positioning/nerve injury

Question 1

Supine effects:

circulation

Answer 1

minimal

Question 2

Supine effects:

Pulmonary

Answer 2

decreased FRC (800cc)
cephalad displacement of diaphragm to compress the lung bases

Question 3

Supine effects:

what should u do to facilitate Venous return

Answer 3

flex hips and knees to facilitate venous drainage from lower extremities

Question 4

Supine effects:

what do u wanna make sure you pad

Answer 4

occiput

heels

Question 5

Trendelenburg Effects:

Circulation

Answer 5

decreased SV- hypotension maybe ( and viscera pushes against the diaphragm, which compresses lung bases and pushes on heart to decrease SV)

Question 6

Trendelenburg Effects:

Pulmonary

Answer 6

lung bases compresed

Question 7

Trendelenburg Effects:

what will happen to venous return

Answer 7

increase (but may not help the decrease in BP)

Question 8

Trendelenburg Effects:

what could it do to ICP

Answer 8

increase it

Question 9

Trendelenburg Effects:

what type of pets would you use this position with caution (not head puts think general population)

Answer 9

obese

Question 10

Prone effects:

circulation- what can become compressed

Answer 10

inferior venacava

Aorta

Question 11

Prone effects:

Pulmonary- what happens to lung bases

Answer 11

forced cephalad

Question 12

Prone effects:

what could hinder venous return

Answer 12

vascular compression

Question 13

Prone effects:

turning head in prone may obstruct drainage of what?

Answer 13

Jugular veins

vertebral artery

Question 14

Prone effects:
placement of what under the pts sides receive abdominal compression and increases venous return to the heart, and eases ventilation

Answer 14

abdominal rolls (chest rolls)

Question 15

Lateral Decubitus (on Ventilator) effects:
increased circulation goes to what lung?

Answer 15

dependent lung

Question 16

Lateral Decubitus (on Ventilator) effects:
there may be decreased blood to the kidney if what is being used

Answer 16

kidney rest

Question 17

Lateral Decubitus (on Ventilator) effects:
there will be decreased ventilation to what lung?

Answer 17

dependent

Question 18

Lateral Decubitus (on Ventilator) effects:
there will be increased ventilation to what lung

Answer 18

non dependent lung

Question 19

Lateral Decubitus (on Ventilator) effects:
should there be a problem with venous return

Answer 19

no

Question 20

Lateral Decubitus (on Ventilator) effects:
what should be in place and where on all pt's in lateral decubitus

Answer 20

axillary rolls

placed under thorax just caudal to axilla

Question 21

Sitting effects:

there is an increase in drainage from where?

Answer 21

head/ neck/ and upper body

Question 22

Sitting effects:

what happens to intrathoracic blood volume

Answer 22

decreases

Question 23

Sitting effects:

what changes occur to the pulmonary system?

Answer 23

none

Question 24

Sitting effects:

what can u do to increase venous return form the lower extremities?

Answer 24

use compression stockings

Question 25

Sitting effects:

with the decreased venous return what happens to cerebral perfusion pressure?

Answer 25

decreases

Question 26

Sitting effects:

with decreased Venous return what happened to cardiac output

Answer 26

decreases

Question 27

Sitting effects:

what is a hazard/potential complication from this position?

Answer 27

air embolism

Question 28

Lithotomy effects:

any problems with circulation

Answer 28

no

Question 29

Lithotomy effects:

what happens to the lung bases?

Answer 29

d/t cephalad displacement of lungs the bases are compressed

Question 30

Lithotomy effects:

how should the legs be raised and lowered

Answer 30

together

Question 31

Lithotomy effects:

what is a common compliction

Answer 31

nerve injury

Question 32

Lithotomy effects:

what nerves are injured

Answer 32

sciatic
Common peroneal
femoral
saphenous
obturator

Question 33

what is the most common postop peripheral neuropathy

Answer 33

ulnar nerve injury

Question 34

what is the 2nd most common postop peripheral neuropathy

Answer 34

Brachial plexus

Question 35

what causes the ulnar injury

Answer 35

compression of medial epicondyle of humorous and sharp edge of OR table

Question 36

the ulnar nerve is stretched when the hand is in what position

Answer 36

pronated

Question 37

what causes the brachial plexus injury

Answer 37

stretch injury when neck is extended and the head is turned away or the arm is abducted to greater than 90 degrees

Question 38

s/s of median nerve injury

Answer 38

“ape hand”

unable to oppose thumb

Question 39

S/S of ulnar nerve injury

Answer 39

“claw hand” deformity

Question 40

S/S of radial nerve injury

Answer 40

wrist drop

Question 41

what is the most frequently injured nerve in the lower extremity

Answer 41

common peroneal n.