THE ART OF COMMUNICATION
THE SURGICAL TEAM + SUITE
PRE-OP PRIORITIES
INTRA-OPERATIVE
PROTOCOLS
POST-OPERATIVE COMPLICATIONS
100
The nurse would consider it a priority to report what type of allergies to the surgical team? (Identify at least 2).
What is latex, PCN/Antibiotics, iodine.
100
H/she is responsible for administering and monitoring the use of anesthetic agents in the operative patient.
Who is anesthesiologist
100
These are factors that must be present for a patient to provide informed consent. (Name at least 3 factors).
What is A&O X4, coherent, free of coercion, and of legal age.
100
This is done at the beginning of each invasive procedure, prior to the initial incision, to ensure patient safety.
What is a Time Out (Identifies correct patient, surgeon, and procedure). (May say verify correct site).
100
The post-operative nurse would monitor what findings FIRST after receiving a patient from the OR. (Name at least 3 priorities).
What is ABC's, Dressing & Drainage, Fluid and Electrolyte Balance, and Pain.
200
The Pre-Operative Nurse would provide this information in the hand-off report to the Intra-Operative Nurse. (Identify at least 2 pieces of information).
What is patient demographics, specific history, allergies, pre-op medications/antibiotics, NPO status, surgical preparation, etc.
200
H/she would be responsible for maintaining an accurate count of sponges, sharps, and instruments; and would do a re-count if an item was missing during surgery.
Who is Scrub Nurse
200
This would be required if surgical consent was being obtained via the telephone.
What is a Two RN verification/signatures.
200
The operating room nurse ensures that this is done properly to prevent skin, nerve, and joint damage.
What is correct positioning, and padding of joints/bony prominences.
200
This can often been the first sign of a neurological complication after anesthesia/surgery.
What is increased confusion/restlessness.
300
The Circulating Nurse would provide this information in hand-off report to the PACU nurse. (Identify at least 3 pieces of information).
What is patient demographics, surgery, anesthesia/complications, unexpected findings in OR, length of surgery, EBL, sutures/dressing, precautions.
300
These members of the surgical team are required to perform a surgical scrub.
Who is the Surgeon (and any surgical residents), and Scrub Nurse/Tech.
300
These medications should be discontinued prior to the day of surgery. (Identify 2 medications).
What is ASA, NSAIDs, Anticoagulants, Anti-depressants.
300
These are the stages of progression when using general anesthetic agents:
What is Induction, Excitement/Delirium, Surgical Anesthesia, Danger.
300
These interventions are aimed at preventing atelectasis and Pneumonia in post-operative patients. (Name at least 3 interventions).
What is breathing exercises (IS, coughing/deep breathing), Ambulation, Increasing fluids.
400
These would be the proper instructions a nurse would provide a patient when using an Incentive Spirometer.
What is 1. sit in upright position. 2. Take a breathe and form a tight seal around the mouthpiece. 3. Take a breathe in and hold for about 5 seconds to move the bellow up. 4. breathe out/ repeat approx. 10x an hour.
400
These environmental factors are tightly controlled to prevent bacterial growth in the OR (Operating Room).
What is humidity (20-60%) and temperature (68-73 F).
400
These factors would be a part of the Pre-Operative checklist (Name at least 5).
What is proper patient identification, allergy/blood product identification, skin preparation, bowel/bladder preparation, NPO, dentures/jewelry removed.
400
These would be signs and symptoms that the surgical team would monitor for in Malignant Hyperthermia. (Name at least 4 signs and symptoms).
What is muscle rigidity, tachypnea, tachycardia, hypotension, skin mottling, cyanosis, myoglobinuria, increase in CO2 and decrease in O2 saturation, severe rise in body temperature (late).
400
These actions would be ones the nurse would avoid when caring for a patient's post-surgical drain. ( Name at least 2 actions to be avoided).
What are: milking/stripping the tube, handling the drain without washing hands/gloves, twisting or clamping the tube.
500
The nurse would question these laboratory findings in a pre-surgical patient. (Identify 3 abnormal labs).
What is H/H (low values), BUN and Cr (high values), K levels (high or low), glucose (high or low), platelets (low), WBC (high and low), etc.
500
These would be some of the main responsibilities of a Circulating Nurse. (Identify at least 3 responsibilities).
What is coordinating all activities within the OR, preparing OR bed, holding room responsibilities, ensuring safety, monitoring traffic, report findings to surgeon/anesthesiologist, monitor sterility of surgical field, help scrub nurse keep track of sponges, etc.
500
These are initiatives in the SCIP protocol to prevent peri-operative complications, that the pre-op nurse must follow.
What is administer/provide antibiotics 1 hour prior to surgery, begin VTE prevention 24 hours prior to surgery, hair clipping, blood sugar controls (<200mg/dL).
500
These agents are known to cause Malignant Hyperthermia.
What are Volatile Inhaled Agents and Succinylcholine.
500
The nurse would have this equipment at the bedside for a patient that is high-risk for dehiscence.
What is non-adherent sterile/saline dressing, possible NGT.
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