General info
National organization for perianesthesia nurses
What is ASPAN
American Society of PeriAnesthesia Nurses
Perianesthesia nurses only work in PACU
What is False; they work in preop, PACU and preadmission units
Who is ultimately responsible for the surgery site to be marked?
Surgeon, PA, ARNP
List 2 patient identifiers
What are: Name, DOB
Toddler age range
What is 1-3 years
Name the two advanced certifications PACU nurses hold
What are ACLS and PALS
Patients who have had a general anesthetic don't always need to go to Phase I recovery
What is False
In your preoperative assessment you note the patient is consented for a LEFT sided ACL repair, however, the patient is marked on the RIGHT side. The patient says, "I thought that was weird, I'm supposed to have my left side repaired." What do you do?
What is: Stop the line! Confirm with patient and provider, review the patient's clinic notes and ask that the correct site be the only site marked
How do you confirm the consent and scheduled procedure with the patient?
What is: You ask the patient to describe the procedure they are having in their own words. This is confirmed with the consent.
Name two considerations when caring for a neonate
What are:
Thermo-regulate and they have very delicate tissue (lack of subcutaneous fat, thermoregulatory system is not developed)
Skin Sensitivity: concern with prep solution and skin marking
Two levels of post anesthesia care
What are Phase I recovery and Phase II recovery
The consent does not need to be verified by the RN, the surgeon has already filled it out and confirmed it with the patient
What is FALSE
A resident leaves the OR tracking blood down the hallway on their shoes. What do you do?
What is Ask them to clean their shoes and/or remove shoe covers and explain the rationale.
Discussion and planning with the patient and his or her family is what phase of the nursing process?
What is Perioperative ASSESSMENT
Name 3 factors in elderly patient population to consider when planning for surgery
What are:
wrinkling and thinning skin is prone to injury,
lack of subcutaneous fat make patient sensitive to temperature changes,
skin elasticity decrease,
sweat glands begin to atrophy making temperature changes harder to tolerate
First priority upon admission to Phase I recovery
What is airway
You have to wear a mask in the restricted area
(Pre COVID)
What is False; only when sterile items are open is a mask required
Why do we confirm the surgical procedure and site at the end of the procedure?
Emergency additions to the procedure need confirmation
List four questions you ask a patient pre-operatively
What is:
Verify name
Verify procedure
Verify Site
Allergies
NPO status
Surgical history
Implants
Medications
etc.
Indicators that should be checked when patient's skin condition is assessed
What are: Color, turgor, thickness
Time frame for post operative phone calls to patients
What is 24-48 hours, upwards of a week is acceptable in some facilities.
If their position is causing harm or injury, the patient can adjust
False
List 3 Joint Commission Patient Safety Goals
*Bonus Point for each additional goal listed*
What are:
1. Improve the accuracy of patient identification
2. Improve the effectiveness of communication among caregivers
3. Improve the safety of using medications.
4. Reduce the harm associated with clinical alarm systems.
5. Reduce the risk of health care–associated infections.
6. Identify patient safety risks
7. Prevents mistakes in surgery
Pediatric patient having surgery require what for their legal consent?
What is:
Legal guardian to sign consent
Verification that signature is the legal guardian
Must a DNR be suspended for surgery?
What is No, ethically we must abide by the patient's wishes. There may be certain medical interventions the patient is comfortable with but that is a discussion between the patient, surgeon and anesthesia provider