Test L, M Flashcards
goals for positioning
provider exposure for surgeon
safe, comfortable position
access for anesthesia
what you need to know for proper positioning
anatomy
equipment
types of surgical positions/why
who determines the position for the patient?
the surgeon
who places patient in correct positioning?
CN, anesthesiologist may assist
why does anesthesiologist assist positioning patient?
unobstructed airway
IV accessibility
support of head/neck
when do they position the patient?
after anesthesia
factors that affect time of positioning
site of operation
age/size of patient
pain
anesthesia given
what should you always remember when positioning the patient?
the patients diginity
pressure points
breakdown of tissue which may lead to decubilis ulcer
good respiration position
maintain airway
unhindered diaphragmatic movement
arms not over chest
accessibility for anesthesiologist
airway
BP
monitoring equipment
IV
special needs of patient
arthritis
obesity
cardiac or asthma
where do you place safety strap
2-3” above knees for supine, below knees for prone
extremity table
looks like ironing board, used for arm and hand surgeries
bardene pad
elevate chest from table in prone position
kidney brace
slipped in from table edge to stabilize patient in lateral position
rule for patient contacting table
patient should never touch the metal on table
patient positioning when conscious
explain what you’re doing
avoid exposure
make the most comfortable
patient positioning when anesthetized
get approval from anesthesiologist before moving
avoid exposure
get help for moving
dorsal position
patient laying on back
uses for dorsal position
appendectomy
thyroidectomy
T&A
inguinal hemiorrhaphy
another name for supine
dorsal recumbent
where are arms for supine position?
beside body secured under lifter
supine-arm extension
arms positions not more than 90 degrees
how are palms on arm board?
facing up to prevent ulnar nerve damage
uses for supine-arm extension
mastectomy
bowel resection
breast biopsy
exploratory laparotomy
body for trendelenburg
table tilted head down about 45 degrees, knees over break in table
what is trendelenburg used for?
displacing the abdominopelvic organs to provide better visualization
what surgeries are trendelenburg used for?
abdominal hysterectomy
ovarian cystectomy
prostatectomy
reverse trendelenburg
table tilted so head higher than feet
uses for reverse trendelenburg
cholecytectomy
gastrectomy
thyroidectomy
where are on the body does reverse trendelenburg used for?
upper abd cavity or upper anterior body
lithotomy uses
D&C
vaginal hysterectomy
hemorrhoidectomy
where are arms for lithotomy?
at side or on armboards
where is buttock for lithotomy
at break in table
what can you add for lithotomy position
SCD for leg circulation
when do you turn patient for prone?
once the anesthesiologist gives the okay
uses for prone position
lumbar laminectomy
cyst removal
what do you need to place with prone position?
bardene pad/get pads for chest
pillows under ankles and feet
donut for head
kraske (jackknife)
same as prone with hips over center break, leg section lowered 90 degree, hips are elevated above body
uses for jackknife position
hemorrhoidectomy
pilonidal cystectomy
lateral(kidney) use
lung resection
nephrectomy
hip arthroplasty
what can be added for lateral position
double armboard
sims position
typically patient remains on stretcher
patient is usually awake
what side is patient on for sims position?
left
uses for sims position
colonoscopy
endoscopic procedures of the anus
BMBX
where are arms for sitting position?
on lap
head for sitting position
head section of OR table is removed, head is placed in cranial headrest
legs for sitting position
pad area to prevent sciatic nerve damage
uses for sitting position
craniotomy
cervical laminectomy
fowlers
same as sitting except patients head rests on OR table so no cranial headrest, patient at 45 degree angle
uses for fowlers position
dental extractions
rhinoplasty
shoulder arthroscopy
body parts used for fowlers position
breast
head/neck
shoulder
final checks after patient is positioned
nerves free from pressure airway is present circulation not impaired good alignment junk check feet not crossed no metal IVs ok
moving anesthetizied patient
move patient slowly to allow cardiovascular system to adjust
what happens if you move anesthetized patient fast?
hypotension
elevated cerebral pressure
your safety for transporation
used good body mechanics
patient fears and concerns
protect from embarrassment, be supporting
patient safety
iID verified
no injury
protection of lines
what should you do first when moving a patient?
move lines before the patient
opening doors with patient in stretcher
open door first then push stretcher through
how do you push a stretcher?
from head end
patient observation
children medications elderly motion sickness be on offensive
when is standard stretcher used?
awake patient only
uses for multipurpose stretcher
transporting critical patients
as recovery bed
as OR table for minor procedures
trans lift stretcher
used for transfer of critically injured patient- won’t have to move them as much
air beds
for bedridden patients to prevent skin breakdown
cribs
patients under 3 years old
when do you need to remember for crib
keep side rails up when transporting
used for isolettes
newborn and premature infants
what is a isolettes
portable incubator
wheelchairs
local or no anesthesia
last step for wheelchair
put warm blanket on
confirm patients identity
staff examines identification band
ask patient to state name
ask patient to tell you the procedure
do wheelchairs have safety straps?
yes
when entering an elevator
pull patient in so that they can see when they come out of the elevator
people with transferring conscious patient
2 people
people with transferring unconscious patient
4 people
steps for moving mobile patient
notify unit cleark and collect chart
knock on pts door
introduce yourself, verify pt
lower bed rails on stretcher and align with bed, lock wheels
identify and free up all tubing, guide pt slowly across bed to stretcher
What type of procedures are wheelchairs used for?
Diagnostic procedures
