SOLUTION: Mary Jones is a 64 year old woman scheduled for a lumbar 4-5 discectomy. She is 5’2” and weighs 210 lbs. She has a history of diabetes mellitus hypertension coronary artery disease (CAD) and used to smoke 1 pack of cigarettes per day for 20 years but quit smoking  25 years ago. She has a past surgical history of a cholecystectomy in 1997 with no complications. She currently takes the following medications: Insulin 4 units Regular every AM subcutaneous. Lisiniopril 20 mg every day PO. Aspirin 325 mg every day PO.

1) What are the nursing responsibilities of the perioperative nurse in the immediate preoperative period? What items are included on the preoperative checklist? (3 points),

2) Identify the priority nursing care assessments for Ms. Jones prior to her procedure. Explain why these assessments are necessary to her care. (3 points),

3) What are the surgeon and anesthesia provider responsible for obtaining from the patient prior to surgery to ensure informed consent? What must the patient consent to prior to the surgery being done? How would the nurse verify that informed consent has been obtained? (4 points)

SOLUTION: Mary Jones is a 64 year old woman scheduled for a lumbar 4-5 discectomy

4) What does it mean that Ms. Jones has an advance directive?  How will it apply to her surgical procedure? (2 points),

5) During the admission assessment, the nurse questions Ms. Jones to determine if there is a latex allergy or sensitivity.  Why is this essential to the patient’s safety?  What symptoms would the nurse question Ms. Jones about in order to determine an allergy or sensitivity? How should a latex allergy or sensitivity be addressed by the perioperative nurse? (3 points),

6) Which of Ms. Jones’s medications may be concerning to the nurse, and why? Should the patient be instructed to stop taking medications before surgery? (2 points) SOLUTION: Mary Jones is a 64 year old woman scheduled for a lumbar 4-5 discectomy,

 7) What preoperative teaching should the perioperative nurse include prior to the patient undergoing surgery? (3 points),

 8) Recently some institutions have shifted their practice to completing the perioperative interview in the OR rather than the OR holding area in an effort to save time between procedures. Why might this be concerning for the safety of the patient? Do you see a benefit to this this new approach? Please share your opinion. (5 points)

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