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A comprehensive overview of perioperative nursing practices and safety considerations in the operating room. It covers patient positioning, monitoring, electrical safety, laser use, documentation, and surgical equipment use. The document highlights the importance of following guidelines and protocols to ensure patient safety and minimize complications. It emphasizes the perioperative nurse's role in maintaining a safe and efficient operating room environment through proper identification and reporting of safety hazards, compliance with emergency plans, and adherence to electrical and fire safety practices.
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what is an appropriate action for a nurse assisting anesthesia? - ✔✔Apply cricoid pressure if needed during intubation What is not considered a basic monitor for anesthesia? - ✔✔Arterial line What drug is used to reverse valium and midazolam (Versed)? - ✔✔Flumazenil What method is used to prevent aspiration during endotracheal intubation? - ✔✔ How can the perioperative nurse assist eh provider with placement of a spinal or epidural block? - ✔✔Calm the patient During intravenous regional anesthesia (Bier Block), the tourniquet should be deflated slowly to prevent which of the following from the entering circulation? - ✔✔Bolus of anesthetic What is the most consistent indicator of malignant hyperthermia during a surgical intervention? - ✔✔unexplained increase in end title CO Which of the following can be provided without an anesthesia provider? - ✔✔ Which assessment factor is important to include when screening patients for potential risk of malignant hyperthermia? - ✔✔Family history of problems with anesthesia What are complications associated with laparoscopic surgery? - ✔✔CO2 embolism, Umbilical hernia
Identify some methods used to maintain a sterile camera head - ✔✔ which pieces of equipment are used in laparoscopic surgery? - ✔✔ Which options can the scrub person take to help prevent accidental thermal burns? - ✔✔inspect laparoscopic instrumentation for excessive wear replace instruments that have damaged insulation clean all instruments with sterile water identify one characteristic difference between laparoscopic surgery instruments and those used in open procedures - ✔✔Laparoscopic instruments have long thin shafts to accommodate trochar cannulas What region of the patients abdomen is traditionally used to establish pneumoperitoneum for laparoscopic surgery? - ✔✔ What is an important safety consideration when using a light source? - ✔✔Place the light in standby mode when not in use Carbon Dioxide is the gas used for abdominal insufflation because it - ✔✔is inexpensive suppresses combustion is rapidly eliminated from the body The single most Important factor in preventing the spread of infection is - ✔✔Hand hygiene Damp dusting of the OR as part of the preliminary room preparation should be done - ✔✔in the morning before bringing in surgical supplies Which methods are most effective for terminal cleaning the floors in the OR? - ✔✔damp mop with two mop system
what physiological effects are most likely to result from positioning a patient in lithotomy? - ✔✔Circulatory and respiratory compromise due to compression on the abdomen What are safety measures to take into consideration when placing the patient in a lateral position? - ✔✔Upper leg is straight and supported with pillows between the legs Lower arm on same plane as OR mattress; forearm and wrist in neutral positions; palm up The patients dependent ear should be assessed to ensure that it is not folded Documentation should include but is not limited to - ✔✔type of positioning devices used names of persons positioning the patient what are factors that should be considered in the periop assessment - ✔✔age nutritional status pre-existing conditions The use of PNDS helps a nurse to: - ✔✔Plan the nursing interventions assess and develop nursing diagnosis' assess and evaluate the patients status Evaluate responses to positioning A table flexed 90 degress for the _______ position is a variation of the _____ position - ✔✔jack-knife (kraske), prone What response is the result of tissue layers moving on each other - ✔✔Shearing What surgical positions adversely affect diaphragmatic movement? - ✔✔Trendelenberg, prone and lateral The purpose of National patient safety goals is to - ✔✔Promote specific improvements in safety highlight problematic areas in healthcare
describe evidence and expert-based system wide solutions to the problems What is a practice that implements Joint commissions universal protocol for preventing, wrong site, wrong person, wrong procedure - ✔✔using a timeout procedure before beginning case The elements require to create a culture of safety include - ✔✔a sense of trust among team members a sincere commitment to affirming safety as the first priority development and support of a proactive approach rather than a reactive approach dissemination of receipt of information to all levels The IOM report describes the importance of setting standards and expectations for patient safety the report states that setting standards can .... - ✔✔Set expectations for the health professionals Establish consistency when it comes individuals and organizations Help set expectations of consumers and purchasers Individual staff members play the biggest role in marinating a safe OR environment they are required to:
Mechanical issues and problems that can cause skin injury include - ✔✔placing heavy items on the patient dragging the patients body across the sheets Improperly applying sequential compression stockings Which of the following practices is recommended to reduce the patients risk of intraoperative skin injury
Radiation exposure safety controls include: - ✔✔Nonessential personnel should leave the room pregnant health care workers should avoid or limit exposure lead protective aprons, gloves and thyroid covers should be worn Nursing documentation for pneumatic tourniquet use includes - ✔✔identification/serial number and model of the specific tourniquet location of the cuff skin and tissue integrity time of inflation and deflation of cuff Safety measures to prevent complications or injury due to the use of pneumatic tourniquet includes - ✔✔keep fluids form pooling under cuff only minimal effective pressure should be used to create a bloodless field there should be a complete preoperative assessment the cuff should fit properly on the patient the inflation time should be monitored which of the following is a correct application of the AORN guidelines for proper eyewear during laser use - ✔✔the eyewear should match the type of laser, optical density and wavelength Volatile liquid - ✔✔a liquid that evaporates quickly combustible skin agent - ✔✔a skin antiseptic agent that will burn with a flash point of grater than 100 degrees, 38.7 C Flammable skin agent - ✔✔a skin antiseptic agent that has a flash point of less than 100 degrees, 38.7 C Combustible rating - ✔✔an established rating used with skin antiseptic solutions that can be found by reviewing MSDS sheets
the primary purpose of documentation is to - ✔✔record the chronological order of events during the nursing care of a patient which of the following is true about the use of abbreviations in documentation - ✔✔they put patients at risk for medication errors accurate perioperative documentation includes - ✔✔patient identification perioperative orders patient assessment when documenting a surgical drain what should be included - ✔✔where the drain was placed on the patient Components of the electrical surgical unit include - ✔✔Active electrode, dispersive electrode and generator to reduce the possibility of injury related to burn where should the nurse place the dispersive electrode - ✔✔as close to the operative site as feasible which statement best describes the path for bipolar surgical current? - ✔✔current leaves the generator, is applied to tissue using two poled instrument and returns to the generator if the surgeon continuously asks for higher power settings what is the first action the perioperative RN should take - ✔✔check the circuitry for possible disruption Alternate pathway burns can occur because of improper placement, where should the dispersive electrode not be places - ✔✔hairy skin surfaces burn tissue bony prominences When using argon-enhanced coagulation AEC there is a risk of - ✔✔gas emboli
what are considered exhaust ventilation LEV devices - ✔✔central suction systems with 0.1 micrometer in line filter central suction system with HEPA in-line filter Smoke evacuator unit Which precautions should be take for a patient with an implanted Electronic device - ✔✔all team members should be informed about the ED the active and dispersive electrodes should be located as close together as possible What is needed for documenting with an electrical surgical device - ✔✔location of dispersive electrode serial or biometric device number patients kin condition before and after applying the dispersive pad during laparoscopic surgery perioperative RNs can reduce the chance of capactive-coupling injuries by - ✔✔using the lowest power setting and the low-voltage cutting wave form AORNS guidelines for perioperative practice provides - ✔✔information on administrative topics information that can be used to develop institution specific guidelines scientific evidence for clinical practices what is true regarding AORN's guidelines for perioperative practice - ✔✔they are based on what nurses do in ideal situations they may be fulfilled in varying degrees in different situations why is it important for perioperative nurses to have a basic understanding of business principles? - ✔✔to enable them to plan safe and effective care that is also cost effective to facilitate competition for patient volume to manage and allocate resources wisely