INTRAOPERATIVE STAGE

Question 1

INTRAOPERATIVE STAGE

Answer 1

 Begins with the client’s arrival in the operating room and ends with client’s transfer to the recovery room.
 Teaching continues during the initial intraoperative phase.
 Explaining all preparation, answering last-minute questions, and explaining delays to the client and family.

Question 2

3 PHASES OF INTRAOPERATIVE PHASE

Answer 2

1. ADMISSION TO OR
2. ANESTHESIA SURGERY
3. RECOVERY ROOM/PACU

Question 3

NURSING GOALS

Answer 3

1. ASEPSIS AND INFECTION CONTROL
2. HOMEOSTASIS AND HEMOSTASIS
3. SAFE ADMINISTRATION OF ANESTHETIC AGENTS

Question 4

SURGICAL TEAM

Answer 4

1. SCRUBBED TEAM
2. UNSCRUBBED TEAM
3. PATIENT

Question 5

SCRUBBED TEAM

Answer 5

SURGEON
ASSISTANT TO SURGEON
SCRUB NURSE

Question 5

UNSCRUBBED TEAM

Answer 5

ANESTHESIOLOGIST/ANESTHETIST
CIRCULATING NURSE
PATHOLOGIST
OTHERS

Question 5

ANESTHESIOLOGIST RESPONSIBILITIES

Answer 5

 Or a certified registered nurse anesthetist (CRNA)
 Gives and controls the anesthetic for the client
 Must see to it that all the equipment & supplies necessary for the induction of anesthesia are available
 Determine when the surgeon or circulating nurse may proceed with positioning & preparing the operative site
 Monitors the client’s vital signs, intake & output during operation
 Keeps the surgeon aware of the client’s condition
 Determine when the client may be moved to the post-anesthesia recovery stretcher after the operation has been completed

Question 5

RESPONSIBILITIES OF SURGEON

Answer 5

 Primary responsible for the preoperative medical history and physical assessment.
 Performance of the operative procedure according to the needs of the patients.
 The primary decision maker regarding surgical technique to use during the procedure.

Question 6

ASSISTANT SURGEON RESPONSIBILITY

Answer 6

 May be a physician (surgeon, resident, intern or clerk), physician assistant, certified registered nurse first assistant (CRNFA) or Surgical technologist.
 Assists the surgeon during the surgery in any way the surgeon requests
 Holds retractors in the wound to expose the operative site.
 Places clamps on blood vessels
 Assists in suturing & ligating bleeders

Question 6

CIRCULATING NURSE RESPONSIBILITIES

Answer 6

 Send for the patient at the appropriate time
 Receives, greets, identifies the patient
 Checks the chart for completeness
 Assists the client in moving safely to operating table
 Ties the scrubbed member’s gowns
 Functions as the coordinator & overseer of the room during the procedure to maintain sterility
 Check operating room lights for good condition
 Positions the client
 Performs urinary catheterization if required & connects the catheter to the drainage bag
 Does the counting(instrument, sponge, and needles) with the scrub nurse
 Supplies foot stools if needed by the surgical team
 Watches foreheads of surgical team for perspiration
 Fills out required operative records completely & legally
 Remains in the room as much as possible to be constantly available
 Watches progress of surgery anticipates needs, reacts quickly to emergency
 Sees that the surgical team is supplied with every necessary item to perform the operation efficiently
 Uses equipment & supplies economically & conservatively
 Directs cleaning of room & preparation for next operation

Question 6

SCRUB NURSE RESPONSIBILITIES

Answer 6

 Sets up sterile supplies and instruments
 Assists in gowning & gloving of the surgical team
 Assists in draping the client and the field
 Assists the surgeon as needed throughout the surgery
 Hands instrument, sutures, sponges, etc. as needed in efficient manner
 Keep operative field tidy during the case
 Wipes blood from instruments
 Keeps close watch on needles, instruments & sponges so that none will be misplaced or lost in the operative field
 Keeps accurate needle/instrument count
 Supplies sterile dressing materials
 Cares for all instruments & supplies left after case

Question 7

MEDICAL ASEPSIS

Answer 7

REDUCES # OF PATHOGENS
CLEAN TECHNIQUE
USED IN MED ADMINISTRATION, TUBE FEEDINGS, DAILY HYGIENE

Question 8

SURGICAL ASEPSIS

Answer 8

ELIMINATES ALL PATHOGENS
STERILE TECHNIQUE
DRESSING CHANGE, CATHETERIZATION, SURGICAL PROCEDURE

Question 9

2 SURGICAL SCRUB

Answer 9

TIME SCRUB
BRUSH STROKE SCRUB

Question 10

COMMON ANTIMICROBIAL SKIN AGENTS USED FOR THE SURGICAL SCRUB

Answer 10

 Chlorhexidine Gluconate
 Povidone iodine
 Triclosan

Question 11

SEDATION AND ANESTHESIA

Answer 11

1. NARCOSIS
2. HYPNOSIS
3. INDUCTION

Question 12

NARCOSIS

Answer 12

 Is state of profound unconsciousness produced by a drug

Question 13

HYPNOSIS

Answer 13

 Is artificially induced sleep

Question 14

INDUCTION

Answer 14

 Is the period from the beginning of administration of anesthetic until the client losses consciousness

Question 15

EFFECTS OF ANESTHESIA ARE MONITORED BY:

Answer 15

1. Respiration
2. O2 saturation
3. CO2 levels
4. HR and BP
5. Urine output

Question 16

TYPES OF ANESTHESIA

Answer 16

1. GENERAL
2. REGIONAL
3. LOCAL

Question 17

 reversible state consisting of complete loss of consciousness and sensation
 protective reflexes such as cough and gag are lost
 provides analgesia, muscle relaxation and sedation
 produces amnesia and hypnosis

Answer 17

GENERAL ANESTHESIA

Question 18

STAGES OF ANESTHESIA

Answer 18

1. INDUCTION
2. EXCITEMENT OR DELIRIUM
3. SURGICAL/OPERATIVE ANESTHESIA
4. MEDULLARY PARALYSIS/DANGER

Question 19

METHODS OF ADMINISTRATION OF GENERAL ANESTHESIA

Answer 19

1. INHALATION
2. INTRAVENOUS

Question 19

 The circulation, usually via the peripheral vein. A drug that produces hypnosis, sedation, amnesia and or analgesia that is injected directly into the vein

Answer 19

INTRAVENOUS ANESTHESIA

Question 20

TYPES OF INHALATION ANESTHESIA

Answer 20

1. MASK INHALATION 2. GETA (GENERAL ENDOTRACHEAL TUBE ANESTHESIA) 3. LMA (LARYNGEAL MASK AIRWAY)

Question 21

 Briefly disrupts sensory nerve impulse transmission from a specific body area or region, with or without affecting the motor function and not impairing consciousness

Answer 21

REGIONAL/LOCAL ANESTHESIA