Module 20: ENT and Perioperative Nursing

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Questions and Answers

What is a significant concern related to patients undergoing facial or neck surgery?

Long-term aesthetic changes (correct)

Increased appetite due to recovery

Improved body image

Short-term hearing loss

Which of the following assessments is NOT typically part of a pre-operative respiratory assessment?

Smoking history

Blood pressure monitoring (correct)

Quality of breathing

Nutritional status

What type of anaesthetic is typically used for surgeries lasting less than two hours?

Local anaesthetic with neurolept (correct)

General anaesthetic

Regional anaesthetic

Sedative anaesthetic

Which of the following structures is composed of c-shaped rings of cartilage?

Trachea Signup and view all the answers

What is the purpose of using topical epinephrine during laryngeal surgery?

To achieve vasoconstriction Signup and view all the answers

Prior to surgical prep for head and neck surgeries, hair removal is performed in which scenario?

If it may fall into the wound Signup and view all the answers

What instruction should be emphasized to patients receiving local anaesthetic with neurolept?

To remain immobile intraoperatively Signup and view all the answers

What is an important consideration when assessing facial structures during a pre-operative assessment?

Asymmetry and lesions Signup and view all the answers

What is a potential complication that may arise if a patient coughs during anesthesia emergence after a thyroid surgery?

Formation of a hematoma at the surgical site Signup and view all the answers

Which procedure is primarily focused on the removal of malignant tissues in the neck region?

Radical neck dissection Signup and view all the answers

During which surgical procedure might it be necessary to preserve the sternocleidomastoid muscle and internal jugular vein?

Modified neck dissection Signup and view all the answers

What may be a required pre-procedural intervention for patients undergoing a neck dissection due to potential airway issues?

Preparation for a tracheostomy Signup and view all the answers

What type of surgery might involve harvesting tissue and bone from the patient’s own body for reconstruction?

Radical neck dissection Signup and view all the answers

What is the primary function of the sterile nerve stimulator in head and neck surgeries?

To protect the recurrent laryngeal nerves Signup and view all the answers

Which of the following instruments is NOT mentioned as part of the minor instrument set?

Electrocautery device Signup and view all the answers

When preparing the operating room, which equipment is crucial for complex procedures requiring magnification?

Surgical microscope Signup and view all the answers

In the context of otologic surgeries, which approach is commonly used?

Endaural or transcanal approach Signup and view all the answers

What is an essential consideration when using power drills during surgery?

Sharp safety principles must be applied Signup and view all the answers

What is the purpose of forced-air warming blankets in the operating room?

To prevent hypothermia unless contraindicated Signup and view all the answers

Which laser type is NOT listed for use in vaporizing scar tissue?

Ruby laser Signup and view all the answers

What is the correct sequence for instrument counts in minor surgical procedures?

Initial Count, Closing Count, Final Count Signup and view all the answers

What is the primary benefit of using a microscope drape during surgical procedures?

To prevent contamination of the surgical field Signup and view all the answers

What type of scissors is NOT likely used in the minor instrument set?

Suture scissors Signup and view all the answers

What is the primary goal of a closed reduction of a nasal fracture?

To achieve manual realignment without skin incision Signup and view all the answers

What is often used intraoperatively during a nasoseptoplasty to control bleeding?

Lidocaine with epinephrine infiltration Signup and view all the answers

What is the purpose of inserting splints during a nasoseptoplasty?

To ensure proper healing and prevent adhesions Signup and view all the answers

Why might a surgeon use a suspension laryngoscope holder during laryngoscopy?

To free up the surgeon's hands for other tasks Signup and view all the answers

What are the common indications for a tonsillectomy?

Oropharyngeal infections and breathing difficulties Signup and view all the answers

What might postoperative care involve after closed reduction of a nasal fracture?

Utilizing a mustache dressing Signup and view all the answers

What anatomical structures are primarily affected by a nasoseptoplasty?

Cartilaginous and osseous segments of the septum Signup and view all the answers

What essential precaution is necessary intraoperatively when performing a thyroidectomy?

Ensuring meticulous hemostasis to avoid excessive bleeding Signup and view all the answers

What is imperative to remind a patient postoperatively after a nasal fracture reduction?

To breathe through the mouth due to nasal packing Signup and view all the answers

What type of tissue specimens may be sent for examination during laryngoscopy procedures?

Vocal cord tissues Signup and view all the answers

What is the recommended position for patients undergoing head and neck surgeries?

Supine position with a shoulder roll Signup and view all the answers

Why is chlorhexidine avoided in otorhinolaryngology procedures?

It is known to be ototoxic Signup and view all the answers

What type of instrument is specifically used for myringotomy procedures?

Myringotomy knife Signup and view all the answers

What should a perioperative nurse ensure regarding patient electrodes and safety during surgery?

The return electrode pad is applied and the safety strap is secured Signup and view all the answers

Which of the following instruments is commonly associated with rhinosurgery?

Sinuscope Signup and view all the answers

What is the purpose of the shoulder roll during surgery?

To improve visualization and support the patient's shoulders Signup and view all the answers

What safety measure should be taken before surgery concerning patient positioning?

Ensure the patient is positioned safely with collaboration from the surgical team Signup and view all the answers

What is a common prep solution in otorhinolaryngology, barring any allergies?

Providone-iodine solution Signup and view all the answers

Which of the following is NOT a characteristic of instruments used in otorhinolaryngology?

They are specifically designed for general use Signup and view all the answers

What should be ensured regarding the positioning performance checklist prior to surgery?

It should be followed to ensure appropriate practices are adhered to Signup and view all the answers

Study Notes

Airway Structure and Muscles

The trachea comprises c-shaped rings of cartilage providing structural support.
Posterior to the trachea lie the sternohyoid and sternothyroid muscles, along with the thyroid glands.

Perioperative Nursing Considerations

Pre-operative assessment includes evaluating respiratory status, quality of breathing, and smoking history.
Nutritional status is monitored, paying attention to weight loss from swallowing or chewing difficulties.
Facial symmetry, structure, color, and any lesions or nodules are assessed.
Patients undergoing facial or neck surgery may face body image concerns and long-term effects like facial numbness or hearing loss.

Anesthesia Considerations

Local anesthetic with neurolept may be used for brief procedures, requiring patient immobility.
General anesthetic is indicated for patients based on health conditions or surgical needs.
Nasal surgeries involve packing the nasal cavity with vasoconstrictor-soaked patties to manage bleeding.

Surgical Preparation

Hair removal in head and neck surgeries is performed only if necessary, using clippers.
Povidone-iodine is the preferred prep solution in otorhinolaryngology; chlorhexidine is avoided due to its ototoxic properties.
Patient positioning varies but typically involves a supine position with a shoulder roll for optimal access.

Instrumentation and Counting

Otorhinolaryngology requires specific delicate instruments for otologic and rhinologic surgeries.
Minor counts are generally required for head and neck surgeries to ensure no instruments or sponges are left in the surgical field.

Equipment in the OR

Essential equipment includes cautery, suction systems, light sources, monitors, and microscopes for enhanced visualization.
Power drills are used with sterile water for specific surgeries, while laser technology helps vaporize tissue without collateral damage.
Forced-air warming blankets are utilized to prevent hypothermia during procedures.

Surgical Interventions

Otologic surgeries often involve approaches through the ear canal or behind the ear.
Closed reduction of nasal fractures typically requires local anesthetics and may utilize nasal packing for stabilization.
Nasoseptoplasty aims to correct septal deviations, often necessitating hemostatic methods during surgery.

Oral Cavity and Neck Surgeries

Laryngoscopy allows visualization of glottis/vocal cords using a laryngoscope, with options for using a self-retaining holder.
Tonsillectomy and adenoidectomy may occur simultaneously.
Thyroidectomy involves the removal of thyroid tissues and careful monitoring for nerve injuries, with drains placed before closure.

Additional Surgical Procedures

Parotidectomy carries risks to the facial nerve and may also require drainage.
Radical neck dissection entails the removal of malignant tissues, often with reconstructive options deriving from the patient’s tissues.
Tracheostomy involves creating an opening in the trachea for airway access, performed electively or in emergencies.

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Description

This quiz focuses on the anatomy of the airway and perioperative considerations in nursing care. It includes topics such as the composition of the trachea and the pre-operative assessment of respiratory and nutritional status. Test your knowledge of ENT structures and nursing assessments in a surgical context.