La‌‌Union‌‌‌
T
‌ el.‌ ‌072.682.0663‌

Embracing‌‌World‌‌Class‌‌Standards ‌ Care‌‌to‌‌learn,‌
‌Learn‌‌to‌‌care‌
ACTIVITY 3

You are caring for a 57-year-old patient who came from the OR to the postanesthesia recovery unit 30
minutes ago after surgery for a hernia repair. He responds when you say his name, but he is mildly
confused about where he is and why he is here. He continuously attempts to remove the oxygen
cannula from his nose and says it itches, but allows you to gently replace it several times. Vital signs
taken 15 minutes ago were BP 130/90, pulse 88, respirations 20. Vital signs now show BP 120/80, pulse
86, respirations 18.

1. Are any of the changes in vital signs a cause for concern? If so, which ones?

Yes, at this time, vitals signs are stable. Placing the nasal cannula back on the patient has likely
influenced the difference in vital signs from 15 minutes prior until now.

2. Should you be assessing for postsurgical bleeding? Why or why not? If so, where would you assess for
this bleeding?

Yes, you will assess every postsurgical patient for evidence of postsurgical bleeding. Analyze the
surgery site and the results from the laboratory.

3. Should you remove oxygen from the patient? Why or why not?

No, you won't take the oxygen away. Until a directive to stop using oxygen is received, it should be
continued. Make that the pulse oximetry is still reading at 95% or higher oxygen saturation.

4. Should you notify the surgeon or anesthesia provider? Why or why not?

While monitoring should continue, there is no need to alert the surgeon or anesthetic provider at this
time.
 DON‌‌MARIANO‌‌MARCOS‌‌MEMORIAL‌‌STATE‌‌UNIVERSITY‌‌‌
South‌‌La‌‌Union‌‌Campus‌‌‌
COLLEGE‌‌OF‌‌COMMUNITY‌‌HEALTH‌‌AND‌‌ALLIED‌‌MEDICAL‌‌SCIENCES‌‌‌
Agoo,‌‌La‌‌Union‌‌‌
T
‌ el.‌ ‌072.682.0663‌

Embracing‌‌World‌‌Class‌‌Standards ‌ Care‌‌to‌‌learn,‌
‌Learn‌‌to‌‌care‌
PRETEST 4
Before you start our fourth lesson, let us check if you are ready to begin our course by answering this
pretest. It is all about Surgical Instruments. Write your answer in a piece of paper. Good luck. Be
honest to yourself.

Matching Type: Match Column A to Column B

Cutting Instruments - SCALPES

Dissecting Instruments – PENFIELD

Debulking Instruments - OSTEOTOMES

Grasping and Holding Instruments – ADSON FORCEPS

Clamping and Occluding Instruments – HEANEY CLAMP

Retracting and Exposing Instruments – TOUNGE RETRACTOR

Closure and Approximation Instruments – NEEDLE HOLDER

Viewing Instruments – EAR SPECULUM

Aspiration, Instillation and Irrigation Instruments- SUCTION TUBES

Dilating and Probing Instruments – HEGAR DILATOR

Measuring Instruments - CALIPERS

Accessory Instruments - MALLET

 DON‌‌MARIANO‌‌MARCOS‌‌MEMORIAL‌‌STATE‌‌UNIVERSITY‌‌‌
South‌‌La‌‌Union‌‌Campus‌‌‌
COLLEGE‌‌OF‌‌COMMUNITY‌‌HEALTH‌‌AND‌‌ALLIED‌‌MEDICAL‌‌SCIENCES‌‌‌
Agoo,‌‌La‌‌Union‌‌‌
T
‌ el.‌ ‌072.682.0663‌

Embracing‌‌World‌‌Class‌‌Standards ‌ Care‌‌to‌‌learn,‌
‌Learn‌‌to‌‌care‌

ACTIVITY 4

ACTIVITY 4: Identify what is defined or described in the following statement. Write your answer in a
separate sheet and send your answer to jmamungay@dmmmsu.edu.ph. See the rubrics located in the
appendix on how your activity will be evaluated.

FORCEPS 1. Surgical Instrument with 2 blades and handle use for handling,
grasping or compressing.

DRESSING/BANDAGE SCISSORS2. It is used to cut dressing/gauze, drains, etc.

NEEDLE HOLDERS 3. It is used to grip needle with suture.

SCALPELS 4. It is used for the incision of skin.

CURETTES 5. Surgical instrument for scraping and cleaning a diseased surface

TOOTHED TISSUE FORCEPS 6. It has sharp teeth for grasping tougher tissues such as fascia or excised
tissue

MANUAL RETRACTORS 7. used to retract deep abdominal/chest incisions

RETRACTORS 8. used to hold back organs, tissues or incision edges for better operative
site exposure