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?

    <p>Trachea</p> Signup and view all the answers

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

    <p>To achieve vasoconstriction</p> Signup and view all the answers

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

    <p>If it may fall into the wound</p> Signup and view all the answers

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

    <p>To remain immobile intraoperatively</p> Signup and view all the answers

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

    <p>Asymmetry and lesions</p> 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?

    <p>Formation of a hematoma at the surgical site</p> Signup and view all the answers

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

    <p>Radical neck dissection</p> Signup and view all the answers

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

    <p>Modified neck dissection</p> 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?

    <p>Preparation for a tracheostomy</p> Signup and view all the answers

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

    <p>Radical neck dissection</p> Signup and view all the answers

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

    <p>To protect the recurrent laryngeal nerves</p> Signup and view all the answers

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

    <p>Electrocautery device</p> Signup and view all the answers

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

    <p>Surgical microscope</p> Signup and view all the answers

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

    <p>Endaural or transcanal approach</p> Signup and view all the answers

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

    <p>Sharp safety principles must be applied</p> Signup and view all the answers

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

    <p>To prevent hypothermia unless contraindicated</p> Signup and view all the answers

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

    <p>Ruby laser</p> Signup and view all the answers

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

    <p>Initial Count, Closing Count, Final Count</p> Signup and view all the answers

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

    <p>To prevent contamination of the surgical field</p> Signup and view all the answers

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

    <p>Suture scissors</p> Signup and view all the answers

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

    <p>To achieve manual realignment without skin incision</p> Signup and view all the answers

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

    <p>Lidocaine with epinephrine infiltration</p> Signup and view all the answers

    What is the purpose of inserting splints during a nasoseptoplasty?

    <p>To ensure proper healing and prevent adhesions</p> Signup and view all the answers

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

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

    What are the common indications for a tonsillectomy?

    <p>Oropharyngeal infections and breathing difficulties</p> Signup and view all the answers

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

    <p>Utilizing a mustache dressing</p> Signup and view all the answers

    What anatomical structures are primarily affected by a nasoseptoplasty?

    <p>Cartilaginous and osseous segments of the septum</p> Signup and view all the answers

    What essential precaution is necessary intraoperatively when performing a thyroidectomy?

    <p>Ensuring meticulous hemostasis to avoid excessive bleeding</p> Signup and view all the answers

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

    <p>To breathe through the mouth due to nasal packing</p> Signup and view all the answers

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

    <p>Vocal cord tissues</p> Signup and view all the answers

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

    <p>Supine position with a shoulder roll</p> Signup and view all the answers

    Why is chlorhexidine avoided in otorhinolaryngology procedures?

    <p>It is known to be ototoxic</p> Signup and view all the answers

    What type of instrument is specifically used for myringotomy procedures?

    <p>Myringotomy knife</p> Signup and view all the answers

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

    <p>The return electrode pad is applied and the safety strap is secured</p> Signup and view all the answers

    Which of the following instruments is commonly associated with rhinosurgery?

    <p>Sinuscope</p> Signup and view all the answers

    What is the purpose of the shoulder roll during surgery?

    <p>To improve visualization and support the patient's shoulders</p> Signup and view all the answers

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

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

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

    <p>Providone-iodine solution</p> Signup and view all the answers

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

    <p>They are specifically designed for general use</p> Signup and view all the answers

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

    <p>It should be followed to ensure appropriate practices are adhered to</p> 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.

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