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OR Nurse:
doi: 10.1097/01.ORN.0000434524.65462.8f
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Laparoscopic surgery: A cut above the rest?

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INSTRUCTIONS Laparoscopic surgery: A cut above the rest?


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Laparoscopic surgery: A cut above the rest?

General Purpose: The purpose of this learning activity is to provide information about the advantages and disadvantages of laparoscopic surgery. Learning Objectives: After reading this article and taking this test, the nurse will be able to: 1. Discuss the techniques used to establish a pneumoperitoneum. 2. Recognize complications of laparoscopic surgery. 3. Describe nursing considerations related to laparoscopic surgery.

1. Laparoscopy allows for visualization of the abdominal cavity through the use of a

a. port.

b. endoscope.

c. retractor.

d. trocar.

2. Pneumoperitoneum is achieved by insufflating the abdomen to a pressure of

a. 0 to 5 mm Hg.

b. 6 to 10 mm Hg.

c. 12 to 15 mm Hg.

d. 25 to 30 mm Hg.

3. The most suitable gas to create the pneumoperitoneum is

a. air.

b. carbon dioxide.

c. oxygen.

d. nitrous oxide.

4. Which surgical technique uses a Veress needle to access the abdomen?

a. closed access

b. open access

c. direct visual access

d. laser-assisted access

5. A failed drop test indicates that the Veress needle is

a. in the proper place.

b. malpositioned.

c. clogged.

d. bent.

6. The incidence of complications occurring during laparoscopic procedures is

a. 1% to 5%.

b. 6% to 9%.

c. 10% to 12%.

d. d.13% to 15%.

7. Complications of laparoscopic procedures include all categories except

a. complications of access.

b. complications during the procedure.

c. physiologic complications related to pneumoperitoneum.

d. physiologic complications related to closure.

8. A serious complication associated with the closed technique is injury to the

a. Kidneys.

b. Bowel.

c. lungs.

d. liver.

9. Which symptom is not apparent within 2 to 4 days following small bowel injury?

a. lower abdominal pain

b. fever

c. nausea

d. elevated WBC count

10. The most fatal complication associated with laparoscopic surgery is

a. liver injury.

b. lung injury.

c. bowel injury.

d. vascular injury.

11. Pneumoperitoneum causes which acid-base imbalance?

a. metabolic acidosis

b. metabolic alkalosis

c. respiratory acidosis

d. respiratory alkalosis

12. The most frequent complication of laparoscopic surgery is

a. infection.

b. hemorrhage.

c. electrosurgical injury.

d. urologic injury.

13. Patients with which disorder are at particular risk for death from pneumoperitoneum?

a. hypertension

b. sickle cell disease

c. heart failure

d. asthma

14. Women with a previous cesarean section may be at high risk for

a. laser injury.

b. necrotizing faciitis.

c. bladder injury.

d. bowel injury.

15. The most common respiratory complication of laparoscopy is

a. pneumothorax.

b. subcutaneous emphysema.

c. carbon dioxide embolism.

d. endobronchial intubation.

16. Treatment of a gas embolism consists of placing the patient in which position?

a. right lateral head up

b. right lateral head down

c. left lateral head up

d. left lateral head down

17. A nursing care priority immediately postoperatively is to monitor for

a. bloating.

b. pain.

c. elevated WBC count.

d. infection.

18. To minimize the risk of postoperative complications after discharge, patients should be encouraged to

a. move and walk as much as tolerated.

b. continue on a clear liquid diet.

c. elevate the head of bed.

d. gently clean the umbilicus with a cotton swab.

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