Podcast
Questions and Answers
What is the primary role of the circulating nurse during the intraoperative period?
What is the primary role of the circulating nurse during the intraoperative period?
- Direct and coordinate patient care (correct)
- Maintain aseptic technique
- Administer anesthesia
- Assist with intubation
Which of the following is NOT a phase of general anesthesia?
Which of the following is NOT a phase of general anesthesia?
- Recovery (correct)
- Induction
- Emergence
- Pre-induction
The Joint Commission's Universal Protocol includes which of the following?
The Joint Commission's Universal Protocol includes which of the following?
- Time-Out
- Preoperative Verification
- Marking the Surgical Site
- All of the above (correct)
What is the purpose of the 'Time-Out' in surgery?
What is the purpose of the 'Time-Out' in surgery?
Which of the following is a requirement of the Surgical Care Improvement Project (SCIP)?
Which of the following is a requirement of the Surgical Care Improvement Project (SCIP)?
The nurse observes a patient under general anesthesia showing tachycardia, hyperthermia, and muscle rigidity. What is the priority intervention?
The nurse observes a patient under general anesthesia showing tachycardia, hyperthermia, and muscle rigidity. What is the priority intervention?
A patient is undergoing regional anesthesia for a knee replacement. What is a potential complication?
A patient is undergoing regional anesthesia for a knee replacement. What is a potential complication?
The nurse preparing a patient for surgery under Monitored Anesthesia Care (MAC) expects which patient response?
The nurse preparing a patient for surgery under Monitored Anesthesia Care (MAC) expects which patient response?
Which nursing intervention is essential when positioning a patient intraoperatively?
Which nursing intervention is essential when positioning a patient intraoperatively?
What is the purpose of balanced anesthesia?
What is the purpose of balanced anesthesia?
A patient is intubated for general anesthesia, and the nurse hears high-pitched stridor. What should the nurse suspect?
A patient is intubated for general anesthesia, and the nurse hears high-pitched stridor. What should the nurse suspect?
The nurse is caring for a patient with regional anesthesia. The patient reports dizziness and a metallic taste. What should the nurse suspect?
The nurse is caring for a patient with regional anesthesia. The patient reports dizziness and a metallic taste. What should the nurse suspect?
Which of the following are characteristics of general anesthesia? (Select all that apply.)
Which of the following are characteristics of general anesthesia? (Select all that apply.)
What are complications associated with endotracheal intubation? (Select all that apply.)
What are complications associated with endotracheal intubation? (Select all that apply.)
The nurse is preparing a patient for spinal anesthesia. What potential side effects should be discussed? (Select all that apply.)
The nurse is preparing a patient for spinal anesthesia. What potential side effects should be discussed? (Select all that apply.)
Which actions should the circulating nurse take to maintain aseptic technique in the OR? (Select all that apply.)
Which actions should the circulating nurse take to maintain aseptic technique in the OR? (Select all that apply.)
During the intraoperative period, the nurse's primary concern is:
During the intraoperative period, the nurse's primary concern is:
A patient undergoing surgery with regional anesthesia suddenly reports ringing in the ears, dizziness, and confusion. What should the nurse do first?
A patient undergoing surgery with regional anesthesia suddenly reports ringing in the ears, dizziness, and confusion. What should the nurse do first?
What is a major complication of Monitored Anesthesia Care (MAC)?
What is a major complication of Monitored Anesthesia Care (MAC)?
A nurse observes that the patient is positioned with arms extended greater than 90 degrees during surgery. What complication should the nurse be most concerned about?
A nurse observes that the patient is positioned with arms extended greater than 90 degrees during surgery. What complication should the nurse be most concerned about?
A patient undergoing general anesthesia is at risk for hypothermia. What interventions should the nurse implement?
A patient undergoing general anesthesia is at risk for hypothermia. What interventions should the nurse implement?
The nurse is preparing to assist with a 'Time-Out' before surgery. What elements must be confirmed?
The nurse is preparing to assist with a 'Time-Out' before surgery. What elements must be confirmed?
A patient undergoing spinal anesthesia suddenly develops severe hypotension. What should the nurse do first?
A patient undergoing spinal anesthesia suddenly develops severe hypotension. What should the nurse do first?
A nurse observes that a patient under general anesthesia has increased end-tidal CO2, muscle rigidity, and tachycardia. What should the nurse suspect?
A nurse observes that a patient under general anesthesia has increased end-tidal CO2, muscle rigidity, and tachycardia. What should the nurse suspect?
Which of the following statements about volatile anesthetics is correct?
Which of the following statements about volatile anesthetics is correct?
A patient is being prepared for surgery with epidural anesthesia. The nurse should monitor for which complications?
A patient is being prepared for surgery with epidural anesthesia. The nurse should monitor for which complications?
The circulating nurse is responsible for which tasks? (Select all that apply.)
The circulating nurse is responsible for which tasks? (Select all that apply.)
Which are signs of local anesthetic systemic toxicity (LAST)? (Select all that apply.)
Which are signs of local anesthetic systemic toxicity (LAST)? (Select all that apply.)
What are complications of general anesthesia? (Select all that apply.)
What are complications of general anesthesia? (Select all that apply.)
The nurse is preparing a patient for intubation. What complications should be monitored for? (Select all that apply.)
The nurse is preparing a patient for intubation. What complications should be monitored for? (Select all that apply.)
A patient is receiving regional anesthesia. The nurse should monitor for: (Select all that apply.)
A patient is receiving regional anesthesia. The nurse should monitor for: (Select all that apply.)
Which interventions help prevent infection in the OR? (Select all that apply.)
Which interventions help prevent infection in the OR? (Select all that apply.)
What actions help manage a sentinel event in surgery? (Select all that apply.)
What actions help manage a sentinel event in surgery? (Select all that apply.)
A patient under general anesthesia has a sudden drop in blood pressure and an increase in end-tidal CO2 levels. What is the priority nursing intervention?
A patient under general anesthesia has a sudden drop in blood pressure and an increase in end-tidal CO2 levels. What is the priority nursing intervention?
Which of the following factors increase a patient's risk for anesthesia complications?
Which of the following factors increase a patient's risk for anesthesia complications?
A patient undergoing spinal anesthesia develops a severe headache when sitting up. What is the most appropriate nursing intervention?
A patient undergoing spinal anesthesia develops a severe headache when sitting up. What is the most appropriate nursing intervention?
The nurse is assisting with patient positioning after anesthesia induction. What is the most important consideration?
The nurse is assisting with patient positioning after anesthesia induction. What is the most important consideration?
Which of the following are signs of a developing airway emergency during general anesthesia? (Select all that apply.)
Which of the following are signs of a developing airway emergency during general anesthesia? (Select all that apply.)
The nurse is monitoring a patient for postoperative anesthesia recovery. What findings indicate complications? (Select all that apply.)
The nurse is monitoring a patient for postoperative anesthesia recovery. What findings indicate complications? (Select all that apply.)
What are essential components of safe anesthesia administration? (Select all that apply.)
What are essential components of safe anesthesia administration? (Select all that apply.)
Flashcards
Circulating Nurse Role
Circulating Nurse Role
The circulating nurse ensures patient safety, manages communication, and coordinates activities in the OR, enhancing overall patient outcomes.
Phases of General Anesthesia
Phases of General Anesthesia
General anesthesia phases include pre-induction, induction, maintenance, and emergence, preparing the patient, maintaining unconsciousness, and facilitating recovery.
Joint Commission's Universal Protocol
Joint Commission's Universal Protocol
The Universal Protocol ensures correct patient identity, procedure, and site to prevent surgical errors, enhancing patient safety and procedural accuracy.
"Time-Out" in Surgery
"Time-Out" in Surgery
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SCIP's Aim
SCIP's Aim
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Priority Intervention for MH
Priority Intervention for MH
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Purpose of Balanced Anesthesia
Purpose of Balanced Anesthesia
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Signs of Local Anesthetic Toxicity
Signs of Local Anesthetic Toxicity
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Characteristics of General Anesthesia
Characteristics of General Anesthesia
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Primary Concern of Intraoperative Nurse:
Primary Concern of Intraoperative Nurse:
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Patient Response Expected During Monitored Anesthesia Care (MAC)
Patient Response Expected During Monitored Anesthesia Care (MAC)
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Complication from Positioning: Arms Extended > 90 Degrees
Complication from Positioning: Arms Extended > 90 Degrees
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High-Pitched Stridor During General Anesthesia
High-Pitched Stridor During General Anesthesia
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Complications of general anesthesia.
Complications of general anesthesia.
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Priority Nursing Intervention for sudden drop in blood pressure.
Priority Nursing Intervention for sudden drop in blood pressure.
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Study Notes
Circulating Nurse's Role
- Circulating nurses direct and coordinate patient care during the intraoperative phase.
- They ensure patient safety, manage communication, and coordinate OR activities.
Phases of General Anesthesia
- Recovery is a postoperative phase, not a phase of general anesthesia.
- General anesthesia includes pre-induction, induction, maintenance, and emergence.
Joint Commission's Universal Protocol
- Includes Time-Out, Preoperative Verification, and Marking the Surgical Site.
- It ensures correct patient identity, procedure, and site to prevent surgical errors.
Purpose of "Time-Out" in Surgery
- A mandatory pause before incision.
- Ensures all surgical details are correct and patient safety is maintained.
Surgical Care Improvement Project (SCIP)
- Requires the administration of prophylactic antibiotics.
- Aims to reduce surgical complications, focusing on infection prevention through antibiotic use.
Recognizing Malignant Hyperthermia (MH)
- Signs include tachycardia, hyperthermia, and muscle rigidity under general anesthesia.
Priority Intervention for MH
- Administer Dantrolene, the only antidote for MH.
Regional Anesthesia Complications
- Headache is a potential complication of regional anesthesia for knee replacement.
- Post-spinal headaches occur due to CSF leakage.
Monitored Anesthesia Care (MAC)
- Sedation allows the patient to remain responsive and maintain their own airway.
- The expected patient response is a depressed level of consciousness but responsiveness.
Intraoperative Positioning
- Essential nursing intervention involves preventing occlusion of arteries and veins.
- Proper positioning prevents complications like pressure ulcers and nerve damage.
Balanced Anesthesia
- Achieve desired effects using multiple agents.
- Combines different drug classes for muscle relaxation, analgesia, and amnesia.
High-Pitched Stridor Post-Intubation
- Should raise suspicion for laryngospasm.
- Laryngospasm: A serious airway obstruction requiring immediate intervention.
Regional Anesthesia Side Effects
- Dizziness and a metallic taste indicate local anesthetic toxicity.
General Anesthesia Characteristics
- Loss of consciousness.
- Skeletal muscle relaxation.
- Analgesia.
- Elimination of somatic and autonomic responses.
- General anesthesia depresses the CNS, leading to loss of sensation and reflexes.
Endotracheal Intubation Complications
- Sore throat.
- Hoarseness.
- Bronchospasm.
- Intubation can cause related airway trauma and irritation.
Spinal Anesthesia Side Effects
- Hypotension.
- Urinary retention.
- Headache.
- Spinal anesthesia affects the autonomic nervous system, causing hypotension and urinary retention.
Maintaining Aseptic Technique in the OR
- Ensure all personnel follow hand hygiene protocols.
- Monitor for breaks in sterile technique.
- Replace contaminated instruments immediately.
- Keep the OR doors closed.
- Aseptic technique prevents infection through adherence to sterile protocols.
Intraoperative Nurse's Primary Concern
- Maintaining patient safety by ensuring a safe environment and preventing complications.
- Focus on preventing infections and positioning injuries.
Local Anesthetic Toxicity
- Ringing in the ears, dizziness, and confusion are signs during regional anesthesia.
- Stop the anesthesia administration to prevent CNS depression.
Major Complication of Monitored Anesthesia Care (MAC)
- Respiratory depression from benzodiazepines and opioids is possible.
Arm Positioning During Surgery
- Arms extended greater than 90 degrees is concerning for peripheral nerve injury.
- Overextension can cause brachial plexus injury, leading to weakness and paresthesia.
Hypothermia Prevention Under General Anesthesia
- Increase room temperature.
- Maintaining a warm environment and using warm IV fluids helps.
"Time-Out" Confirmation
- Ensures correct patient, procedure, and site before the first incision.
Managing Hypotension During Spinal Anesthesia
- Elevate the patient’s legs.
- Hypotension is a common spinal anesthesia complication, and leg elevation promotes venous return.
Nurse Suspects Malignant Hyperthermia
- Nurse should suspect with increased end-tidal COâ‚‚, muscle rigidity, and tachycardia.
- MH presents with hypercarbia, muscle rigidity, and hyperthermia.
MH Emergency Treatment
- Dantrolene must be administered.
Volatile Anesthetics
- Usually delivered via an endotracheal tube.
- Require ETT or LMA administration and are mixed with oxygen.
Epidural Anesthesia Complication
- Monitor respiratory depression, urinary retention, and hypotension.
Circulating Nurse Responsibilities
- Positioning the patient.
- Monitoring aseptic technique.
- Maintaining communication among surgical team members.
- The circulating nurse handles non-sterile duties, including patient safety and coordination.
Signs of Local Anesthetic Systemic Toxicity (LAST)
- Tinnitus
- Metallic taste
- Seizures
- LAST presents with CNS symptoms first, then cardiac toxicity.
General Anesthesia Complications
- Aspiration.
- Sore throat.
- Hypothermia.
- Laryngospasm.
- General anesthesia impairs protective reflexes, increasing aspiration risk.
Intubation Complications to Monitor
- Broken teeth.
- Hoarseness.
- Laryngospasm.
- Bronchospasm.
- Intubation can cause airway trauma, vocal cord irritation, and bronchospasm.
Monitoring for Regional Anesthesia
- Hypotension.
- Numbness.
- Urinary retention.
- Regional anesthesia can cause these effects.
OR Infection Prevention Interventions
- Strict hand hygiene.
- Proper sterilization of instruments.
- Maintaining closed OR doors.
- These measures reduce infection risk.
Sentinel Event Management
- Immediate investigation.
- Root cause analysis.
- Reporting is required per policy.
- Revise protocols.
- Sentinel events need immediate reporting and systemic evaluation.
Sudden Blood Pressure Drop Under Anesthesia
- Stop anesthesia and provide 100% oxygen.
- These signs indicate Malignant Hyperthermia (MH), requiring immediate cessation of anesthesia and high-dose oxygen.
Increase Patient's Risk for Anesthesia Complications
- Age and BMI
- Older age and obesity increase risks for delayed anesthesia clearance and airway difficulties.
Post-Spinal Headache Intervention
- Encourage fluid intake and keep the patient flat.
- A post-spinal headache is due to CSF leakage; fluids and bed rest relieve symptoms.
Positioning Consideration After Anesthesia
- Preventing pressure on nerves and blood vessels.
- Improper positioning can lead to nerve compression injuries, vascular occlusion, and pressure ulcers.
Signs Of a Developing Airway Emergency
- Stridor.
- Hypoxia.
- Cyanosis.
- These suggest airway obstruction or inadequate ventilation.
Postoperative Anesthesia Recovery Complication
- Oâ‚‚ saturation less than 90%.
- Delayed return of reflexes.
- Increased drowsiness unresponsive to stimuli.
- Low oxygen levels, delayed reflexes, and prolonged sedation indicate poor anesthesia recovery.
Essential Components of Safe Anesthesia Administration
- Continuous monitoring of oxygenation and ventilation.
- Administration of reversal agents when needed.
- Proper patient positioning to avoid.
- Safe anesthesia involves oxygen monitoring, reversal agents when necessary, and proper positioning.
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