26 Questions
What is the primary goal of surgical site preparation?
To reduce the risk of surgical site infection
What type of suture is used for skin wound closure?
Non-Absorbable sutures
What is the role of the circulating nurse in surgical site preparation?
To perform surgical site preparation
Which of the following areas requires special consideration during surgical site preparation?
All of the above
What is the purpose of applying antimicrobial agents during surgical site preparation?
To reduce the risk of surgical site infection
What is the characteristic of Povidone-Iodine as an antimicrobial agent?
All of the above
What type of suture is used for internal body tissues where sutures will not be removed?
Absorbable sutures
What is the purpose of sutures in wound closure?
To hold tissue together until healing takes place
What is the primary goal of surgical skin preparation?
To reduce the risk of surgical site infection
What is the name of the position where the patient is lying on their back with their legs flexed and elevated?
Lithotomy
What type of anesthesia involves injecting local anesthetic into the lumbar intrathecal space or subarachnoid space?
Spinal anesthesia
What is a common complication of spinal anesthesia?
Hypotension
What is the name of the position where the patient is lying on their side with their body aligned in a straight line?
Lateral recumbent
What type of anesthesia involves injecting local anesthetic into the epidural space?
Epidural anesthesia
What is the primary consideration when positioning a surgical patient?
Anatomy involved with the procedure
What type of anesthesia involves injecting local anesthetic around a nerve that supplies sensation to a small area of the body?
Peripheral nerve blocks
What is the name of the position where the patient is lying on their stomach with their head turned to the side?
Prone
What is the primary purpose of malignant hyperthermia treatment?
To prepare for cardiopulmonary resuscitation
What is the primary focus of perioperative nursing?
Rendering nursing care to the total surgical experience of the patient
Which of the following patients is considered a surgical risk patient?
A 70-year-old patient with cardiovascular disease
What is the purpose of diagnostic surgery?
To verify a suspected diagnosis
Which of the following medications can affect the surgical client?
Antibiotics
What is the classification of surgery that requires immediate attention?
Emergent
Which of the following is a physical effect of surgery on a client?
Pain
What is the classification of surgery that involves a high degree of risk?
Major
Which phase of perioperative nursing occurs during the surgery?
Intraoperative phase
Study Notes
Malignant Hyperthermia
- Malignant hyperthermia: a life-threatening medical emergency
- Induction of general anesthesia: drowsy, dizzy, exaggerated pain sensation, decreased consciousness
- Loss of consciousness: relaxation, light hypnosis, loss of consciousness, increased muscle tone
- Regular pattern of respiration: total paralysis of intercostal muscles, cessation of voluntary respiration
- Danger stage: respiratory failure, possible cardiac arrest, prepare for cardiopulmonary resuscitation
Regional Anesthesia
- Production of anesthesia in a specific body part
- Injecting local anesthetics in close proximity to appropriate nerves
- Spinal Anesthesia: local anesthetic injected into lumbar intrathecal space/subarachnoid space
- Spinal anesthesia produces excellent analgesia and relaxation for abdominal and pelvic procedures
- Epidural Anesthesia: local anesthetic injected into epidural space via lumbar puncture
- Peripheral Nerve Blocks: anesthetic injected around a nerve supplying sensation to a small area
- Intravenous Block: local agent injected into a vein with an occlusion tourniquet
- Local Anesthesia (Infiltration): agent injected into surgical site for minor and superficial procedures
- Topical Anesthesia: anesthetic agent applied directly to skin and mucous membranes
Complications of Spinal Anesthesia
- Hypotension
- Nausea and vomiting
- Urinary retention
- Post-spinal headache
Positioning Surgical Patient
- 5 factors to consider: anatomy involved, surgical approach, patient comfort, patient and staff safety, respiratory and circulatory freedom
- Supine (Dorsal Recumbent): abdominal, extremity, vascular, chest, neck, and facial procedures
- Lateral Recumbent: chest and kidney procedures
- Trendelenburg: lower abdominal and pelvic organ procedures
- Kraske (Jacknife): rectal, sigmoidoscopy, and colonoscopy procedures
- Prone: surgeries involving the posterior surface of the body, spine, neck, buttocks, and lower extremities
Perioperative Nursing
- 3 phases: preoperative, intraoperative, and postoperative
- Effects of surgery on a client: physical and psychological effects
Surgical Risk Patients
- Extremes of age
- Malnourished (emaciated/obese)
- Dehydrated patients
- Patients with severe trauma or injury, infection, or sepsis
- Patients with cardiovascular disease
- Endocrine dysfunction
- Hepatic/renal disease
Medications Affecting Surgical Client
- Antibiotics
- Antidysrhythmics
- Anticoagulants
- Corticosteroids
- Insulin
- Diuretics
- Antidepressants
Classifications of Surgery
- According to urgency: emergent, urgent, required, elective, and optional
- According to degree of risk: major and minor
- According to purpose: diagnostic, exploratory, curative, ablative, and reconstructive
Surgical Skin Prep
- Aseptic procedure to reduce resident and transient flora on the skin surface
- Performed by the circulating nurse
- Prior to draping
- Antimicrobial solutions: povidone-iodine (Betadine) and chlorhexidine gluconate
Special Areas of Consideration
- Eyes
- Traumatic open wounds
- Fractures
- Tumors, aneurysm, and ovarian cyst
- Dirty contaminated areas
- Emergency preps
Sutures
- Absorbable sutures: chromic, plain, polydiaxone (PDS), polyglactin 910 (Vicryl), polyglycolic acid (Biovek)
- Non-absorbable sutures: silk, nylon, prolene (polypropylene)
- Used either on skin wound closure or in stressful internal environments where absorbable sutures won't suffice
This quiz is about the signs and symptoms of malignant hyperthermia during general anesthesia induction and the patient's response to it. It covers the patient care considerations during this situation.
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