BODY POSITIONING QUESTIONS Flashcards
What nerves are at highest risk of damage in the lateral recumbent position and what are the signs and symptoms of those nerve(s) damage?
Brachial Plexus Nerve: burning sensation and weakness in arm and hand
The Brachial Plexus includes what three nerves?
Musculocutaneous, Ulnar, Median
What physiological change would you expect to see in a patient who is in the lateral recumbent position?
Increase in heart rate and SVR
decrease in cardiac output, systolic BP, and MAP. Pulmonary - ventilation perfusion mismatch to dependent lung and decrease functional residual capacity
A prudent SRNA would anticipate the patient to be in a lateral decubitus position for what surgical procedure(s)?
Temporal lobe craniotomy,
skull base and posterior fossa procedures, retroperitoneal, thoracic, and thoracolumbar spine are common procedures for the lateral decubitus position.
- While the patient is in the prone position, proper padding and rotation of the arms is essential for prevention of what major complication?
Ulnar nerve compression
- Expected physiological changes while the patient is in the prone position might include which of the following
Increased FRC
An Arkansas State SRNA’s primary (most important) responsibility while planning to move a patient from supine to prone while intubated would include which of the following?
Securing airway
Which answer is not a known complication of the supine position?
a) Backache
b) Ulnar nerve compression
c) Aortocaval compression
d) Reduces FRC
e) Injury to the sciatica and perineal nerves
Injury to the sciatica and perineal nerve
What is a possible complication associated with the supine position in pregnancy?
Aortocaval syndrome
How would you prepare a patient to prevent ulnar nerve damage? CHOOSE 2
Avoid excessive pressure on the post condylar groove of the humerus
Hand and forearm position will need to be either supinated and/or in neutral position
The most significant complication from the sitting position is..
Venous Air Embolism
Invasive arterial blood pressure should be monitored at what level?
External auditory meatus to optimize cerebral perfusion pressure
As a SRNA you are well aware of the risk factors associated with the sitting position, so when your patient develops a venous air embolism, you remain calm and do the following. Select three that apply
Discontinue N2O immediately and deliver 100% oxygen with anesthetic inhalation
Attempt to aspirate central venous catheter to retrieve entrained air
Implement Bilateral jugular vein compression
What are the various physiological effects of the Trendelenburg position at 1 minute, at 10 minutes, and in longer procedures? What steps can be taken to prevent them?
1 Min: 9% increase in Cardiac Output
10 Min: C.O. returns to baseline
Overall: Functional Residual Capacity decreases,
Pulmonary Compliance Decreases;
Increased Intraocular Pressure & Intracranial Pressure
Identify the surgical procedure for which Trendelenburg position is used - Select 2
Cholecystectomy
Robot-Assisted Laparoscopic radical Prostatectomy
Compression or stretch injury to the brachial plexus is common in Trendelenburg positions. What safety steps must be implemented to reduce the risk of brachial plexus neuropathy?
Proper padding and fitting of shoulder braces to prevent injury.
- There is a 32 year old male going in for a transurethral prostate resection. What surgical position will be most beneficial for this patient and type of surgery?
Lithotomy position
Why is it beneficial and important to position the patient in the lithotomy position? Choose three
Prevents peripheral nerve damage
prevents skin and deep tissue injury
sedation eliminates patient sensation
What specific lithotomy position is used for procedures that require simultaneous access to the perineum and the abdomen?
Low lithotomy position
supine position is also known as?
dorsal decubitus
where is the head in trendelenburg and reverse trendelenburg
Trendelenburg is head down
Reverse is head up (highest part of body)
what trendelenburg position reduces the chance of air embolism?
Normal trendelenburg with the head down.
