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Questions and Answers
What is the primary goal of patient positioning during surgery?
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?
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?
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?
Which factor is NOT considered a preoperative risk factor for patient positioning?
What role does the circulating nurse play in patient positioning?
What role does the circulating nurse play in patient positioning?
Which of the following is an intraoperative risk factor affecting patient positioning?
Which of the following is an intraoperative risk factor affecting patient positioning?
Who typically assists in positioning the patient during the surgical procedure?
Who typically assists in positioning the patient during the surgical procedure?
What should be continually assessed during the intraoperative phase?
What should be continually assessed during the intraoperative phase?
What is the positioning concern for the Obturator Nerve?
What is the positioning concern for the Obturator Nerve?
In the Fowler position, how is the head of the bed adjusted?
In the Fowler position, how is the head of the bed adjusted?
Which nerve is at risk of compression from the medial side of the knee brace?
Which nerve is at risk of compression from the medial side of the knee brace?
What is the correct positioning for legs in the lateral position?
What is the correct positioning for legs in the lateral position?
What is a consideration when positioning a patient in the prone position?
What is a consideration when positioning a patient in the prone position?
What is one of the physiological effects of positioning that can lead to a decrease in cardiac output?
What is one of the physiological effects of positioning that can lead to a decrease in cardiac output?
Which positioning technique is recommended to prevent a sudden drop in blood pressure when using the lithotomy position?
Which positioning technique is recommended to prevent a sudden drop in blood pressure when using the lithotomy position?
What is a common risk for patients with preexisting respiratory diseases during positioning?
What is a common risk for patients with preexisting respiratory diseases during positioning?
What adverse effect can occur from prolonged pressure on the integumentary system?
What adverse effect can occur from prolonged pressure on the integumentary system?
Which positioning technique can lead to shearing injuries?
Which positioning technique can lead to shearing injuries?
What condition occurs when the epidermis is weakened by moisture?
What condition occurs when the epidermis is weakened by moisture?
What should be avoided to maintain adequate circulation to arms positioned on armboards?
What should be avoided to maintain adequate circulation to arms positioned on armboards?
What is the primary cause of friction when a patient is moved during positioning?
What is the primary cause of friction when a patient is moved during positioning?
What is the recommended position for the arms in the supine position?
What is the recommended position for the arms in the supine position?
What is a common risk associated with the lithotomy position?
What is a common risk associated with the lithotomy position?
How should the legs be handled when transitioning in the lithotomy position?
How should the legs be handled when transitioning in the lithotomy position?
What is the purpose of padding in the supine position?
What is the purpose of padding in the supine position?
What should be used to protect the radial nerve during positioning?
What should be used to protect the radial nerve during positioning?
What is the key consideration when positioning a patient in Trendelenburg?
What is the key consideration when positioning a patient in Trendelenburg?
In which position should the arms be placed if they are extended on arm boards?
In which position should the arms be placed if they are extended on arm boards?
What is a necessary action to prevent low back pain when in the supine position?
What is a necessary action to prevent low back pain when in the supine position?
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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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