Surgical Patient Positioning Quiz

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Questions and Answers

What is the primary goal of patient positioning during surgery?

To decrease operation time

To maximize surgical team comfort

To adjust to surgeon's preference

To ensure physiological and anatomical safety (correct)

Which healthcare professional is responsible for monitoring the patient's physiological functions during anesthesia?

Surgeon

Registered practical nurse

Anesthesiologist (correct)

Circulating nurse

What can result from incorrect positioning of the surgical patient?

Enhanced exposure of surgical area

Reduced surgery time

Injury from pressure or movement (correct)

Improved patient recovery

Which factor is NOT considered a preoperative risk factor for patient positioning?

Length of surgery Signup and view all the answers

What role does the circulating nurse play in patient positioning?

Using body mechanics and providing proper equipment Signup and view all the answers

Which of the following is an intraoperative risk factor affecting patient positioning?

Hypothermia Signup and view all the answers

Who typically assists in positioning the patient during the surgical procedure?

The registered practical nurse (RPN) Signup and view all the answers

What should be continually assessed during the intraoperative phase?

The patient's positioning Signup and view all the answers

What is the positioning concern for the Obturator Nerve?

Compression from hip flexion Signup and view all the answers

In the Fowler position, how is the head of the bed adjusted?

Raised 90 degrees Signup and view all the answers

Which nerve is at risk of compression from the medial side of the knee brace?

Saphenous Nerve Signup and view all the answers

What is the correct positioning for legs in the lateral position?

Lower leg will be straight and upper leg will be bent Signup and view all the answers

What is a consideration when positioning a patient in the prone position?

Ensure the knees and hips are supported Signup and view all the answers

What is one of the physiological effects of positioning that can lead to a decrease in cardiac output?

Compression of the Vena Cava Signup and view all the answers

Which positioning technique is recommended to prevent a sudden drop in blood pressure when using the lithotomy position?

Raising the legs together slowly Signup and view all the answers

What is a common risk for patients with preexisting respiratory diseases during positioning?

Compromised respiration Signup and view all the answers

What adverse effect can occur from prolonged pressure on the integumentary system?

Pressure sores and ischemia Signup and view all the answers

Which positioning technique can lead to shearing injuries?

Sliding the patient down the table Signup and view all the answers

What condition occurs when the epidermis is weakened by moisture?

Maceration Signup and view all the answers

What should be avoided to maintain adequate circulation to arms positioned on armboards?

Avoiding compressive forces Signup and view all the answers

What is the primary cause of friction when a patient is moved during positioning?

Dragging the patient across the linen Signup and view all the answers

What is the recommended position for the arms in the supine position?

Tucked at sides with palms facing legs Signup and view all the answers

What is a common risk associated with the lithotomy position?

Venous thrombosis due to leg elevation Signup and view all the answers

How should the legs be handled when transitioning in the lithotomy position?

Lowered simultaneously with two team members Signup and view all the answers

What is the purpose of padding in the supine position?

To prevent pressure sores and nerve damage Signup and view all the answers

What should be used to protect the radial nerve during positioning?

Elbow pads Signup and view all the answers

What is the key consideration when positioning a patient in Trendelenburg?

Supine positioning guidelines should be followed Signup and view all the answers

In which position should the arms be placed if they are extended on arm boards?

Extended straight at the shoulders Signup and view all the answers

What is a necessary action to prevent low back pain when in the supine position?

Use a pillow to support the knees Signup and view all the answers

Study Notes

Positioning in the Operating Room

Patient positioning is crucial for safety and efficiency during surgery.
Objectives include maintaining physiological safety, ensuring airway access, and achieving optimal surgical exposure.
Incorrect positioning can lead to patient injuries, emphasizing the importance of prevention.

Roles of Healthcare Team

All team members must respect patient privacy and understand positioning effects on various body systems.
The surgeon decides the optimal position based on surgical needs and patient tolerance.
Anesthesiologists monitor the patient during anesthesia, facilitating safe movements.
Circulating nurses utilize body mechanics and anatomical knowledge for effective positioning and equipment provision.

Risk Factors for Positioning

Preoperative: Age, weight, skin condition, nutritional status, health conditions, physical mobility.
Intraoperative: Surgery duration, positioning devices, anesthesia type, blood loss, hypothermia.
Postoperative: Mobility issues, pain management, respiratory status.

Physiological Effects of Positioning

Circulatory System

Changes in position can cause hypotension and venous pooling in extremities.
Compression of the vena cava may occur; a "bump" under the right hip can alleviate pressure.
Anti-embolic stockings can help prevent complications.
Arms on armboards need circulation checks to avoid injury.

Respiratory System

Patients with respiratory issues face higher risks during certain positions (e.g., prone, lateral).
Vital lung capacity could decrease due to pressure limiting chest expansion.

Integumentary System

Skin can suffer from injuries due to pressure forces, shearing, friction, and maceration.
Important factors include:
- Pressure: Force from body weight and equipment.
- Shearing: Stretching of blood vessels when patients slide on the table.
- Friction: Skin damage from dragging across linens.
- Maceration: Skin breakdown from moisture exposure.

Nervous System Considerations

Protective measures for nerves are essential during positioning to avoid injury.

Surgical Positions

Supine: Most common; arms secured, legs not crossed. Protect nerves with padding.
Trendelenburg: Supine with head down, following same considerations as supine.
Reverse Trendelenburg: Supine with head up, following supine considerations.
Lithotomy: Four variations; arms can be tucked or extended. Requires careful leg manipulation to prevent injury and thrombosis.
Fowler's Position: 90-degree elevation of the head; footrest provided.
Semi-Fowler's Position: 45-degree elevation with slight leg lowering.
Lateral: Side lying; requires limb support and padding between knees, with safety straps.
Prone: Similar arm positioning to supine; ensure eye protection and padding of knees and hips.

Protection of Specific Nerves

Suitable padding methods should be used to protect:
- Radial Nerve: Use elbow pads in supine.
- Common Peroneal Nerve: Minimize pressure in the popliteal area.
- Obturator Nerve: Watch for hip flexion.
- Saphenous and Femoral Nerves: Be cautious of medial and lateral pressures, respectively.

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Description

This quiz focuses on Module 9: Positioning from Alexander’s Care of the Patient in Surgery. It will help you understand various surgical positions, their impact on the circulatory, respiratory, and integumentary systems, and the importance of proper positioning in perioperative care.

Surgical Patient Positioning Quiz - Module 9

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