A nurse is interviewing a client who is scheduled for a surgical ...

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A nurse is interviewing a client who is scheduled for a surgical procedure using nitrous oxide. Which statement by the client is most important for the nurse to communicate to the surgeon?
 
  1. I've never had any type of surgery before this.
  2. The last surgery I had was done under spinal anesthesia.
  3. I take St. John's wort daily to decrease my tendency toward depression.
  4. I have a fear of enclosed spaces.

Question 2

Which nursing action would be best to help a client clear nitrous oxide anesthesia from the system?
 
  1. Run intravenous fluids at 125 mL/hr for several hours after the procedure.
  2. Keep the client NPO for at least 2 hours after the procedure.
  3. Have the client deep breathe several times each hour for several hours after the procedure.
  4. Monitor urine output every hour for at least 4 hours after the procedure.

[ApricotDream]

Answer to Question 1

Correct Answer: 3
Rationale 1: While this is an important finding, it is not the highest priority.
Rationale 2: This is important, but not the most important statement.
Rationale 3: St. John's wort should be discontinued 2 to 3 weeks prior to administration of general anesthesia due to possible hypotension risk.
Rationale 4: This fear is not a significant finding for this situation.
Global Rationale: St. John's wort should be discontinued 2 to 3 weeks prior to administration of general anesthesia due to possible hypotension risk. Telling the surgeon that the client has never had any type of surgery in the past or that the last surgery was done under spinal anesthesia are both important, but are not the highest priority. The fear of enclosed spaces is not a significant finding for this situation.

Answer to Question 2

Correct Answer: 3
Rationale 1: Increasing fluids will not help clear nitrous oxide from the system.
Rationale 2: Keeping the client NPO has no impact on clearance of nitrous oxide.
Rationale 3: Nitrous oxide is cleared through the respiratory system, and deep breathing will help in this process.
Rationale 4: Monitoring urine output will not help clear nitrous oxide.
Global Rationale: Nitrous oxide is cleared through the respiratory system, and deep breathing will help in this process. Increasing fluids will not help clear nitrous oxide from the system. Keeping the client NPO has no impact on clearance of nitrous oxide. Monitoring urine output will not help clear nitrous oxide.

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