Key Risk Factors
Procedures lasting more than ______ hours place a patient at risk for a pressure injury.
What is 2 hours?
To avoid injury to the brachial plexus, how do you position the patient's arms on arm boards?
What is padding the arm boards to match the elevation of the patient's shoulders to avoid stretching and causing injury to the brachial plexus?
Lifting an elderly patient, rather than _________ or ___________ can help reduce shearing injuries.
What is dragging or sliding?
Skin breakdown can occur from moisture and prep solutions trapped where?
What is skin folds?
OR-acquired pressure injuries may appear within what timeframe?
What is 24-72 hours after surgery and are seldomly visible at the end of the surgical procedure or it appears as skin redness?
Patients positioned in lithotomy for a prolonged period of time may have an increased risk of nerve injury to the __________ extremities.
What is the lower extremities?
How are the patient's hands positioned when tucking arms and what positioning aid is used?
What is thumbs up, palms against thighs, and not tucked too tightly or loosely with the use of elbow pads to protect the ulnar nerve?
It is imperative to assess range of motion with elderly patients, thus what will you include in your preoperative assessment?
What is neck extension and movement in the spine and extremities?
Name at least 3 additional positioning aids that may be necessary to utilize when positioning patients with obesity.
What is bed extenders, bariatric stirrups, longer/wider safety straps, additional foam/gel supports, and a hover matt?
What are tools utilized to assess a patient's risk factor for pressure injuries?
What is the Braden Scale, Munro Scale, or the Scott Triggers Tool?
Name 2 assessment findings/medical conditions that place the patient at greater risk for skin breakdown caused by pressure.
What is DM, malnutrition, advanced age, and anemia?
Why do we provide slight flexion to the knees?
What is to prevent popliteal vein compression, thus reducing the risk for DVT's?
What assessment finding are common for older adults?
What is loss of subcutaneous fat, poor skin turgor, and tissue fragility.
To facilitate the airway and to alleviate pressure off the vena cava, what could you suggest or provide?
What is elevating HOB or ramping up the patient and placing a wedge under the right flank to alleviate pressure off the vena cava?
7 Factors that can cause pressure-related injuries. This factor reduces peripheral circulation, reducing oxygen delivery to the skin and underlying tissues, causing delayed healing times.
What is cold?
Name 2 assessment findings that may necessitate a change in the plan of care for how the patient is positioned and may require additional padding/equipment.
What is congenital anomalies, pre-existing injuries, arthritis, and the presence of a prosthesis?
Placing the safety strap directly over the knees may cause injury to what nerve?
What is the peroneal nerve?
During pregnancy the uterus can compress the aorta and the inferior vena cava. When this occurs, perfusion to the uterus is impaired and blood return to the heart is reduced, causing what?
What is supine hypotension?
Name at least 3 complications for severely/morbidly obese patients.
What is:
7 Factors that can cause pressure-related injuries. This factor involves folding of underlying tissue when the skeletal structures move while the skin remains stationary. This can occur when the head of the bed is raised or lowered and when the patient is in Trendelenburg or reverse Trendelenburg position.
What is shearing? A parallel force creates shear while a perpendicular force creates pressure.
Patients who are scheduled for vascular surgery may be at risk for injury because...
What is the patients optimal blood perfusion may already be compromised due to disease process?
Always assure what is used for every procedure?
What is always assure the use of safety straps to reduce the risk of patient falls. Pt.’s should NEVER be left unattended and NEVER walk away from the OR bed until the patient is secured. Clearly communicate when safety straps are removed and only do so just before transferring patients?
At what week do we place the pt. in a left lateral tilt by using a wedge-shaped positioning device under the right lumbar region above the iliac crest and below the lower costal region or to the right pelvis to achieve a 12-15° lateral tilt, or tilting the OR bed 15-45° to the left.
What is 16 weeks pregnant?
Name at least 3 reasons why airway and breathing mechanisms may be compromised during surgery for patients with obesity.
What is:
7 Factors that can cause pressure-related injuries. This factor occurs when layers of materials (e.g. sheets/blankets) are placed over the OR mattress or padding. Extra linen can add rigidity. Such linen is absorbent, abrasive, and can produce high and inconsistent pressure.
What is negativity? Eliminating extra layers of materials between the pt. and the OR bed can reduce sacral pressure readings.