Intraoperative Quiz Questions And Answers

Intubation during a surgical procedure is primarily done to provide an airway for ventilation. This means that the tube helps to ensure that the patient is able to breathe properly during the procedure. It allows for the delivery of oxygen and anesthesia gases to the lungs, while also facilitating the removal of carbon dioxide. This is essential for maintaining adequate oxygenation and ventilation, especially when the patient is under anesthesia and unable to breathe on their own. The other options, such as protecting the esophagus, administering anti-emetics, or monitoring heart rate, are not the primary reasons for intubation during a surgical procedure.

As people age, their ability to regulate body temperature decreases, making them more susceptible to hypothermia. Therefore, the 72-year-old woman in this scenario would be at increased risk for hypothermia during the intraoperative period.

The correct answer is A) Sterile surfaces or articles may touch other sterile surfaces. This guideline is important for maintaining surgical asepsis because it ensures that contamination is minimized during surgery. By allowing sterile surfaces or articles to touch other sterile surfaces, the risk of introducing pathogens or contaminants into the surgical field is reduced. This helps to maintain a sterile environment and prevent surgical site infections.

The basis of the collaboration of the surgical team that results in the best outcome for the patient is evidence-based practice. This means that the decisions and actions of the surgical team are guided by the best available evidence from scientific research, clinical expertise, and patient values and preferences. By relying on evidence-based practice, the surgical team can ensure that their interventions are based on proven effectiveness and are tailored to meet the specific needs and circumstances of each patient, ultimately leading to the best possible outcome.

Keeping the patient lying flat after surgery under a spinal anesthetic can help prevent a spinal headache. When the patient remains in a supine position, it reduces the risk of cerebrospinal fluid leakage from the spinal puncture site, which is a common cause of spinal headaches. By maintaining this position, the nurse can ensure that the puncture site heals properly and minimize the chances of the patient experiencing a spinal headache.

The nurse should monitor the patient for hypothermia because general anesthesia can cause a decrease in body temperature. This is due to the anesthesia's effects on the body's thermoregulation mechanisms and the patient's decreased ability to shiver or generate heat. Hypothermia can lead to complications such as impaired wound healing, increased risk of infection, and cardiovascular issues. Therefore, it is important for the nurse to monitor the patient's temperature closely and take measures to prevent and treat hypothermia during and after surgery.

In the restricted zone of the operating room, surgical asepsis is necessary to prevent the introduction of microorganisms into the surgical field. Wearing a mask covering the nose and mouth is essential for the nurse to prevent the spread of their own respiratory droplets and to protect against inhaling any potential airborne pathogens. Reusable shoe covers, goggles, and gloves are also important for maintaining a sterile environment, but the mask is specifically required to protect the respiratory system.

Dropping the gauze onto the patient's abdomen introduces potential contamination to the sterile gauze. To maintain a sterile environment, it is necessary to discard the contaminated gauze and repack the wound with new sterile gauze. This ensures that the wound is properly packed without the risk of introducing infection.

Patient advocacy in the operating room entails maintaining the patient's privacy. This means ensuring that the patient's personal information, medical history, and any other sensitive information are kept confidential. It also involves providing a private and secure environment for the patient during procedures, such as closing curtains or doors to protect their privacy. Maintaining patient privacy is an essential aspect of providing quality healthcare and respecting the patient's rights and dignity.

As the circulating nurse, you are solely responsible for monitoring the patient and documenting their condition. This includes keeping track of vital signs, documenting any changes in the patient's condition, and ensuring that all necessary documentation is complete and accurate. This role requires constant vigilance and attention to detail to ensure the patient's safety and well-being throughout the surgical procedure.

The anesthetist needs to be informed about the patient's latex allergy because it is crucial for the safety of the patient during surgery. Latex is commonly found in medical equipment and supplies, such as gloves and catheters. If the patient has a latex allergy, it is important for the anesthetist to take necessary precautions and use latex-free alternatives to prevent an allergic reaction during the surgery. This information is vital for the anesthetist to provide appropriate care and ensure the patient's well-being.

The patient's statement about his grandmother's experience of spiking a high temperature in the operating room and nearly dying suggests a potential risk for the patient developing malignant hyperthermia. Malignant hyperthermia is a rare but potentially life-threatening condition that can be triggered by certain medications used during anesthesia. This information is relevant because it indicates that the patient may have a genetic predisposition to this condition, which would require special precautions during surgery.

During the preparation of the patient in the operating room for a total hip replacement, it is important to consider assessing and padding pressure points. This is because pressure points are areas of the body where the bones are close to the skin's surface, making them vulnerable to pressure ulcers or skin breakdown. Assessing and padding these pressure points helps to distribute the patient's weight evenly and reduce the risk of complications.

A transsacral block would be useful for pain control in inguinal hernia repair surgeries. This type of block involves injecting local anesthetic into the sacral hiatus, which is located at the base of the spine. By blocking the nerves in this area, the patient can experience pain relief during the surgery. Transsacral blocks are not typically used for thoracotomy, breast reduction, or closed reduction of a right humerus surgeries.

After the anesthesiologist administers the anesthetic, the next step in the care of this patient would be to intubate them. Intubation involves inserting a tube into the patient's airway to ensure proper ventilation and oxygenation during surgery. This is a crucial step to maintain the patient's breathing and prevent any complications during the procedure.

A patient receiving moderate sedation should never be left unattended by the nurse because sedation can cause changes in the patient's level of consciousness and respiratory function. The nurse needs to closely monitor the patient's vital signs, level of sedation, and airway patency to ensure their safety and intervene promptly if any complications arise. Leaving the patient unattended could lead to potential risks and complications, making it essential for the nurse to remain present throughout the procedure.

Complying with the physician's order for the patient to lie flat postoperatively is important because it helps prevent the development of a headache. After spinal anesthesia, the patient may experience a headache due to leakage of cerebrospinal fluid from the puncture site. By lying flat, the patient can help reduce the risk of this complication. Hypotension, respiratory depression, and pain at the lumbar injection site are not directly related to the need for the patient to lie flat.

During the excitement stage of anesthesia, patients may exhibit restlessness, confusion, and uncontrolled movements. Restraint may be necessary to ensure the safety of the patient and the healthcare team. Restraint can help prevent the patient from accidentally harming themselves or others, and it allows for the administration of further anesthesia or necessary medical procedures. Rubbing the patient's back, encouraging the patient to express feelings, or stroking the patient's hand may not be effective interventions during this stage.

Pouring solution onto a sterile field cloth violates surgical asepsis because it introduces a non-sterile substance onto the sterile field. Surgical asepsis requires maintaining a sterile field and preventing any contamination by non-sterile objects or substances. Therefore, pouring solution onto a sterile field cloth would introduce potential contaminants and compromise the sterile environment.

One of the major goals for each patient as a circulating nurse is to maintain their dignity. This means ensuring that the patient's privacy and modesty are respected throughout the surgical process. It involves providing them with appropriate draping and ensuring that their personal belongings are secure. It also includes communicating with the patient in a respectful and compassionate manner, addressing their concerns and answering their questions. Maintaining the patient's dignity helps to create a positive and supportive environment, promoting their overall well-being and comfort during their surgical experience.

As individuals age, their cardiovascular system undergoes changes that can increase the risk of hypovolemia, which is a decreased volume of blood in the body. This can be attributed to factors such as decreased cardiac output, decreased elasticity of blood vessels, and decreased kidney function. In the case of a 72-year-old female patient undergoing a total knee replacement, the surgical procedure itself can lead to blood loss and fluid shifts, further increasing the risk of hypovolemia. Therefore, this patient is at an increased risk for hypovolemia due to her aging cardiovascular system.

In this scenario, it is important to address the inappropriate remark made by the colleague about the patient's weight, even though the patient is unconscious. Ignoring the comment would not address the issue and could perpetuate a negative workplace culture. By discouraging the comments, you are actively taking a stand against inappropriate behavior and promoting a respectful and inclusive environment. Reporting the comment to the supervisor may also be necessary to ensure appropriate action is taken. Realizing humor is needed in the workplace is not a suitable response in this situation.

As the circulating nurse, reviewing the patient's record is important to ensure that the necessary information about the patient's medical history and current physical condition is available. This includes details about any pre-existing conditions, allergies, medications, and any recent diagnostic tests or procedures. By reviewing the history and physical, the nurse can gather crucial information that will help in planning and providing appropriate care during the surgery. Progress notes, admission papers, and intake and output records may also be important, but the history and physical provide a comprehensive overview of the patient's health status.

An interdisciplinary approach is the best approach to surgery because it involves collaboration and coordination between multiple healthcare professionals from different disciplines. This ensures that all aspects of the patient's care are addressed, including medical, surgical, nursing, and any other relevant disciplines. By working together, healthcare professionals can provide comprehensive and holistic care to the patient, improving outcomes and patient satisfaction.

The correct answer is B) Respecting the patient's cultural values. As an advocate, the intraoperative nurse ensures that the patient's cultural values and beliefs are respected and taken into consideration during their care. This includes being sensitive to their cultural practices, preferences, and beliefs, and incorporating them into the patient's care plan. By doing so, the nurse promotes patient-centered care and helps create a supportive and inclusive healthcare environment.

Tachycardia is often the earliest sign of malignant hyperthermia. Malignant hyperthermia is a rare but potentially life-threatening reaction to certain medications used during general anesthesia. It is characterized by a rapid increase in body temperature, muscle rigidity, and metabolic acidosis. Tachycardia, or a fast heart rate, is one of the first signs that the body is experiencing this hypermetabolic state. It is important for nurses in the operating room to recognize this early sign and take immediate action to prevent further complications.

Incorporating cultural, ethnic, and religious considerations can help reinforce the patient's ability to influence their outcome by respecting their beliefs, values, and preferences. This can help create a supportive and inclusive environment for the patient, which can positively impact their emotional state and overall surgical experience. It shows that the healthcare team acknowledges and respects the patient's individuality, which can enhance their sense of control and empowerment during the surgical procedure. Assessing coping strategies and teaching guided imagery can also be beneficial, but incorporating cultural, ethnic, and religious considerations is a more comprehensive approach that addresses the patient's unique needs and preferences. Giving anti-anxiety medication may not necessarily empower the patient to influence their outcome, as it focuses more on symptom management rather than addressing the underlying emotional state.

A paravertebral block can be used to block the nerves leading to the chest. This technique involves injecting local anesthetic into the paravertebral space, which is located just outside the spinal column. By blocking the nerves in this area, the patient can experience pain relief in the chest region during the needle biopsy procedure. Transsacral block, brachial plexus block, and peudental block are not appropriate for blocking the nerves leading to the chest.

Aspirated vomitus can lead to hypoxia. When a person vomits and inhales the vomit into their lungs, it can cause a blockage in the airways. This blockage can prevent oxygen from reaching the lungs and being transported to the rest of the body. Without sufficient oxygen, the body's tissues and organs may not function properly, leading to hypoxia.

The Trendelenburg position is a position used in surgery where the patient's head is lower than their feet. This position can cause irreparable nerve damage because it increases the pressure on the nerves in the lower body, particularly in the legs and feet. The increased pressure can compress the nerves and potentially lead to nerve damage. Therefore, the Trendelenburg position should be used with caution and the patient's position should be regularly monitored to prevent any nerve damage.

Elderly patients are at higher risk for complications and adverse outcomes during the intraoperative period because they have a reduced ability to adjust rapidly to emotional and physical stress. This can lead to difficulties in maintaining homeostasis and responding to the physiological changes that occur during surgery. The body's stress response, including the release of stress hormones and activation of the sympathetic nervous system, may be blunted in older adults, making it harder for them to adapt to the demands of surgery. Additionally, age-related changes in organ function and decreased reserve capacity can further increase their vulnerability to complications.

When moving around surgical areas, a distance of 1 foot must be kept from the sterile field. This is important to prevent contamination and maintain the aseptic environment in the operating room. Keeping a distance of 1 foot helps to minimize the risk of accidentally touching or contaminating the sterile field, which could lead to surgical site infections or other complications.

In the operating room, lasers can be considered as an environmental hazard. Lasers are commonly used in surgical procedures to cut or cauterize tissue. However, if not used properly, lasers can cause harm to the patient, such as burns or damage to surrounding tissues. Therefore, the circulating nurse needs to be aware of the potential risks associated with laser use and take necessary precautions to ensure the safety of the patient.

As an intraoperative nurse, it is your responsibility to recognize the signs and symptoms of malignant hyperthermia, be knowledgeable about the protocol for managing it, and have the appropriate medication available. This is important because malignant hyperthermia is a potentially life-threatening condition that can occur during anesthesia, and prompt recognition and appropriate management are crucial to ensure patient safety. Directing the surgeon and anesthesiologist through the protocol may not be the nurse's responsibility, as it is typically the role of the anesthesia provider to lead the management of malignant hyperthermia.

The nurse uses touch as a basic communication skill. Touch can convey warmth, comfort, and reassurance to the patient. It can help establish a connection and build trust between the nurse and the patient. Touch can also be used to provide physical support and comfort during the surgical process.

The most direct relevance to the operating room among the 2009 National Patient Safety Goals is to reduce the risk of surgical fires. This goal is specifically focused on preventing fires that can occur during surgical procedures, which is a significant concern in the operating room. The goal aims to improve safety measures and protocols to minimize the risk of fires and ensure the safety of patients and healthcare providers during surgeries.

Using tissue adhesives to close a surgical wound can put the patient at an increased risk for anaphylaxis. Anaphylaxis is a severe allergic reaction that can occur in response to certain substances, including tissue adhesives. This reaction can be life-threatening and requires immediate medical attention. Therefore, it is important for the nurse to be aware of this risk and monitor the patient closely for any signs or symptoms of anaphylaxis during and after the surgery.

Anesthesia awareness refers to a rare but serious condition where a patient becomes aware or conscious during surgery or a medical procedure that is supposed to be performed under general anesthesia. This patient being an obstetric patient puts her at an increased risk for anesthesia awareness because pregnant women have a higher risk due to physiological changes in their body, increased blood volume, and altered metabolism. Therefore, anesthesia awareness is the correct answer for this patient.

During the intraoperative phase of the surgical experience, reflexes, ability to communicate, and loss of pain sense can subject the surgical patient to possible injury. Reflexes can cause involuntary movements that may interfere with the surgical procedure or cause harm to the patient. The ability to communicate is important for the patient to express any discomfort or concerns during the surgery. Loss of pain sense can prevent the patient from feeling pain, which may result in injury if they are not aware of any potential harm or complications.

As a circulating nurse in a day surgery center, it is important to be aware of potential complications that can occur during surgery. Hypothermia can occur due to the cold environment in the operating room and the use of anesthesia, leading to a decrease in body temperature. Anaphylaxis is a severe allergic reaction that can occur in response to medications or substances used during surgery. Nausea is a common side effect of anesthesia and can occur postoperatively. Pain is also a potential complication that can occur intraoperatively, but it is not listed as an option in the answer choices. Therefore, the correct answers are C) Hypothermia, D) Anaphylaxis, and E) Nausea.

A circulating nurse in the intraoperative setting may use the nursing diagnosis of disturbed sensory perception for patients under general anesthesia as they may experience altered sensations or perceptions during the procedure. The nurse may also consider the risk of latex allergy response as a diagnosis for patients who may be at risk of developing an allergic reaction to latex products used in the operating room. Additionally, anxiety may be a relevant nursing diagnosis for patients undergoing surgery, as they may experience heightened levels of stress and worry.