Test L, M Flashcards by Lexi Wollersheim

goals for positioning

provider exposure for surgeon
safe, comfortable position
access for anesthesia

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what you need to know for proper positioning

anatomy
equipment
types of surgical positions/why

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who determines the position for the patient?

the surgeon

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who places patient in correct positioning?

CN, anesthesiologist may assist

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why does anesthesiologist assist positioning patient?

unobstructed airway
IV accessibility
support of head/neck

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when do they position the patient?

after anesthesia

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factors that affect time of positioning

site of operation
age/size of patient
pain
anesthesia given

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what should you always remember when positioning the patient?

the patients diginity

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pressure points

breakdown of tissue which may lead to decubilis ulcer

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good respiration position

maintain airway
unhindered diaphragmatic movement
arms not over chest

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accessibility for anesthesiologist

airway
BP
monitoring equipment
IV

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special needs of patient

arthritis
obesity
cardiac or asthma

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where do you place safety strap

2-3” above knees for supine, below knees for prone

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extremity table

looks like ironing board, used for arm and hand surgeries

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bardene pad

elevate chest from table in prone position

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kidney brace

slipped in from table edge to stabilize patient in lateral position

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rule for patient contacting table

patient should never touch the metal on table

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patient positioning when conscious

explain what you’re doing
avoid exposure
make the most comfortable

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patient positioning when anesthetized

get approval from anesthesiologist before moving
avoid exposure
get help for moving

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dorsal position

patient laying on back

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uses for dorsal position

appendectomy
thyroidectomy
T&A
inguinal hemiorrhaphy

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another name for supine

dorsal recumbent

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where are arms for supine position?

beside body secured under lifter

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supine-arm extension

arms positions not more than 90 degrees

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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

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