Chapter·SurgeryPost-op care

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1

The surgical equipment used during a craniectomy is sterilized using pressurized steam at 121°C for 15 minutes. Reuse of these instruments can cause transmission of which of the following pathogens?

ANon-enveloped viruses

BSporulating bacteria

CPrions

DEnveloped viruses

EYeasts

2

A 56-year-old previously healthy woman with no other past medical history is post-operative day one from an open reduction and internal fixation of a fractured right radius and ulna after a motor vehicle accident. What is one of the primary ways of preventing postoperative pneumonia in this patient?

AShallow breathing exercises

BIncentive spirometry

COutpatient oral antibiotics

DHyperbaric oxygenation

EIn-hospital intravenous antibiotics

3

A 22-year-old man is brought to the emergency department by his friends 30 minutes after falling down a flight of stairs. His friends report that they were at a college party, where he drank large amounts of alcohol. He is aggressive and restless. Examination shows tenderness to palpation and swelling of his right lower leg. An x-ray of the right leg shows a lower tibial shaft fracture. The physician recommends overnight observation and surgery the following morning. The patient refuses the suggested treatment and requests immediate discharge. Otherwise, he says, he will call his lawyer and sue the entire medical staff involved in his care. Which of the following is the most appropriate response by the physician?

AYou can leave the hospital after signing a self-discharge against medical advice form.

BIf you don't consent to treatment, I'll be forced to obtain consent from your parents.

CI understand that you want to go home, but I'll have to keep you here as long as you are intoxicated.

DHave you ever felt you should cut down on your drinking?

EI can't force you to stay here, but I'll have to inform your dean of this incident.

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