Exam 12: Surgery of the Biliary Tract, pancreas, liver, and Spleen

The Whipple procedure is the removal of the head of the pancreas,the entire duodenum,a portion of the jejunum,the distal third of the stomach,and the ____________ as a surgical treatment for____________.

The donor liver OR is prepared for an open laparotomy procedure with basic laparotomy and vascular instruments and accessories.A second sterile,draped medium-sized instrument table is set up to receive and prepare the procured liver away from the main sterile field.Select the additional instruments and accessories needed on the donor organ preparation table.

A 52-year-old man,9 days post liver transplant,presents to the ER with tachycardia,fever,right upper quadrant pain and jaundice.These symptoms are reflective of what postoperative complication?

A 9-year-old boy is admitted to the emergency department (ED)after a sledding accident in which he lost control of his sled and crashed into a tree.He is pale and in pain; his abdomen is tender and firm to palpation.The computed tomography (CT)scan suggests rupture of the spleen with internal bleeding.The scheduled surgery will most probably be a(n):

The functional units of the liver are the lobules.The functional cells of the liver are the ______________,and they manufacture _______________.

A 29-year-old man with paraplegia caused by a spinal cord injury from a diving accident 4 years ago is scheduled for an open cholecystectomy.The perioperative nurse conducts a preoperative assessment to prepare for his procedure.The patient tells the nurse that he is latex-sensitive because he was told that as a spinal cord injured person he should always be considered latex-allergic.An appropriate risk reduction strategy for the patient's latex sensitivity/allergy would be to:

Review the list below and select the first step the perioperative nurse must accomplish as a best practice for donor organ identification.

A 42-year-old woman from India is visiting her daughter and new grandson.She is a devout follower of Hindu religious practices and has been diagnosed with splenomegaly,possibly from idiopathic thrombocytopenia.The patient is scheduled for a total splenectomy.During the preoperative assessment,the perioperative nurse,an observant practitioner of Hinduism,is concerned about the possibility of significant bleeding because of the patient's coagulopathy and the need for hemostatic agents that are typically used to stop bleeding.Many of these products are manufactured from bovine source products,and it would be in conflict with the patient's religion to use products from a cow.An appropriate risk-reduction strategy for selection of hemostatic agents that would not be in conflict with the patient's belief system would be:

The head of the pancreas is fixed to the:

The recipient liver OR is arranged for a major laparotomy and vascular procedure with customized instruments,supplies,and sutures according to the transplant surgeon's preference.In addition to the general patient care accessories,equipment,and supplies needed for any large surgery,also included are intraoperative laboratory testing and an autotransfusion system.Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant.

What technologic characteristic of robotic surgery provides a superior indication for robotic-assisted laparoscopic cholecystectomy?

The liver is essential in the metabolism of carbohydrates,proteins,and fats,generating nutrient stores of which substance that supplies energy sources to the brain and body?

The liver,pancreas,and spleen share many similarities.Select the statement about these organs that is true.

The biliary system (also called the biliary tree)drains bile from the gallbladder to the ampulla of Vater.The primary function of the gallbladder is to:

Both Maryanne and Charles Rigler had surgery 6 days ago.Charles had a living-related donor liver transplant and Maryanne,the matched donor,provided a segment of her healthy liver for her husband.They have both recovered as expected and are preparing for discharge.They are concerned about who will be the primary caregiver,because they are both recovering at the same time and rate.They also realize that they will need clear and realistic instructions and support because of their unique situation.They are most concerned about incision care,symptoms that could mean complications,nutrition,and activity restrictions and escalation.An appropriate risk reduction strategy for Maryanne and Charles would give first priority to:

While the pancreas' function is carbohydrate metabolism with the production of insulin and digestive enzymes,the spleen's function is primarily ___________ with the production of _______________.

A 51-year-old male with hepatobiliary disease is scheduled for surgery.The perioperative nurse,during the preoperative assessment,questions and examines the patient for signs and symptoms of jaundice,petechiae,and lethargy and:

The circulating nurse approaches the preoperative holding lounge to see her next patient,a 57-year-old nurse,newly diagnosed with pancreatic cancer.He had an endoscopic retrograde cholangiopancreatography (ERCP)1 week ago and,based on the findings,was scheduled for surgery at the comprehensive cancer center,where he works in the interventional endoscopy unit.He is aware of the poor prognosis for this disease,and the nurse has recorded his nursing diagnosis as anxiety related to impending surgical procedure,perioperative events,and surgical outcome.An appropriate nursing action for the patient would be to:

A perioperative nurse was the scrub person during a robotic-assisted laparoscopic cholecystectomy.She locked the robotic endoscissor into the adaptor on the robotic arm and positioned the tip end into the trocar port in order for the surgeon to dissect the cystic duct and artery,while the surgical assistant placed the clips on the cystic duct and artery.As she reached across the sterile field to insert the cholangiocatheter through the port,the anesthesia provider accidentally made contact with the distal end of the catheter as he stood up to reach the monitor controls.The contaminated end of the catheter touched the endoscopic clip applier,the endoscissor connector that the surgeon was using,the glove of the assistant,and the perioperative nurse's gown sleeve.The surgeon ordered everyone to change their gown and gloves and covered the port area with a sterile towel.What was the rationale for the surgeon to continue to dissect and not change his attire?

A 39-year-old,248-lb mother of four children is assisted with transfer from a transport vehicle to the OR bed for laparoscopic cholecystectomy,operative cholangiogram,and possible CBD exploration.The perioperative nurse identifies that the patient is at risk for positional injury related to her size and the positional requirements and OR bed manipulations required for this procedure.An appropriate nursing implementation for positioning this patient would be to: