OR Positions/PreOp/Notes

Question 1

What to look out for re: brachial plexus?

Answer 1

do not raise arm >90 deg
keep head and neck aligned
avoid shoulder restraints

Question 2

What to look out for re: peroneal and tibial nerve?

Answer 2

pillow under knee

padding for lateral knee

Question 3

What is a complication for peroneal and tibial nerve damage?

Answer 3

foot drop

Question 4

What areas to look out for re: ulcers?

Answer 4

sacrum and heel

Question 5

What to look out for when pt is in supine position?

Answer 5

brachial plexus
radial and ulnar nerve
peroneal and tibial nerve

Question 6

What to look out for pt when in trendelenburg?

Answer 6

lung vol - can dec

pressure of organs against diaphragm compresses the heart

Question 7

What to look out for when in reverse trendelenburg?

Answer 7

venous return is diminished

pressure on feet and calneus

Question 8

What are the surgical positions?

Answer 8

basic: supine, prone, lateral, lithotomy
variations: trendelenburg, reverse trendelenburg, fowlers, jackknife

Question 9

What are the ASA classifcations?

Answer 9

I - normal
II - pt wi/mild to mod controlled systemic dz
III - SEVERE systemic dz
IV - SEVERE systemic dz + dz that is constatnt threat to life
V - moribund pt and MUST have surgery to live
VI - brain dead; organ harvest

Question 10

What does the scrub nurse and circulator do?

Answer 10

scrub nurse-keeps sterile field

circulator -not part of the sterile field

Question 11

What to do before getting to surgery?

Answer 11

review pathophys and anatomy
check OR schedule
see preop pts - meds, allergies, site marked
morning orunds

Question 12

What do PAs do in surgery?

Answer 12

first assist: retract, suction, blot

Question 13

What are the admission notes?

Answer 13

A-dmit to floor
D-x PROCESS
C-ondition
V-itals
A-ctivity
A-llergies
N-ursing (orders)
D-iet
I-VF: fluids
S-tudies (CXR)
M-eds
L-abs (order)

Question 14

What to check for on rounds (PE)?

Answer 14

heart

lungs - atelectesis