2.6 Learning Activities

Preoperative Case Study (Case Study answers are located in the Answer Key at the end of the book.)^[1]

Agnes Smith, a 42-year-old woman, underwent total hysterectomy under general anesthesia this morning. During the admission assessment, the client mentions to the nurse that her last menses was two months ago and that the bleeding was heavier than usual, which she assumes is why her surgeon is recommending the surgery. Agnes is unclear if her hysterectomy will be vaginal or abdominal. The client denies taking any prescription medicines but does mention taking aspirin or Tylenol 2 tablets “one or two times per day for pain in her knee.” Agnes is tearful and states, “I have never had surgery. I am afraid of ‘going under.’”

1) What information do you need to know or gather about this client before surgery occurs? Why?

2) Describe the teaching topics that should be provided. How should teaching needs be prioritized?

3) What lab tests and other diagnostic tests should be completed? Why?

4) Is there any information that should be shared with the surgeon or anesthesiologist?

5) What interventions can be used to reduce the client’s anxiety?

6) Based upon the information provided, what type of surgery is being described?

7) What medications might be given preoperatively to this client and why?

8) If the client was 88 years old, how should preoperative care be modified to meet the needs of an older adult?

9) What risks are more likely with an older adult?