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Questions and Answers
What is the primary responsibility of a circulating nurse during intraoperative care?
Which of the following statements regarding sterile technique is incorrect?
What must a scrub nurse be knowledgeable about in order to fulfill their duties effectively?
Which responsibility is NOT part of the scrub nurse's duties during a surgical procedure?
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What is meant by the term 'irreducible minimum' in the context of intraoperative care?
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What is the primary responsibility of the surgeon during the surgical procedure?
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Which anesthesia type is administered around specific nerves?
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What is NOT a role of the anesthesiologist during surgery?
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Which zone in the surgical environment allows for street clothes?
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At what point does the operating room nurse verify the client's identification?
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Study Notes
Intraoperative Care Overview
- Intraoperative care spans the client's admission to the operating room (OR) until transfer to the recovery room (RR) or post-anesthesia care unit (PACU).
- Anesthesia is administered prior to the surgical procedure.
Principles of Sterile Technique
- Only sterile items are used in the sterile field; sterile personnel are gowned and gloved.
- Sterility is maintained at table level, with sterile persons touching only sterile items.
- The edges of containers holding sterile contents are deemed unsterile.
- Sterile fields are set up close to the time of use and kept in view.
- Maintaining a minimum of microorganisms is essential to prevent contamination.
Duties and Responsibilities of a Circulating Nurse
- Possesses knowledge of surgical procedures and anatomy.
- Prepares the operating room and confirms necessary equipment is available and functional.
- Verifies patient ID and surgical details, including informed consent.
- Assists with patient positioning and monitoring devices during surgery.
- Oversees draping and skin preparation, documents intraoperative data, and manages specimens.
Duties and Responsibilities of a Scrub Nurse
- Has knowledge of surgical procedures and assists with scrubbing, gowning, and gloving.
- Responsible for draping and maintaining aseptic technique.
- Passes instruments and monitors irrigation solutions.
- Counts all surgical sponges, needles, and instruments with the circulating nurse.
The Surgical Team
- Comprises the patient, scrub and circulating nurses, surgeon, anesthesiologist, and surgical technologist.
- The surgeon leads the team while the Registered Nurse First Assistant (RNFA) supports during surgery.
Anesthesia Management
- Anesthesiologist assesses patients preoperatively and selects anesthesia type while managing complications during surgery.
Surgical Environment
- Operating rooms are designed for sterility, with limited access through double doors and specialized air filtration systems.
- Divided into three zones: unrestricted (street clothes), semi-restricted (scrubs and cap), restricted (full surgical attire).
Patient Arrival in the Operating Room
- Verification of patient identity through bracelet and verbal confirmation.
- Assessment of the surgical consent, patient history, and allergies.
- IV line initiation may occur before anesthesia administration.
Types of Anesthesia
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Regional Anesthesia: Local anesthetic injected around nerves; includes epidural and spinal anesthesia.
- Epidural Anesthesia: Injection into epidural space with benefits like consciousness maintenance and reduced headache incidence.
- Spinal Anesthesia: Administered into the subarachnoid space, producing loss of sensation in lower body.
- Local Anesthesia: Direct injection at the incision site for minimal surgical procedures.
Potential Adverse Effects of Surgery and Anesthesia
- Allergic reactions, cardiac dysrhythmias, central nervous system changes, trauma, hypotension, and thrombosis can arise.
Intraoperative Complications
- Complications include nausea, vomiting, anaphylaxis, hypoxia, respiratory disturbances, hypothermia, and malignant hyperthermia.
Nursing Process During Surgery
- Diagnosis: Address anxiety, positioning risks, and sensory perception disturbances.
- Goals: Reduce anxiety, prevent injury, ensure patient safety, and avoid complications.
- Interventions: Introduce nurse, verify details, ensure comfortable positioning, and maintain patient safety with environmental control.
Postoperative Care
- Admission to PACU includes airway maintenance, vital sign monitoring, assessing anesthesia effects, and ensuring comfort.
- Goals are to prevent complications, promote incision healing, and restore health.
Immediate Postoperative Care (1 – 4 hours)
- Monitor for hypothermia and apply warm blankets if needed.
- Assess surgical site and document drainage or bleeding.
- Manage fluid and electrolyte balance and monitor intake/output.
- Evaluate gastrointestinal recovery and monitor for pain and effectiveness of pain medications.
Pain Management
- Assess pain type and location, utilize a pain scale, and monitor for objective pain indicators.
- Administer prescribed pain medications and ensure understanding of patient-controlled analgesia.
- Employ noninvasive relief measures and document medication effectiveness.
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Description
This quiz covers the principles and practices of intraoperative care, focusing on the management of patients from admission to the operating room until their transfer to recovery. It emphasizes the importance of sterile technique to ensure patient safety during surgical procedures.
