Chapter 15: Care of Intraoperative Patients

Chapter 15: Care of Intraoperative Patients

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The circulating nurse is plugging in a piece of equipment and notes that the cord is frayed. What action by the nurse is best?
   1. Call maintenance for repair.
   2. Check the machine before using.
   3. Get another piece of equipment.
   4. Notify the charge nurse.

ANS:   C

The circulating nurse is responsible for client safety. If an electrical cord is frayed, the risk of fire or sparking increases. The nurse should obtain a replacement. The nurse should also tag the original equipment for repair as per agency policy. Checking the equipment is not important as the nurse should not even attempt to use it. Calling maintenance or requesting maintenance per facility protocol is important, but first ensure client safety by having a properly working piece of equipment for the procedure about to take place. The charge nurse probably does need to know of the need for equipment repair, but ensuring client safety is the priority.

DIF:     Applying/Application                         REF: 239                     KEY: Intraoperative nursing| circulating nurse| safety                                  MSC:                         Integrated Process: Nursing Process: Implementation                                 NOT:                          Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

2. The circulating nurse and preoperative nurse are reviewing the chart of a client scheduled for minimally invasive surgery (MIS). What information on the chart needs to be reported to the surgeon as a priority?
   1. Allergies noted and allergy band on
   2. Consent for MIS procedure only
   3. No prior anesthesia exposure
   4. NPO status for the last 8 hours

ANS:   B

All MIS procedures have the potential for becoming open procedures depending on findings and complications. The client’s consent should include this possibility. The nurse should report this finding to the surgeon prior to surgery taking place. Having allergies noted and an allergy band applied is standard procedure. Not having any prior surgical or anesthesia exposure is not the priority. Maintaining NPO status as prescribed is standard procedure.

DIF:     Applying/Application                         REF: 250                     KEY: Intraoperative care| informed consent| circulating nurse  MSC:   Integrated Process: Communication and Documentation  NOT:   Client Needs Category: Safe and Effective Care Environment: Management of Care

3. A client is having robotic surgery. The circulating nurse observes the instruments being inserted, then the surgeon appears to “break scrub” when going to the console and sitting down. What action by the nurse is best?
   1. Call a “time-out” to discuss sterile procedure and scrub technique.
   2. Document the time the robotic portion of the procedure begins.
   3. Inform the surgeon that the scrub preparation has been compromised.
   4. Report the surgeon’s actions to the charge nurse and unit manager.

ANS:           B

During a robotic operative procedure, the surgeon inserts the articulating arms into the client, then “breaks scrub” to sit at the viewing console to perform the operation. The nurse should document the time the robotic portion of the procedure began. There is no need for the other interventions.

DIF:            Applying/Application                         REF: 242                     KEY: Intraoperative care| circulating nurse| robotic technology| sterile procedure MSC:                 Integrated Process: Communication and Documentation  NOT:         Client Needs Category: Safe and Effective Care Environment: Management of Care

4. The circulating nurse is in the operating room and sees the surgeon don gown and gloves using appropriate sterile procedure. The surgeon then folds the hands together and places them down below the hips. What action by the nurse is most appropriate?
   1. Ask the surgeon to change the sterile gown.
   2. Do nothing; this is acceptable sterile procedure.
   3. Inform the surgeon that the sterile field has been broken.
   4. Obtain a new pair of sterile gloves for the surgeon to put on.

ANS:           C

The surgical gown is considered sterile from the chest to the level of the surgical field. By placing the hands down by the hips, the surgeon has broken sterile field. The circulating nurse informs the surgeon of this breach. Changing only the gloves or only the gown does not “restore” the sterile sections of the gown. Doing nothing is unacceptable.

DIF:            Applying/Application                         REF: 244                     KEY: Intraoperative nursing| sterile field| surgical scrub| surgical gowning MSC:                                Integrated Process: Communication and Documentation  NOT:         Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control