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As a perioperative nurse, you know that the National Patient Safety Goals have the potential to improve patient outcomes in a wide variety of health care settings. Which of these Goals has the most direct relevance to the OR?
- A. Improve safety related to medication use
- B. Reduce the risk of patient harm resulting from falls
- C. Reduce the incidence of health care-associated infections
- D. Reduce the risk of fires
Correct Answer: D
Rationale: The National Patient Safety Goals all pertain to the perioperative areas, but the one with the most direct relevance to the OR is the reduction of the risk of surgical fires.
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A 59-year-old male patient is scheduled for a hemorrhoidectomy. The OR nurse should anticipate assisting the other team members with positioning the patient in what manner?
- A. Dorsal recumbent position
- B. Trendelenburg position
- C. Sims position
- D. Lithotomy position
Correct Answer: D
Rationale: The lithotomy position is used for nearly all perineal, rectal, and vaginal surgical procedures. The Sims or lateral position is used for renal surgery and the Trendelenburg position usually is used for surgery on the lower abdomen and pelvis. The usual position for surgery, called the dorsal recumbent position, is flat on the back, but this would be impracticable for rectal surgery.
The OR nurse is providing care for a 25-year-old major trauma patient who has been involved in a motorcycle accident. The nurse should know that the patient is at increased risk for what complication of surgery?
- A. Respiratory depression
- B. Hypothermia
- C. Anesthesia awareness
- D. Moderate sedation
Correct Answer: C
Rationale: The Joint Commission has issued an alert regarding the phenomenon of patients being partially awake while under general anesthesia (referred to as anesthesia awareness). Patients at greatest risk of anesthesia awareness are cardiac, obstetric, and major trauma patients. This patient does not likely face a heightened risk of respiratory depression or hypothermia. Moderate sedation is not a complication.
The anesthetist is coming to the surgical admissions unit to see a patient prior to surgery scheduled for tomorrow morning. Which of the following is the priority information that the nurse should provide to the anesthetist during the visit?
- A. Last bowel movement
- B. Latex allergy
- C. Number of pregnancies
- D. Difficulty falling asleep
Correct Answer: B
Rationale: Due to the increased number of patients with latex allergies, it is essential to identify this allergy early on so precautions can be taken in the OR. The anesthetist should be informed of any allergies. This is a priority over pregnancy history, insomnia, or recent bowel function, though some of these may be relevant.
A 68-year-old patient is scheduled for a bilateral mastectomy. The OR nurse has come out to the holding area to meet the patient and quickly realizes that the patient is profoundly anxious. What is the most appropriate intervention for the nurse to apply?
- A. Reassure the patient that modern surgery is free of significant risks.
- B. Describe the surgery to the patient in as much detail as possible.
- C. Clearly explain any information that the patient seeks.
- D. Remind the patient that the anesthetic will render her unconscious.
Correct Answer: C
Rationale: The nurse can alleviate anxiety by supplying information as the patient requests it. The nurse should not assume that every patient wants as much detail as possible and false reassurance must be avoided. Reminding the patient that she will be unconscious is unlikely to reduce anxiety.
A patient waiting in the presurgical holding area asks the nurse, Why exactly do they have to put a breathing tube into me? My surgery is on my knee. What is the best rationale for intubation during a surgical procedure that the nurse should describe?
- A. The tube provides an airway for ventilation.
- B. The tube protects the patients esophagus from trauma.
- C. The patient may receive an antiemetic through the tube.
- D. The patients vital signs can be monitored with the tube.
Correct Answer: A
Rationale: The anesthetic is administered and the patients airway is maintained through an intranasal intubation, oral intubation, or a laryngeal mask airway. The tube also helps protect aspiration of stomach contents. The tube does not protect the esophagus. Because the tube goes into the lungs, no medications are given through the tube. The patients vital signs are not monitored through the tube.