Patient Positioning in Surgery
40 Questions
2 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the appropriate patient position for biliary surgery?

  • Lateral position
  • Supine position (correct)
  • Sitting position
  • Prone position
  • Which count is performed prior to the surgical procedure commencing?

  • Final Count
  • Closing Count
  • Initial Count (correct)
  • Minor Count
  • What is considered the gold standard approach for performing a cholecystectomy?

  • Laparoscopic approach (correct)
  • Endoscopic approach
  • Robotic surgery
  • Open approach
  • What instrument is NOT typically included in the equipment for a cholecystectomy?

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

    Which positioning technique assists with visualization of the organ during surgery?

    <p>Lateral tilt with right side up</p> Signup and view all the answers

    What must a surgeon avoid during the cholecystectomy procedure?

    <p>Bile spillage in the abdominal cavity</p> Signup and view all the answers

    What type of injury could occur with trocar placement during laparoscopic surgery?

    <p>Visceral or vascular injury</p> Signup and view all the answers

    Which element is NOT part of securing patient safety during surgery?

    <p>Giving anesthesia to the patient</p> Signup and view all the answers

    What procedure is performed to remove the recipient's original liver during transplantation?

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

    What are some potential complications of CO2 insufflation during surgery?

    <p>Respiratory acidosis and gas embolism</p> Signup and view all the answers

    What is the main reason patients undergo liver transplantation?

    <p>Chronic liver disease or primary cancer</p> Signup and view all the answers

    Which vessels are typically involved in the anastomosis process during liver transplantation?

    <p>Hepatic artery, portal vein, and inferior vena cava</p> Signup and view all the answers

    During the laparoscopic cholecystectomy, which port serves as the main camera port?

    <p>Umbilical port</p> Signup and view all the answers

    What must occur before the organs can be retrieved for transplantation?

    <p>Brain death must be declared, and consent signed.</p> Signup and view all the answers

    What is the purpose of performing an intraoperative cholangiogram?

    <p>To highlight the biliary structures and assess for blockages</p> Signup and view all the answers

    What is the role of the hemoclips during the laparoscopic surgery?

    <p>To ligate the cystic artery</p> Signup and view all the answers

    What is the purpose of lifelong immunosuppressants for liver transplant patients?

    <p>To prevent rejection of the donor liver</p> Signup and view all the answers

    Which procedure uses a catheter passed through an endoscope to diagnose issues in the biliary tract?

    <p>Endoscopic Retrograde Cholangeopancreatography (ERCP)</p> Signup and view all the answers

    What is critical to check after releasing the clamps on the portal vein and IVC?

    <p>Tissue perfusion and any vessel leaks or bleeding</p> Signup and view all the answers

    What happens to the portion of the donor's liver that is excised during a live donor transplantation?

    <p>It regenerates itself over time.</p> Signup and view all the answers

    What technique is primarily used to remove stones laparoscopically during surgery?

    <p>Flexible Stone Forceps</p> Signup and view all the answers

    What role does the Trillium Gift of Life Transplant Coordinator play in organ retrieval?

    <p>Coordinating the physiological qualification of potential organ recipients</p> Signup and view all the answers

    What happens to the cystic duct during an intraoperative cholangiogram?

    <p>It is clipped to prevent bile flow</p> Signup and view all the answers

    What sequence of actions occurs right after the skin incision in a laparoscopic procedure?

    <p>Creation of pneumoperitoneum</p> Signup and view all the answers

    What is the correct order for organ retrieval during a surgical procedure?

    <p>Heart, lungs, liver, kidneys</p> Signup and view all the answers

    Which type of death does NDD refer to in organ donation?

    <p>Neurological determination of death</p> Signup and view all the answers

    What is one of the primary responsibilities of the perioperative nursing staff regarding postmortem care?

    <p>Preparing the body for transport</p> Signup and view all the answers

    Which of the following is NOT a perioperative nursing consideration during organ retrieval?

    <p>Performing immediate post-surgery checks</p> Signup and view all the answers

    What should be done if a patient's family wishes to see the body after an intraoperative death?

    <p>Use a private area for viewing</p> Signup and view all the answers

    What is critical for effective communication during an intraoperative death scenario?

    <p>Inform the family and involve the coroner when necessary</p> Signup and view all the answers

    What should the perioperative team conduct to support one another after a critical incident?

    <p>Critical incident debriefing</p> Signup and view all the answers

    What is the purpose of a choledochoduodenostomy?

    <p>To reestablish the flow of bile into the intestinal system</p> Signup and view all the answers

    In which population can intraoperative deaths occur?

    <p>In pediatric, adult, and geriatric populations</p> Signup and view all the answers

    Which surgical procedure is typically preferred for draining pancreatic cysts located near the jejunum?

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

    What are the main anatomical branches supplying the pancreas from the celiac axis?

    <p>Hepatic, splenic, and left gastric arteries</p> Signup and view all the answers

    Which of the following best describes the role of the Islets of Langerhans in the pancreas?

    <p>They excrete hormones like glucagon and insulin directly into the bloodstream</p> Signup and view all the answers

    What is the most common type of pancreatic cancer that affects the bile duct?

    <p>Ductal adenocarcinoma</p> Signup and view all the answers

    What is the preferred surgical method used to preserve quality of life in a Whipple procedure?

    <p>Pylorus preserving method</p> Signup and view all the answers

    What is the primary function of the Duct of Wirsung?

    <p>To secrete pancreatic enzymes into the duodenum</p> Signup and view all the answers

    Which anastomosis method connects the common bile duct to the jejunum?

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

    Study Notes

    Patient Positioning

    • Surgical position depends on the type of procedure, with biliary surgery typically requiring the supine position.
    • Refer to ORNAC Standards for proper positioning practices and checklist.
    • Ensure correct placement of patient return electrode pads and forced-air warming blankets if needed.
    • Safety strap must be checked and secured to prevent patient movement.

    Surgical Count

    • Mandatory counts include Major Initial Count, Major Closing Count (for open surgeries), and Minor Final Count (for both open and laparoscopic surgeries).

    Cholecystectomy (Open or Laparoscopic)

    • Procedure for gallbladder removal due to cholecystitis or cholelithiasis.
    • Laparoscopic approach is preferred; open method is used only when necessary.
    • Intraoperative cholangiogram may be performed if conversion to open surgery occurs.
    • Requires identification and ligation of cystic artery and duct to safely extract gallbladder without bile spillage.

    Instrumentation and Equipment

    • Utilizes MIS Tower with a sterile laparoscope, insufflation tubing, and various trocars based on procedure type.
    • Common equipment includes 5mm and 10-12mm trocars located according to surgical needs.

    Procedural Considerations

    • Risks include visceral or vascular injury from trocar placement, and CO2 insufflation complications (e.g., respiratory acidosis, gas embolism).
    • Potential complications: bile leak, bile duct injury, jaundice, infection, and bleeding.

    Operative Procedure Steps

    • Skin incision made with a #11 blade; pneumoperitoneum established.
    • Main camera port created via supraumbilical incision using a 10-12mm Hasson trocar.
    • Additional trocars inserted for instrumentation.
    • Cystic artery ligated with hemoclips; gallbladder dissected and removed through umbilical port.

    Intraoperative Cholangiogram

    • ERCP is a preoperative diagnostic tool for biliary tract issues that may involve stone removal.
    • Intraoperative cholangiogram involves injecting contrast dye into the cystic duct to visualize blockages during surgery.

    Common Biliary Anastomoses

    • Choledochoduodenostomy: common bile duct anastomosed to the duodenum for bile flow restoration.
    • Choledocojejunostomy: common bile duct reanastomosed to jejunum for similar purposes.

    Surgery of the Pancreas: Anatomy

    • The pancreas is a retroperitoneal organ with both exocrine (enzyme secretion) and endocrine (hormonal secretion) functions.
    • It receives blood supply from the celiac axis, comprised of hepatic, splenic, and left gastric arteries.

    Drainage or Excision of Pancreatic Cysts

    • Preferred internal drainage methods include Cystojejunostomy, Cystogastrostomy, and Cystoduodenostomy based on cyst location.

    Laparoscopic Whipple Resection

    • Pancreaticoduodenectomy for localized pancreatic cancer, focusing on reestablishing the continuity of digestive systems post-tumor removal.
    • Pylorus preserving method is preferred for better patient quality of life.

    Liver Transplantation

    • Involves implantation of donor liver after removing the recipient's affected liver.
    • Requires lifelong immunosuppression post-transplant; donor liver can regenerate if a portion is harvested from a living donor.

    Liver Anastomoses

    • Key vessels (hepatic artery, portal vein, common bile duct) must be carefully anastomosed to ensure proper function and blood supply.

    Organ Retrieval Surgery

    • Surgical team ensures optimal conditions for organ removal, guided by consent and coordination with organ donation structure.
    • Sequential removal of organs follows precise protocols to ensure effective transplantation.

    Organ Donation Types

    • Neurological Determination of Death (NDD) and After Circulatory Death (DCD) are two donor classifications pertinent to organ donation.

    Perioperative Nursing Considerations

    • Maintenance of aseptic techniques and completion of surgical safety protocols are critical during organ retrieval processes.

    Operating Room Deaths

    • Intraoperative deaths can occur due to various factors; the perioperative team must provide dignified postmortem care and support for the family.
    • Effective communication is essential during these sensitive situations, and in case of death, support systems like spiritual care and critical incident debriefing should be utilized.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz covers the essential practices for patient positioning during surgical procedures, particularly biliary surgery. It highlights the importance of using the ORNAC Standards and performance checklists to ensure patient safety and comfort. Key aspects include the application of return electrode pads, warming blankets, and securing safety straps.

    More Like This

    Patient Positioning & Body Mechanics
    21 questions
    Patient Positioning in Surgery
    24 questions
    Use Quizgecko on...
    Browser
    Browser