The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [632]
Wu, M.P., Ou, C.S., Chen, S.L. et al. (2000) Complications and recommended practices for electrosurgery in laparoscopy. American Journal of Surgery, 179 (1), 67–73.
Multiple choice questions
1 Accurate postoperative observations are key to assessing a patient’s deterioration or recovery. The Modified Early Warning Score (MEWS) is a scoring system that supports that aim. What is the primary purpose of MEWS?
a Identifies patients at risk of deterioration.
bIdentifies potential respiratory distress.
c Improves communication between nursing staff and doctors.
d Assesses the impact of pre-existing conditions on postoperative recovery.
2 Why is it important that patients are effectively fasted prior to surgery?
a To reduce the risk of vomiting.
b To reduce the risk of reflux and inhalation of gastric contents.
c To prevent vomiting and chest infections.
d To prevent the patient gagging.
3 What are the principles of gaining informed consent prior to planned surgery?
a Gaining permission for an imminent procedure by providing information in medical terms, ensuring a patient knows the potential risks and intended benefits.
b Gaining permission from a patient who is competent to give it, by providing information, both verbally and with written material, relating to the planned procedure, for them to read on the day of planned surgery.
c Gaining permission from a patient who is competent to give it, by informing them about the procedure and highlighting risks if the procedure is not carried out.
d Gaining permission from a patient who is competent to give it, by providing information in understandable terms prior to surgery, allowing time for answering questions, and inviting voluntary participation.
4 Safe moving and handling of an anaesthetized patient is imperative to reduce harm to both the patient and staff. What is the minimum number of staff required to provide safe manual handling of a patient in theatre?
a 3 (1 either side, 1 at head).
b 5 (2 each side, 1 at head).
C 4 (1 each side, 1 at head, 1 at feet).
D 6 (2 each side, 1 at head, 1 at feet).
5 Why are antiembolic stockings an effective means of reducing the potential of developing a deep vein thrombosis?
a They promote arterial blood flow.
b They promote venous blood flow.
c They reduce the risk of postoperative swelling.
d They promote lymphatic fluid flow, and drainage.
6 You are looking after a postoperative patient and when carrying out their observations, you discover that they are tachycardic and anxious, with an increased respiratory rate. What could be happening? What would you do?
a The patient is showing symptoms of hypovolaemic shock. Investigate source of fluid loss, administer fluid replacement and get medical support.
b The patient is demonstrating symptoms of atelectasis. Administer a nebulizer, refer to physiotherapist for assessment.
c The patient is demonstrating symptoms of uncontrolled pain. Administer prescribed analgesia, seek assistance from medical team.
d The patient is demonstrating symptoms of hyperventilation. Offer reassurance, administer oxygen.
7 These multiple choice questions are also available for you to complete online. Visit www.royalmarsdenmanual.com and select the Student Edition tab.
Chapter 15
Wound Management
Overview
The aim of this chapter is to provide an overview of wound care principles and current practice in managing acute surgical wounds, plastic surgical approaches and wounds related to oncology and cancer treatment.
Wounds
Definition
A wound can be defined as an injury to living tissue, breaking its continuity (Martin 2010). Wounds can be divided into six basic categories:
1 contusion (bruise)
2 abrasion (graze)
3 laceration (tear)
4 incision (cut)
5 puncture (stab)
6 burn.
Both external and internal factors can contribute to the formation of a