Inter op

Question 1

Which activities are the circulating nurse’s responsibilities in the operating room?

Answer 1

Monitor the position of the client, prepare the surgical site, and ensure the client’s safety

Question 2

How is the surgical site marked?

Answer 2

-use initials or “yes” with permanent marker
-do not use X it may be ambiguous
-nonoperative sites should not be marked

Question 3

what is the JCAHO protocol for surgical timeout?

Answer 3

1)perform a preoperative verification process (ideally with the patient awake, aware, and involved)
2)mark the operative site to unambiguously identify the intended procedure site
3)the entire operating team takes a “time out” immediately before starting the procedure to conduct a final verification of the correct patient, procedure, site, and any implants

Question 4

what are the 3 goals of anesthesia

Question 4

what happens during a “time out”

Answer 4

-designated person calls a time out
-all activity suspended
-all team members actively participate in the time out
-confirm patient identity, procedure and consent
-correct site and side (verified with site marking as per policy)
-correct antibiotic administered and allergies reviewed

Question 5

what is inside the Restricted area
(requires sterile gown and gloves)

Answer 5

OR
procedure room
sterile core

Question 6

If it is blue or green dont touch unless you are sterile

Question 7

Who are the nonsterile team members in the OR?

Answer 7

Anesthesia provider (anesthesiologist or CRNA)
circulating RN
any unlicensed assistive personnel (patient transport and positioning patient)

Question 8

how is infection prevented in the OR

Answer 8

-scrubbing fingers to hands to arms
-Don sterile gloves and gown
-Skin prep:
assess the patient’s skin
clean with betadine
-Drape patient to isolate surgical area

Question 9

Goals of anesthesia

Answer 9

-amnesia
-analgesia
-pain control
-depression of reflexes
-muscle relaxation
-manipulation of physiological body functions

Question 10

what are the 3 phases of general anesthesia?

Answer 10

1) Induction: when meds start
2) Maintenance: desired effect reached
3) Emergence: Surgery is over, reversing of drugs

Question 11

general anesthesia side effects

Question 12

must know about malignant hyperthermia

Answer 12

-Medical emergency
-genetic
-triggered by “flurane” & succinylcholine
-can occur immediately or PACU

Question 13

signs and symptoms of malignant hyperthermia

Answer 13

-tachycardia (1st sign)
-hypoxemia & hypercarbia
-skeletal muscle rigidity (muscles clamping down on ET tube)
-arrhythmias
-myoglobinuria (urine will start to turn dark brown)
-hyperthermia (up to 110 degrees) (late sign)

Question 14

treatment for malignant hyperthermia

Answer 14

-stop triggering meds
-give dantrolene
-cool the patient
-correct imbalances

Question 15

facts about monitored anesthesia (conscious sedation)- MAC

Answer 15

-IV benzodiazepines: diazepam & midazolam
-maintains own patent airway
-can still answer questions & respond to physical stimulation
-amnesia
-less risky & rapid recovery
-IV narcotics or local anesthetics for pain
-complications: airway obstruction, respiratory depression

Question 16

facts about regional anesthesia

Answer 16

-nerve: major nerve or a group of nerves
-spinal: spinal canal or intrathecal space of lower back
SPINAL HEADACHE IS WORST HEADACHE OF YOUR LIFE
treat headache with rest, fluids, acetaminophen and/or blood patch
-epidural: epidural space of lumbar or thoracic region
side effects are same as spinal but NO HEADACHE

Question 17

facts about local anesthesia

Answer 17

Amides “lidocaine”
-can be mixed with epinephrine to control bleeding at the site
complications:
-severe anaphylaxis
-mild reactions (rash, hives, itching)

Question 18

facts about positioning

Answer 18

-circulating RN responsibility
-correct positioning for access, comfort, and safety
prevent pressure on skin and nerves
prevent occlusion of arteries/veins
protect patient privacy and dignity