Deck 30: Individuals With Acute Surgical Conditions

Question 1

Elective surgery is:

A) not performed in the presence of an infection.
B) not hazardous for a patient with previous lung disease.
C) not influenced by the presence of premorbid cardiovascular disease.
D) not performed in the presence of anesthesia.

Answer 1

A
A patient with an active infection,such as a lower respiratory tract infection,will have surgery postponed until the infection has resolved.Elective surgery can be hazardous for a patient with previous lung disease,is performed in the presence of anesthesia,and can be influenced by premorbid cardiovascular diseases.

Question 2

Which of the following activities will address the postoperative risks of thromboemboli and pulmonary emboli?

A) Compression stockings
B) Ankle pumps
C) Ambulation
D) All of the above

Answer 2

D
The risks of pulmonary and thromboemboli increase after cardiothoracic and thoracic surgery secondary to the decreased movement and position changes that may be associated with postoperative lethargy and pain.All of these techniques can act as prophylaxis toward the increased risk of clot formation.

Question 3

All of the following are goals of immediate extubation after surgery EXCEPT:

A) maximize lung capacity.
B) decrease functional residual capacity.
C) increase cough effectiveness.
D) optimize alveolar ventilation.

Answer 3

B
Early extubation maximizes postoperative ventilation and secretion clearance.All of these options reflect maximizing postoperative ventilation except for a decrease in functional residual capacity.

Question 4

All of the following are true about postoperative analgesia EXCEPT:

A) it is often associated with nausea and vomiting.
B) it decreases the risk of aspiration.
C) it threatens oxygen transport.
D) it decreases arousal and responsiveness.

Question 5

The most common incision(s)used for thoracic surgery is/are ___________________?

A) posterolateral thoracotomy
B) median sternotomy
C) supraclavicular thoracotomy
D) a and b

Question 6

The _________position maximizes the length-tension relationship of respiratory muscles.

A) sitting erect
B) prone
C) side-lying
D) supine

Question 7

You have been consulted to evaluate and treat a patient after coronary artery bypass graft via sternotomy.All of the following would be appropriate treatment interventions EXCEPT:

A) postural drainage with percussion.
B) splinted coughing.
C) incentive spirometry.
D) ambulation.

Question 8

Incentive spirometry is:

A) more effective at removing secretions than huffing.
B) considered more effective than deep breathing for noncompliant patients.
C) detrimental to postoperative oxygenation.
D) used only when the patient is recumbent.

Question 9

Anesthesia results in:

A) decreased atelectasis.
B) depression of breathing.
C) increased functional residual capacity.
D) increased residual volume.

Question 10

Which of the following would promote postoperative complications after thoracic or cardiovascular surgery?

A) Deep breathing
B) Ambulation
C) Reduced arousal
D) Huffing

Question 11

Which of the following is an example of how thoracic or cardiovascular surgery is an insult to the body?

A) Fluid gain
B) Decreased energy requirements
C) Sedation
D) Blood transfusion

Question 12

You are performing preoperative counseling with a patient who will undergo coronary artery bypass grafting x 3 at the end of the week.Which of the following would be MOST appropriate preoperative counseling?

A) Review of modifiable patient risk factors
B) A detailed description of the surgical procedure
C) Preoperative informed consent
D) An overview of the risks associated with the surgical procedure

Question 13

Which of the following would be considered an extrinsic factor contributing to cardiovascular and pulmonary function in the postoperative period?

A) Surgical procedure
B) Patient's conditioning level
C) Hydration
D) Stress level

Question 14

All of the following would be considered modifiable perioperative risk factors EXCEPT:

A) type 2 diabetes.
B) obesity.
C) gender.
D) smoking.

Question 15

Which of the following statements is TRUE about thoracic and cardiovascular surgery?

A) Patients are at increased risk of aspiration postoperatively.
B) Irritation or compression of the phrenic nerve is not possible during surgery.
C) Artificial airways decrease the risk of postoperative complications.
D) Blood gasses do not indicate the need for mechanical ventilation.

Question 16

All of the following are typical upright exercises that can be used after cardiothoracic surgery EXCEPT:

A) lower extremity cycle pedals.
B) chair exercises with low intensity therabands.
C) chest press at 50% of 1 rep max.
D) all of the above are appropriate upright exercises.

Question 17

Rationale: Narcotics and postoperative analgesia are associated with increased risk of aspiration (not decreased), decreased O₂ transport, decreased arousal, and increased nausea and vomiting. All of these have implications to physical therapy interventions.
You are consulted on a patient after resection of the right lung for treatment of lung cancer.The patient has had no postoperative precautions,but you wish to implement treatment plans that will sustain alveolar inflation and functional residual capacity.According to the textbook,_______________________ is/are the most appropriate course of action to achieve these goals.

A) placing the patient in a recumbent position
B) maximal inspiratory maneuvers alone
C) mobilization and position changes
D) forced coughing

Question 18

Which of the following is TRUE regarding the typical pattern of breathing after surgery?

A) Spontaneous deep breaths are normal.
B) Tachypnea and tachycardia are rare.
C) Breath sounds are decreased and lung bases.
D) Mucus is not heard typically on auscultation.

Question 19

All of the following are true about the immediate postoperative period EXCEPT:

A) rest is as important as activity.
B) patients may be using patient-controlled analgesia (PCA).
C) therapists should determine the benefits of nonpharmacologic interventions.
D) oversedation results in an increased respiratory rate.

Question 20

All of the following are factors determining surgical response and outcomes EXCEPT:

A) the type of surgery performed.
B) the types of anesthetics and analgesics used.
C) the type and level of respiratory support given.
D) the type of fluids used during surgery.