Otterbein/Grant CRNA Patient Positioning Review

29 Questions | Total Attempts: 113

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Otterbein/Grant CRNA Patient Positioning Review

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Questions and Answers
  • 1. 
    Which of the following are goals of operative positioning?
    • A. 

      Optimum surgical exposure

    • B. 

      Access for monitoring

    • C. 

      Preventing complications and injuries

    • D. 

      Maintaining body integrity and physiological functions

    • E. 

      All of the above

  • 2. 
    Please fill answer below_______
  • 3. 
    The only position in which the West zones of the lung are normal in the operating room is:
    • A. 

      Supine

    • B. 

      Prone

    • C. 

      Sitting

    • D. 

      Side-lying

  • 4. 
    Please fill answer below_______
  • 5. 
    Select all of the following physiological changes that apply to a patient in the supine position:
    • A. 

      Diaphragm shifts cephalad.

    • B. 

      Abdominal contents push against the diaphragm, decreasing FRC

    • C. 

      The West zones of the lung shift.

    • D. 

      The mediastinum shifts towards the head, increasing the risk for bronchial intubation.

  • 6. 
    Your patient is in Trendelenberg position.  You understand that their FRC is inversely proportional to the steepness of their positioning.
    • A. 

      True

    • B. 

      False

  • 7. 
    In the lithotomy position, respiratory changes are dependent on the extent to which the ____ are flexed on the abdomen
  • 8. 
    In extreme lithotomy positioning, compliance and tidal volumes _______ while airway pressures ________.
    • A. 

      Decrease, increase

    • B. 

      Decrease, decrease

    • C. 

      Increase, decrease

    • D. 

      Increase, increase

  • 9. 
    What patient position is most preferable for ventilation?
    • A. 

      Sitting

    • B. 

      Supine

    • C. 

      Prone

    • D. 

      Side-lying

  • 10. 
    When the patient is in the sitting position but the lower extremities are flexed at the hip, abdominal contents shift upwards against the diaphragm.  This causes a change in FRC similar to the change seen in which position?
    • A. 

      Prone

    • B. 

      Supine

    • C. 

      Side-lying

    • D. 

      Trendelenberg

  • 11. 
    Patients in the lateral position are susceptible to _______ because closing volumes occur above FRC with closing occurring earlier in the dependent lung
    • A. 

      Atelectasis

    • B. 

      Pneumothorax

    • C. 

      Pneumonia

    • D. 

      ARDS

  • 12. 
    Your patient is in the lateral position, you know that you should consider ______ your TV and utilizing a higher RR to prevent declines in oxygenation.
    • A. 

      Increasing (10-12 mL/kg)

    • B. 

      Normalizing (5-7 mL/kg)

    • C. 

      Decreasing (4 mL/kg)

  • 13. 
    In the lateral position, the compliance of the dependent lung:
    • A. 

      Increases

    • B. 

      Decreases

    • C. 

      Remains the same.

  • 14. 
    In the prone position with the abdomen hanging free, FRC:
    • A. 

      Increases

    • B. 

      Decreases

    • C. 

      Remains the same

  • 15. 
    In the prone position, what causes improvement in oxygenation?
    • A. 

      Better matching of ventilation and perfusion.

    • B. 

      Changes in lung volumes/capacities.

  • 16. 
    You have successfully intubated your patient in the supine position.  Your patient is having a procedure on their shoulder, upon raising them to the seated position what do you anticipate happening to your patient's blood pressure?
    • A. 

      Decrease

    • B. 

      Increase

    • C. 

      No change

  • 17. 
    Neuromuscular blockade increases venous return.
    • A. 

      True

    • B. 

      False

  • 18. 
    Your patient is under general anesthesia in the sitting position.  What do you expect to happen to their preload and stroke volume?
    • A. 

      Increase

    • B. 

      Decrease

    • C. 

      No change.

  • 19. 
    Opioids and volatile agents slow the heart rate, decreasing cardiac output and blood pressure.  In healthy patients, MAP is maintained by compensatory increases in heart rate and ______
    • A. 

      Respiratory rate

    • B. 

      SVR

    • C. 

      Pulmonary vascular resistance

    • D. 

      CVP

  • 20. 
    ___________ can be unrecognized in the lithotomy and Trendelenburg positions, because MAP can appear normal despite volume deficit d/t large amount of venous return. 
  • 21. 
    The sitting position increases cerebral blood flow.
    • A. 

      True

    • B. 

      False

  • 22. 
    Which position puts the patient at greater risk for venous air embolism?
    • A. 

      Prone

    • B. 

      Supine

    • C. 

      Sitting

    • D. 

      Lateral

  • 23. 
    Tourniquet pressure > _____ mmHg or longer than 2 hours increase the risk of peripheral nerve injury.
  • 24. 
    Corneal abrasions and post-operative vision loss are complications of the prone positioning, requiring the need for meticulous attention to protection of the eyes - meaning the use of devices to ensure the eyes are kept free of pressure.  The eyes should be check every 15 minutes when in the prone position.
    • A. 

      True

    • B. 

      False

  • 25. 
    Treatment of a venous air embolism is via removing the air via aspiration through a multiorifice central venous catheter.
    • A. 

      True

    • B. 

      False

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