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AORN Periop class > Positioning > Flashcards

Positioning Flashcards

1
Q

What position is when the patient is lying on their back?

A

supine

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2
Q

What is another word for supine?

A

dorsal recumbent

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3
Q

What are modifications for the supine position?

A
  1. lithotomy
  2. sitting/semi-sitting
  3. trendelenburg and reverse trendelenburg
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4
Q

Define lithotomy

A

the patient is supine and the legs are placed in stirrups

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5
Q

define sitting/semi-sitting

A

the patient is placed in a sitting or semi-sitting position

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6
Q

define trendelenburg and reverse trendelenburg

A
  1. the upper torso is lowered and the feet are raised - trendelenburg
  2. head-up, feet down, supine position.
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7
Q

What position is when the patient is lying on their non-operative side?

A

lateral

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8
Q

How does a patient get into the lateral position?

A

Patient is anesthetized in the supine position on the OR bed and then log rolled onto their non-operative side

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9
Q

What position is the patient in when they are lying face down?

A

prone

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10
Q

How does a patient get into the prone position?

A

the patient is anesthetized on a transport vehicle in the supine position and then log rolled onto their abdomen on the OR bed.

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11
Q

What is a variation of the prone position?

A

Jack-knife, or Kraske position

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12
Q

What patient factors do you want to assess that might place a patient at risk for a positioning injury during surgery?

A
  1. age
  2. height and weight
  3. skin condition
  4. nutritional status - dehydration, low albumin
  5. preexisting conditions
  6. physical/mobility limits
  7. body mass index
  8. presence of jewelry
  9. lab results
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13
Q

What are procedural factors that you might want to assess that might place a patient at risk for a positioning injury during surgery?

A
  1. type of anesthesia
  2. length of surgery
  3. position required during surgery
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14
Q

How should arms be positioned when a pt. is in supine?

A

arm extensions should be less than 90 degrees to avoid compression of the brachial plexus

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15
Q

What is an alternative arm placement for supine position?

A

at the sides with thumbs up

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16
Q

What do you want to place under a pt.’s knees in supine?

A

a soft pillow to prevent stress on the lower back

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17
Q

Where should a safety strap go when the pt. is in supine?

A

2 inches above the knees with a sheet or blanket placed between the strap and the patient’s skin.

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18
Q

Where should pad pressure points go?

A

occiput, scapulae, thoracic vertebrae, olecranon process, sacrum/coccyx, elbows

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19
Q

What should you do with a pregnant patient in supine?

A

insert a wedge under the patient’s right side to displace the uterus to the left

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20
Q

What can use to redistribute heel pressure when a pt. is in supine?

A

wide pressure-redistributing surface or heel-suspension device

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21
Q

What 4 procedures is supine used for?

A
  1. abdominal procedures
  2. head and neck procedures
  3. vascular surgery
  4. breast surgery
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22
Q

How is a pt. positioned in lithotomy to prevent strain on the sacrum?

A

the patient’s buttocks are positioned even with the lower break in the OR bed and should not extend over the break

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23
Q

Where should a pt.’s arms go in lithotomy?

A

place the patient’s arms on padded arm boards

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24
Q

What should you protect when manipulating the OR bed and adding positioning attachments to the OR bed?

A

hands and fingers

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25
Q

What 3 physiological changes can occur when a pt. is placed in lithotomy?

A
  1. When the legs are raised and placed in stirrups, the abdominal organs shift, which increases pressure on the diaphragm, leading to respiratory compromise.
  2. A shift in the circulatory volume can occur when legs are removed from the stirrups after surgery.
  3. The circulatory and respiratory systems may be compromised due to compression of the abdominal contents on the
    inferior vena cava and abdominal aorta.
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26
Q

After surgery how should you handle the pt.’s legs who have been in lithotomy?

A

lower the patient’s legs slowly when removing them from he stirrups

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27
Q

what nerve damage can occur when a pt. is placed in lithotomy?

A

to femoral, obturator, and perineal nerves can occur

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28
Q

What procedures is lithotomy used for?

A
  1. vaginal
  2. rectal
  3. urological
  4. colorectal
  5. reproductive laparoscopic procedures
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29
Q

What angle is created between the posterior surface of the patient’s thighs and OR bed surface? standard

A

80 degrees to 100 degrees

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30
Q

What is a modification of lithotomy that puts one of the patient’s legs up?

A

semi lithotomy

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31
Q

What angle is created between the posterior surface of the patient’s thighs and OR bed surface with low lithotomy?

A

40-60 degrees

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32
Q

What angle is created between the posterior surface of the patient’s thighs and OR bed surface with high lithotomy?

A

110-120

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33
Q

What angle is created between the posterior surface of the patient’s thighs and OR bed surface with exaggerated lithotomy?

A

130-150

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34
Q

What is another 2 words to describe semi-sitting?

A

semi fowler or beach chair

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35
Q

What is another word to describe sitting?

A

fowler

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36
Q

What procedures are done in the sitting and semi-sitting position?

A
  1. shoulder
  2. posterior cervical spine
  3. posterior or lateral head
37
Q

How much do you want to flex the pt.’s knees in sitting/semi-sitting?

A

30 degrees to prevent stress on the sciatic nerve

38
Q

What are the angle measurements for the pt. in trendelenburg?

A

patient’s feet are higher than the patient’s head by 15 degrees to 30 degrees

39
Q

What procedures is trendelenburg used for?

A
  1. pelvic organ and low intestinal procedures

2. first line intervention in the treatment of acute hypotension and/or shock

40
Q

What are the angle measurements for the pt. in reverse trendelenburg?

A

the pt.’s head is 15-30 degrees

41
Q

What procedures is reverse trendelenburg used for?

A

head, neck, and upper abdominal procedures

42
Q

Why is the surgical site elevated above the heart in reverse rendelenburg?

A
  1. to improve drainage of body fluids away from the surgical site
  2. reduce intracranial pressure
  3. decrease bleeding in the surgical field
43
Q

What kind of procedures are performed in the lateral position?

A
  1. thoracotomy
  2. kidney surgery
  3. hip surgery
44
Q

What positioning device and/or equipment is not used when placing a patient in the lateral position?

A

boot stirrup

45
Q

Why do the feet need to be maintained in the prone position?

A

to prevent foot drop

46
Q

Why do you want to pad the eyes and avoid pressure?

A

to prevent conjunctival edema, corneal abrasion, or retinal ischemia

47
Q

How should you rotate the arms in prone? why?

A

rotate the arms slowly when placing them on arm boards to prevent brachial plexus injuries

48
Q

What can improper positioning in the prone position do?

A

pressure on the inferior vena cava and femoral veins

49
Q

What can pressure on the inferior vena cava and femoral veins do in prone?

A

can reduce venous return and produce hypotension

50
Q

What can pressure on the carotid artery from the head being turned do in prone?

A

can produce hypotension and arrhythmias

51
Q

In the prone position, what is the patient most vulnerable to?

A

to respiratory problems due to compression of the diaphragm, which impairs gas exchange

52
Q

What can occur from the effects of body weight against the abdominal wall in the prone position?

A

increased airway pressure and difficulty in ventilation

53
Q

What is the prone position used for?

A

back, rectum, and other dorsal areas

54
Q

What is an example of a procedure with prone?

A

lumbar laminectomy

55
Q

What kind of procedure is the jack-knife position used for?

A

hemorrhoidectomy and pilonidal sinus

56
Q

What is a non-blanchable erythema of intact skin?

A

stage 1 pressure injury

57
Q

What is a partial-thickness skin loss with exposed dermis

A

stage 2 pressure injury

58
Q

What is full-thickness skin loss?

A

stage 3 pressure injury

59
Q

What is full-thickness skin and tissue loss?

A

stage 4 pressure injury

60
Q

what is obscured full-thickness skin and tissue loss?

A

unstageable pressure injury

61
Q

What is persistent non-blanchable, deep red, maroon, or purple discoloration?

A

deep tissue pressure injury

62
Q

What are 2 other pressure injuries that that do not fit into the stage 1,2,3, or 4 pressure categories?

A
  1. mucosal membrane pressure injury

2. medical device-related pressure injury

63
Q

What is the result of opposing movement of skeletal structure and the skin. Perpendicular force causes this?

A

shear

64
Q

Maceration can occur when the skin is exposed to what for prolonged time, causing the tissue to break down?

A

moisture

65
Q

Exposure to this occurrence reduces peripheral circulation, reducing oxygen to the skin and tissues>

A

cold

66
Q

Layers of materials, such as extra linen, adds rigidity and can produce high and inconsistent pressure?

A

negativity

67
Q

What should happen with patients that are greater than 18 weeks pregnant?

A

placed in left lateral tilt, with a wedge placed under the right pelvis or lumbar region.

68
Q

What is pressure injury risk assessment tool designed for surgical patients?

A

munro pressure ulcer risk assessment scale

69
Q

Who is responsible for pt. positioning?

A

surgical team

70
Q

To position a patient who is obese in the supine position, you should what?

A

use padded arm guards to contain the arms at the sides

71
Q

When the patient is in the supine position with the arms at the sides, where should you tuck the draw sheet?

A

underneath the patient

72
Q

Raising the patient’s legs into the lithotomy position shifts blood from the legs into the central circulation and…

A

increases cardiac output and venous return

73
Q

What is a standardized, structured, perioperative nursing language that reflects the perioperative nursing process. It can be used as a method to gather, organize, and document perioperative nursing care to create and implement an individualized care plan for each perioperative patient.

A

Perioperative nursing data set

74
Q

What is softened, separated, and wasted away as a result of moisture.9 A patient’s
skin can become macerated when it is in contact with blood, bodily fluids, and other fluids for a period of time?

A

macerated

75
Q

What is a localized injury to the skin and/or underlying tissue
during an inpatient hospital stay and a result of pressure, shear, or both?

A

hospital-acquired pressure injury (HAPI)

76
Q

What is a pediatric pressure injury risk assessment tool?

A

glamorgan scale

77
Q

What is the 65 to 74 years of age?

A

the young-old

78
Q

What is the 75 to 84 years of age?

A

the middle-old

79
Q

What is the 85 to 99 years of age?

A

the old-old

80
Q

What is the 100 years of age or more?

A

the elite-old

81
Q

What is when the patient’s body is dragged across the bed linens instead of being lifted?

A

friction

82
Q

If your BMI is 18.5 to less than 25 what is your classification?

A

normal weight range

83
Q

If your BMI is 25 to less than 30 what is your classification?

A

overweight range

84
Q

If your BMI is 30 or higher what is your classification?

A

obese range

85
Q

If your BMI is less than 18.5?

A

underweight range

86
Q

What is class 1 adult obesity?

A

BMI of 30kg/m2 to <35kg/m2 (obese)

87
Q

What is class 2 adult obesity?

A

BMI of 35 kg/m2 to < 40 kg/m2 (obese)

88
Q

What is class 3 adult obesity?

A

BMI of 40 kg/m2 or higher (extremely obese)

AORN Periop class (23 decks)

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