OR Nursing

Question 1

PRE-OP nursing responsibilities (5, FDITA)

Answer 1

Verbalize feelings
Participate in decision making
Give necessary info
Health teaching
Administer pre-op meds as ordered

Question 2

INTRA-OP nursing responsibilities (5, PARMC)

Answer 2

Proper positioning
Asepsis
Restraints
Monitor responses
Comfortable

Question 3

What is surgical conscience?

Answer 3

When you know you are unsterile, you have to admit it

Question 4

Period when the px is in the OR up to when he/she is brought to recovery room

Answer 4

Intraoperative period

Question 5

What are the two types of regional anesthesia?

Answer 5

Spinal and epidural anesthesia

Question 6

Intact consciousness, loss of motor and sensory perception to a particular area

Answer 6

Regional anesthesia

Question 7

Where is spinal anesthesia injected?

How does it work?

Answer 7

Subarachnoid space (CSF), L2-3 or L3-4

Stops signals from spinal cord = paralysis in LE

Question 8

(T/F) The effect of spinal anesthesia is temporary

Answer 8

TRUE

Question 9

Give the 3 possible complications of epidural anesthesia (HHR)

Answer 9

Hypotension
Spinal headache (brain is pulled down due to low buoyancy)
Respiratory depression

Question 10

Nursing interventions for epidural anesthesia (VTRFHC)

Answer 10

VS

Reverse trendelenburg (respiratory depression)

Watch for return of sensation and motor function

Flat On Bed for at least 8 hrs until sure they returned

Hydration (loss of CSF)

Catheter (urinary retention)

Question 11

In any Abdominal surgery, px are maintained on NPO until

Answer 11

You hear a flatus or fart indicating bowel movement

Question 12

Unconsciousness, blocks motor and sensory pathway to major nerve

Answer 12

General anesthesia

Question 13

What is the milk of amnesia

Answer 13

Propofol

Question 14

General anesthesia comes in two forms:

Answer 14

IV injection and inhalation gas

Question 15

Ability of the drug to reduce or make pain absent

Answer 15

anesthesia

Question 16

What type of anesthesia is usually used for major surgeries?

Answer 16

General anesthesia

Question 17

Nursing interventions for general anesthesia (RS)

Answer 17

Prepare resuscitative equip (CNS depression = cardiorespi arrest)

Avoid stimulating (confusion)

Question 18

Match the stage of anesthesia to its definition

1. Analgesic/analgesia
2. Paradoxical
3. Surgical
4. Medullary

A. dangerous stage, affects brainstem = cardiorespi arrest
B. sleepy, absence of pain
C. fight or flight, will try to resist
D. not moving, muscles are relaxed, body is stable, px does not feel anything

Answer 18

1B
2C
3D
4A

Question 19

Group the surgical team acc to sterile and nonsterile members:

1. Surgeon and assistants
2. Circulating nurse
3. Scrub nurse
4. Anesthesiologist

Answer 19

1. STERILE
2. NON-STERILE
3. STERILE
4. NON-STERILE

Question 20

Who is like the captain of the ship, the one performing the surgery?

Answer 20

Surgeon

Question 21

Who is the one in charge for the equipment in the sterile area?

Answer 21

Scrub nurse

Question 22

Gives anesthetic and monitors vital status of px

Answer 22

Anesthesiologist

Question 23

In charge of OR suite and documentation

Answer 23

Circulating nurse

Question 24

Intraoperative nursing care

Positioning depends on:

Dorsal recumbent is for:

Reverse trendelenburg is for:

Lithotomy:

Lateral:

Surgical asepsis aka:

Equipment needs:

Wound closure is done by:

Answer 24

Need for visualization

Surgery on liver

To allow gravity to move organs

W/stirrups

Side-lying

Handwashing

Proper sterilization

Suturing

Question 25

The air in the OR is ___ and kept in ___ pressure at a temp of __ to __

Answer 25

Filtered Positive <70 Prevent growth of bacteria

Question 26

Device that uses heat and pressure to destroy microorganisms, also kills spores

Answer 26

Autoclave

Question 27

What equipment cannot be autoclaved? What do we do with them?

Answer 27

Catheter and scissors | Antiseptic solution

Question 28

Give the 5 possible intraoperative complications (IFIHM)

Answer 28

``` infection fluid deficit/overload injury due to positioning hypothermia malignant hyperthermia ```

Question 29

Match the ff complications to its interventions 1. infection 2. fluid volume excess/deficit 3. injury r/t positioning A. monitor iv infusion rate, i&o, blood loss B. count equipment before and after C. proper sterilization

Answer 29

1C 2A 3B

Question 30

What tool can we use to help count blood loss?

Answer 30

sponge

Question 31

How and when does malignant hyperthermia occur?

Answer 31

Drug reaction to inhaled anesthetic (halothane) + muscle relaxant Post-op

Question 32

(t/f) malignant hyperthermia is an idiosyncratic reaction = not all px experience

Answer 32

TRUE

Question 33

what are early s/sx of malignant hyperthermia

Answer 33

fever and seizures

Question 34

What do we immediately assess in the post anesthesia care unit (PACU)? 3, ACL

Answer 34

airway circulation LOC

Question 35

What should we monitor if patients are given morphine

Answer 35

RR

Question 36

Lung collapse is aka

Answer 36

Atelectasis

Question 37

Threee interventions for airway and breathing post op include:

Answer 37

Deep breathing/coughing exercises Incentive spirometry O2

Question 38

What is the problem with deep breathing exercises post op?

Answer 38

Px may be in pain = not cooperative = give analgesic first

Question 39

In incentive spirometry, the ball should be

Answer 39

floating and maintained at the marked area

Question 40

Fever longer than 24 hrs may be explained by ___ The intervention for this is _____

Answer 40

Pneumonia antibiotics

Question 41

In the PH setting, who checks the wound and dressing?

Answer 41

doctors

Question 42

What are the 3 things we should assess in wounds (IID)

Answer 42

infected: inflammed + pus integrity: wound dehiscence or evisceration (organ come out) drainage

Question 43

What do we do in organ evisceration?

Answer 43

Cover with wet gauze to preserve organ and REFER

Question 44

(T/F) drains allow for good wound healing

Answer 44

TRUE

Question 45

(T/F) drain increases after 24 hrs

Answer 45

FALSE, it decreases

Question 46

Reddish fluid for the first 24 hrs

Answer 46

Serosanguinous fluid

Question 47

factors that increase risk for infection (AM)

Answer 47

aseptic technique | medical condition

Question 48

Match the form of wound healing to its definition: 1. Primary 2. Secondary 3. Tertiary A. sutured, thin hairline scar or no scar at all B. sutured, got infected, opened, sutured again C. sutured, ulcerations, let heal by itself

Answer 48

1A 2C 3B