Special needs of older adults undergoing surgery

AORN Journal,  March, 2008  by Judith L. Clayton

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1. anticonvulsants.

2. antidepressants.

3. certain diuretics and blood thinners.

4. corticosteroids.

5. thyroid medications.

a. 2 and 3

b. 1, 4, and 5

c. 1, 3, 4, and 5

d. 1, 2, 3, 4, and 5

4. Unless absolutely necessary, nurses should not shave or clip the hair of an older adult patient undergoing surgery because

1. shaving and clipping may traumatize the skin, increasing the risk of postoperative infection.

2. hair growth is decreased especially in the pubic and axillary regions so hair removal may be unnecessary.

3. the skin is likely to be thin, dry, and wrinkled, making shaving more difficult.

a. 1

b. 2

c. 1 and 2

d. 1, 2, and 3

5. It is especially important to prevent intraoperative hypothermia in older adult patients because

1. the metabolism of older adults is decreased.

2. shivering can increase cardiac output and ventilation, which increases oxygen consumption and deprives the heart and brain of necessary oxygen.

3. awakening and the return of reflexes is delayed because of the slowing of metabolism that occurs with hypothermia.

4. an older person's body temperature is normally lower.

a. 1 and 3

b. 2 and 4

c. 1, 2, and 3

d. 1, 2, 3, and 4

6. Older adult patients are prone to hypovolemia because

1. serum levels of fluid-reducing hormones and sodium may be increased by pain, medications, and anesthetics.

2. the cardiovascular system has a decreased ability to expand.

3. the kidneys are no longer able to reabsorb or secrete electrolytes.

4. most older adults have a altered skin integrity, which affects the patient's ability to perspire.

a. 1 and 3

b. 2 and 4

c. 1, 2, and 3

d. 1, 2, 3, and 4

7. Unless extreme caution is taken, placing an older adult patient who has osteoporosis into the lateral or lithotomy position could cause a femoral head fracture or lumbar spine strain.

a. true

b. false

8. Prolonged pressure behind the ankle when the patient's feet are crossed may result in tibial nerve injury that may be reflected as

1. loss of the autonomic nervous system response to pain.

2. motor loss of the calf muscles.

3. neuroendocrine abnormalities of the superficial sweat glands of the feet.

4. sensory loss of the skin on the soles of the feet.

a. 1 and 3

b. 2 and 4

c. 1, 2, and 3

d. 1, 2, 3, and 4

9. The risks presented by anesthetic agents are the same for older adult patients as for younger patients.

a. true

b. false

10. Pain medications should be administered judiciously to older adults because they have decreased responses to pain and delayed renal and hepatic clearance of medications.

a. true

b. false

The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.

This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.