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Cards In This Set
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Name the 4 goals of surgical positioning?
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1) Maintain a physiologically and anatomically safe enviorment
2) Provide optimum exposure during the operative procedure 3) Maintain the pt airway 4) Allow access to monitoring devices and intravenous lines |
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Explain AORN positioning of surgical pts reccommendation IV?
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During periop assessment the periop RN should ID unique pt consideration that require additional precautions for procedure-specific positioning
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Explain AORN positioning of surgical pt reccommendation IV.b?
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The preop interview should include questions that will help to determine pt tolerance to the planned operative position. Assesment includes both pt factors and intraoperative factors
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Explain the pt factors involved in assessment?
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Pt age, ht, wt, skin condition, nutritional status
preexisting conditions physical and mobility BMI, presence of jewlery |
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Explain the intraopeartive factors included in assessment?
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Anesthesia
length of surgery position required |
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Explain the general positioning safety measures AORN reccommendation VIII?
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The preiop RN should actively participate in safely positioning the pt under doc direction
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What are the 3 surgical positions?
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Supine(back)(dorsal recumbent)
Prone(on belly) Lateral(on side) |
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Explain the AORN Reccommendation II and III in positioning of surgical pts
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Recommendation II : during the planning phase of pt care, the periop RN should anticipate the positioning equipment needed for the specific operative or invasive procedure.
Recommendation III: Positioning and transporting equipment should be periodically inspected and maintained in properly functioning condition |
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What is the supine position used for?
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Abd position
Head and Neck procedure Vascular surgery Breast surgery |
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What are the safety measures for supine position?
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1) Arm less than 90 degree to avoid compression of brachial plexus
2) Small pillow under pts head 3)Pressure points are padded(occiput, scapulae, thoracic vertebra, olecranon process, sacrum/coccyx, elbows) 4)elevate heels 5)safety straps applied 2' above the knee with padding placed b/t the strap and the pt skin 6)eyes protected use eye ung and padding 7)pillow under pts knee 8)pregnant pt place wedge under pt right side to displace the uterus to the left 9) 7) 8) 9) |
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Explain cardiovascular effect of placing a pt on supine position?
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Decreased HR
increase in CO decrease in systolic pressure venous pooling in lower extremities |
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Explain respiratory effect of placing a pt in supine position?
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Compromised respiratoy function
Decrease vital capacity Decrease in diaphragmatic expansion Even distribution of lung ventilation |
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The Trendelenburg's position is a modification of what position?
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Supine
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What is the Trendelenburg position used for?
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Used for procedure on lower abd and pelvic organs
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Explain the cardiovascular effects when pt is positioning in the trendelenburg's position?
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Elevated BP
Rapid return to the supine position can produce a drop in BP Cyanosis Increase vascular load from the lower extremities to the heat can occur |
