positioning/nerve injury Flashcards
Supine effects:
circulation
minimal
Supine effects:
Pulmonary
decreased FRC (800cc) cephalad displacement of diaphragm to compress the lung bases
Supine effects:
what should u do to facilitate Venous return
flex hips and knees to facilitate venous drainage from lower extremities
Supine effects:
what do u wanna make sure you pad
occiput
heels
Trendelenburg Effects:
Circulation
decreased SV- hypotension maybe ( and viscera pushes against the diaphragm, which compresses lung bases and pushes on heart to decrease SV)
Trendelenburg Effects:
Pulmonary
lung bases compresed
Trendelenburg Effects:
what will happen to venous return
increase (but may not help the decrease in BP)
Trendelenburg Effects:
what could it do to ICP
increase it
Trendelenburg Effects:
what type of pets would you use this position with caution (not head puts think general population)
obese
Prone effects:
circulation- what can become compressed
inferior venacava
Aorta
Prone effects:
Pulmonary- what happens to lung bases
forced cephalad
Prone effects:
what could hinder venous return
vascular compression
Prone effects:
turning head in prone may obstruct drainage of what?
Jugular veins
vertebral artery
Prone effects:
placement of what under the pts sides receive abdominal compression and increases venous return to the heart, and eases ventilation
abdominal rolls (chest rolls)
Lateral Decubitus (on Ventilator) effects: increased circulation goes to what lung?
dependent lung
Lateral Decubitus (on Ventilator) effects: there may be decreased blood to the kidney if what is being used
kidney rest
Lateral Decubitus (on Ventilator) effects: there will be decreased ventilation to what lung?
dependent
Lateral Decubitus (on Ventilator) effects: there will be increased ventilation to what lung
non dependent lung
Lateral Decubitus (on Ventilator) effects: should there be a problem with venous return
no
Lateral Decubitus (on Ventilator) effects: what should be in place and where on all pt's in lateral decubitus
axillary rolls
placed under thorax just caudal to axilla
Sitting effects:
there is an increase in drainage from where?
head/ neck/ and upper body
Sitting effects:
what happens to intrathoracic blood volume
decreases
Sitting effects:
what changes occur to the pulmonary system?
none
Sitting effects:
what can u do to increase venous return form the lower extremities?
use compression stockings
Sitting effects:
with the decreased venous return what happens to cerebral perfusion pressure?
decreases
Sitting effects:
with decreased Venous return what happened to cardiac output
decreases
Sitting effects:
what is a hazard/potential complication from this position?
air embolism
Lithotomy effects:
any problems with circulation
no
Lithotomy effects:
what happens to the lung bases?
d/t cephalad displacement of lungs the bases are compressed
Lithotomy effects:
how should the legs be raised and lowered
together
Lithotomy effects:
what is a common compliction
nerve injury
Lithotomy effects:
what nerves are injured
sciatic Common peroneal femoral saphenous obturator
what is the most common postop peripheral neuropathy
ulnar nerve injury
what is the 2nd most common postop peripheral neuropathy
Brachial plexus
what causes the ulnar injury
compression of medial epicondyle of humorous and sharp edge of OR table
the ulnar nerve is stretched when the hand is in what position
pronated
what causes the brachial plexus injury
stretch injury when neck is extended and the head is turned away or the arm is abducted to greater than 90 degrees
s/s of median nerve injury
“ape hand”
unable to oppose thumb
S/S of ulnar nerve injury
“claw hand” deformity
S/S of radial nerve injury
wrist drop
what is the most frequently injured nerve in the lower extremity
common peroneal n.
