Intraop Team/Roles
Which team member has overall responsibility for performing the surgical procedure?
The surgeon.
What does marking the surgical site help to prevent?
Wrong-site surgery.
Is malignant hyperthermia inherited, and if so, what is the pattern of inheritance?
Yes, it is typically inherited in an autosomal dominant pattern.
What is the top nursing priority when the patient first arrives in the PACU?
Maintaining a patent airway and adequate breathing.
Why is early ambulation so important after surgery?
It helps prevent DVT/PE, pneumonia, and ileus, and promotes circulation and bowel function.
What is the main role of the scrub nurse or scrub tech during surgery?
Maintains the sterile field and passes instruments and supplies to the surgeon.
What is the primary purpose of an OR “time-out”?
To provide a final pause for the entire team to confirm the correct patient, procedure, and site.
What early sign of malignant hyperthermia is often noticed first in the OR?
Muscle rigidity and/or a rapidly rising end-tidal CO₂.
In the immediate postoperative period, vital signs are checked very frequently. About how often are they usually taken at first?
Approximately every 15 minutes initially (e.g., q15 min × 2).
What should the nurse routinely assess at the surgical incision site?
Redness, swelling, warmth, drainage, approximation of edges, and signs of bleeding or infection.
What is the central role of the circulating nurse in the OR?
Manages the non-sterile environment, documentation, supplies, and communication between team members.
Name two items that must be verified during the time-out procedure.
Correct patient identity, correct procedure, correct site and side, correct position, and availability of needed equipment.
Name two metabolic consequences of malignant hyperthermia.
Metabolic acidosis, hyperkalemia, rhabdomyolysis, and very high body temperature.
Name two signs that may indicate early hypovolemia in the PACU.
Dropping blood pressure, rising heart rate, cool/clammy skin, restlessness or confusion.
How does effective pain management support postoperative recovery?
It allows the patient to breathe deeply, mobilize, and participate in care, thereby reducing complications and supporting healing.
Name two typical responsibilities of the LPN in the intraoperative setting.
Help position the patient, help maintain the sterile field, assist the anesthesia team, monitor basic vital signs, and promote patient safety.
Give one example of an infection-control practice that helps prevent surgical site infections in the OR.
Strict sterile technique, proper instrument sterilization, appropriate skin prep, and timely prophylactic antibiotics.
What are the priorities for the team when malignant hyperthermia is suspected?
Stop the triggering anesthetic (e.g., inhaled agents, succinylcholine), call for help, and begin emergency management.
Give two nursing interventions to help maintain or restore normal body temperature after surgery.
Apply warm blankets, use warming devices, give warmed IV fluids, and adjust room temperature.
What are two responsibilities of the nurse for surgical drains, such as Jackson-Pratt or Hemovac drains?
Check and document type/amount/colour of drainage; maintain suction as ordered; empty and re-compress as needed; report sudden changes.
What is a “surgical count” and why is it performed?
A count of instruments, sponges, and sharps before and after surgery to prevent retained items in the patient.
How can poor patient positioning during surgery lead to complications?
It can cause nerve injuries, pressure ulcers, respiratory compromise, or circulatory problems due to pressure or malalignment.
What is the drug of choice for malignant hyperthermia, and how does it work at the muscle level?
Dantrolene sodium inhibits calcium release from the sarcoplasmic reticulum in skeletal muscle, reducing contraction and heat production.
Describe one nursing action in the PACU that helps prevent respiratory complications such as atelectasis or pneumonia.
Positioning to promote lung expansion, plus encouraging deep breathing/coughing or using incentive spirometry; providing oxygen as ordered.
Give one key discharge teaching point on when to seek medical attention for a surgical wound.
Report fever, increasing redness, warmth, swelling, foul drainage, separation of the wound, or severe, worsening pain at the site.