Exam 6: Positioning the Patient for Surgery

The circulating nurse instructed the new anesthesia resident in the proper positioning of the arm and hands on the OR bed arm boards.She cautioned him to avoid pressure on the elbow to prevent:

Select the positioning device and accessory commonly used for neurosurgical procedures.

A circulating nurse and anesthesia provider employed protective measures for a 68-year-old,ASA PS-2 female positioned in extreme 45-degree Trendelenburg for a robotic-assisted laparoscopic hysterectomy.These measures included :

While Fowler's position offers the best respiratory excursion for the patient,the patient is at higher risk for ____________________ because of dependent pooling in the hips and legs.

Prolonged lithotomy positioning can result in neuropathies of the legs.The most frequently injured nerves are the obturator,sciatic,femoral,and _____________ nerves,which can result in injury from ______________.

Select the nursing activity that would reduce the impact of an extrinsic factor that could cause a pressure injury to the patient.

A 68-year-old,American Society of Anesthesiologists (ASA)physical status (PS)-2 male with early-stage prostatic cancer,was intubated and positioned for a robotic-assisted laparoscopic radical prostatectomy.The initial position for insertion of the trocars was supine with arms tucked and secured within under-mattress sled arm positioners padded with gel.His hands were placed in a natural position with the fingers wrapped around gauze rolls and touching his lateral thighs.The new anesthesia provider,who had never seen a robotic prostatectomy,was concerned about anesthesia implications when the patient would be repositioned into extreme Trendelenburg for the dissection and anastomosis.The circulating nurse assured her that they would implement protective measures and work together to ensure the best patient outcome.Select all of the potentially harmful effects of extreme 45-degree Trendelenburg in a robotic procedure.

Pressure injury assessment tools designed specifically for use in the perioperative population include the:

A 52-year-old 425-lb male patient is scheduled for surgery at the bariatric surgery center in 3 days.He has osteoarthritis and had a spinal fusion when he was 13.His long-time neighbor,a perioperative nurse at the bariatric center,has asked to be the patient's circulating nurse and is contemplating his plan of care.He shared his concern that he would not be able to move himself over to the OR bed and would be embarrassed if the nurses could not lift him.Based on this information,the nurse has identified this nursing diagnosis: ___________________ and these three positioning-relevant nursing interventions: _______ _______ _______.Select from the options to fill in the blanks.

A patient undergoing a laparoscopic Nissen fundoplication procedure will be positioned in both high and low lithotomy during the procedure.After the patient is repositioned into low lithotomy,the perioperative nurse should:

A 14-year-old patient with marked scoliosis is in prone position with gel bolster rolls,gel pads,and pillows for a spinal fusion.Before the skin prep is begun,the perioperative nurse should check the positioning for pressure areas on the:

While basic positioning prevention strategies apply to all robotic-assisted procedures,in steep Trendelenburg with severe head-down position,strategies to prevent the patient from slipping toward the head of the OR bed must be considered.These strategies include:

Select the positioning devices and accessories commonly used for bariatric surgery.

Recent studies on the relevance of the Braden pressure ulcer risk scale in the perioperative and critical care setting are inconclusive.In which perioperative setting would the Braden scale be most predictive as a baseline metric?

A 325-lb male is scheduled for a 6-hour abdominal surgery.While assessing the patient in the preoperative holding area,the perioperative nurse is concerned about the risk for pressure injury because of the weight of the patient's body pressing against the surface of the operating room (OR)bed for a long surgery.Which of these other factors may also produce pressure?

Lateral,lateral chest,and lateral kidney positions all place pressure on structures of the dependent side: ears,shoulder,ribs,hips,greater femoral head,knees,and ankles.The potential for injury to the patient is significant,based on these pressure areas.Which resultant injury or harm could be related to these lateral positions?

Select three basic criteria requirements that an OR bed mattress must meet.

A 325-lb male is undergoing a 6-hour abdominal surgery.While asleep and intubated,the surgeon requests the patient to be placed in lithotomy position for a sigmoidoscopy before the open procedure.The team of five nonscrubbed persons lifts the patient with the lift sheet,slides the patient down toward the foot of the OR bed,and places him into position.After the sigmoidoscopy,the perioperative nurse has the team roll the patient to his side for a skin assessment of his back before he is repositioned supine.What injury is the perioperative nurse concerned that she might see?

A 92-year-old frail female nursing home patient was admitted for dehydration,anemia,and respiratory symptoms.She has type 2 diabetes and low albumin levels,is underweight,and continues to smoke cigarettes.The patient is on complete bed rest in a hospital bed with an alternating pressure mattress overlay.She is not able to turn herself in bed and must be assisted to change position.Based on this description of the patient,which factor classification dominates her vulnerability and risk for injury?

The perioperative nurse noticed abrasions on a patient's elbows when she visited him in the intensive care unit (ICU)the day after his 6-hour abdominal surgery.The patient told her that the ICU nurses had difficulty pulling him back up in bed every time he slid down toward the bottom,and he was not able to be much help in moving himself.This skin injury was probably the result of which physical force?