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Periop 101: Positioning the Surgical Patient

Terms in this set (20)

what are the overall goals of surgical positioning? SATA
a. ensure the pt is strapped to prevent sliding
b. provide access to monitoring devices and IV lines
c. provide optimal exposure
d. maintain the pt's airway
b. provide access...
c. provide optimal...
d. maintain the pt's airway
identify the correct statements about supine position: SATA
a. the supine position is used only for breast sx
b. the pt lies flat on their back with arms extended at less than 90 degree angle on padded arm boards
c. arm extension should be less than 45 degrees
d. there is in increase in systolic BP
e. there is a decrease in diaphragmatic expansion
f. use a heel susupension device to redistribute heel pressure
b. the pt lies flat...
e. there is a decrease in....
f. use a heel suspension...
Match the complications with the positions:
a. venous pooling in the lower extremities and hypotension related to the position and the affect of anesthesia
b. cyanosis and increased vascular load from the lower extremities to the heart and respiratory embarrassment due to decreased lung volume
c. decrease in brainstem perfusion and decreased cardiac return
----
1. Trendelenburg
2. reverse Trendelenburg
3. sitting/semi-sitting
A- 3
B-1
C-2
Identify the statements that correctly describe the lithotomy position: SATA
a. nerve damage can occur to the femoral nerve
b. lithotomy position should never be used for perineal procedures
c. the pts buttocks should extend over the break of the table to prevent strain on the sacrum
d. dislocation of the hips can occur if the legs aren't raised simultaneously
e. injury can occur to the fingers if they are left too close to the break of the table
a. nerve damage...
d. dislocation of the hips...
e. injury can occur...
Identify the correct statements about the prone position: SATA
a. face positioner is used to place the head in a neutral position
b, padding is placed under the stomach
c. ensure that the breasts, abd and genitals are free from torsion or pressure
d. the pt is positioned after admin of anesthesia
e. improper positioning can result in pressure on the superior vena cava
a. face positioner....
c. ensure the breasts...
d. the pt is positioned...
Which position is used for most abd procedures and vascular procedures?
a. supine
b. prone
c. lateral
d. Kraske
e. trendelenburg
a. supine
match the surgical position with its correct physiological effect
a. supine
b. trendelenburg
c. reverse trendelenburg
d. lithotomy
e. sitting or semi sitting
f. prone
g. lateral
----
1. hypotension related to the position
2. pooling of blood in the dependent limb
3. increase in CO
4. decreased cardiac return
5. elevated BP
6. compression of the diaphragm
7. potential femoral, obturator, and perineal nerve damage
A- 3
B- 5
C-4
D- 7
E- 1
F-6
G-2
identify the statements that are true about integumentary and musculoskeletal effects of positioning: SATA
a. shearing accompanied by pressure can result in a decubitus ulcer
b. shearing can denude the epidermis
c. prolonged exposure to skin prep solution chemicals under pressure can increase the likelihood of atopic dermatitis
d. elderly pts at risk from shearing
e. friction can also lead to the formation of pressure ulcers
f. pts with arthritis are more prone to musculoskeletal stress
a. shearing accompanied...
d. elderly pts....
e. friction can also lead...
f. pts with arthritis...
identify the correct statements regarding positioning documentation. SATA
a. after positioning, the RN should evaluate the pts body alignment and tissue integrity
b. the documentation should include location of padding devices
c. documentation should not include the names of persons positioning the pts
d. postop outcome eval is an integral part of documentation
a. after positioning....
b. the documentation should....
d. postop outcome eval...
identify the potential nursing dx that might occur when positioning the pt
a. risk for impaired skin integrity
b. impaired skin integrity
c. risk for periop positioning injury
d. disturbed sensory perception
e. impaired physical mobility
a. risk for...
b. impaired skin integrity
c. risk for periop positioning injury
e. impaired physical mobility
to follow the AORN guidelines for positioning the pt, the periop nurse should:
a. depend on the pt's natural defense mechanisms to indicate the need for positioning alterations
b. rely on the surgeon's and anesthesia professional's assessment to guide positioning
c. use a consistent method of procedure specific positioning for each pt
d. use additional precautions as appropriate based on unique pt considerations
d. use additional...
which of the following physiological effects is most likely to result from positioning a pt in the lithotomy position?
a. circulatory and respiratory compromise due to pressure on the abd
b. circulatory pooling in the legs
decreased brainstem perfusion
c. decreased brainstem perfusion
d. pressure on the brachial nerves
a. circulatory and respiratory....
the following safety measures should be considered when placing a pt in the lateral position: SATA
a. the upper leg is straight and supported with pillows between the legs
b. lower arm on the same plane with the OR bed mattress, forearm and wrist in a neutral position palm up
c. safety strap is applied at chest level
d. the pt's dependent ear should be assessed to ensure it is not folded
a. the upper leg...
b. lower arm on the same plane...
d. the pt's dependent ear...
documentation of the periop nursing care should include but not be limited to: SATA
a. type of positioning devices used
b. name of operating surgeon
c. names of persons positioning the pt
d. preop outcome evlauation
a. types of positioning devices
c. names of persons positioning the pt
which of the following pt factors should be considered in the periop assessment?
a. age
b. ethnicity
c. nutritional status
d. preexisting conditions
e. gender
a. age
c. nutritional status
d. preexisting conditions
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