Chapter 18 - Intraoperative Care
Answer: a. Ensure correct placement of the grounding pad.
Rationale: Care must be taken to correctly place the grounding pad and all electrosurgical
equipment to prevent injury from burns or fire. It is important to ensure that fire extinguishers are
available and that sprinklers protect everyone in the operating room in case of a fire but placing
the grounding pad will prevent direct burn injury to the patient. Verifying that electrosurgical
equipment is working properly does not protect the patient unless the grounding pad is placed
correctly. - ANS-Which action should the perioperative nurse take to protect the patient from
burn injury during surgery?
a. Ensure correct placement of the grounding pad.
b. Check emergency sprinklers in the operating room.
c. Verify that a fire extinguisher is available during surgery.
d. Confirm that all electrosurgical equipment is working properly.
Answer: a. Starting an IV in the patient's unaffected arm.
Rationale: For MAC, IV sedatives, such as the benzodiazepines, are given. Therefore, the
patient needs IV access. Inhaled and epidural agents are not included in MAC. RNs who are
trained and are allowed by agency protocols and state nurse practice acts can provide
moderate to deep sedation. However, the provider of MAC must be an anesthesia care provider
since it may be necessary to change to general anesthesia during the procedure. -
ANS-Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a
patient's dislocated shoulder. What action does the nurse anticipate?
a. Starting an IV in the patient's unaffected arm.
b. Securing an airtight fit for the inhalation mask.
c. Preparing for placement of an epidural catheter.
d. Giving deep sedation under physician supervision.
Answer: b. "I will check with the anesthesia care provider to find out what is planned."
Rationale: Routine general anesthesia is usually induced by the IV route with a hypnotic,
anxiolytic, or dissociative agent. However, general anesthesia may be induced by IV or
inhalation. The nurse should consult with the anesthesia care provider to determine the method
selected for this patient. The anesthesia care provider will select the method of anesthesia, not
the surgeon. Inhalation agents may be given through an endotracheal tube or a laryngeal mask
airway. - ANS-A patient scheduled to undergo total knee replacement surgery under general
anesthesia asks the nurse, "Will the doctor put me to sleep with a mask over my face?" Which
response by the nurse is most appropriate?
, a. "Only your surgeon can tell you what method of anesthesia will be used."
b. "I will check with the anesthesia care provider to find out what is planned."
c. "General anesthesia is given by injecting drugs into your veins, so you will not need a mask
over your face."
d. "Masks are no longer used for anesthesia. A tube inserted into your throat will deliver gas that
puts you to sleep."
Answer: b. Alert the anesthesia care provider of the family member's reaction to surgery.
Rationale: The anesthesia care provider (ACP) needs to be notified and made aware of the
patient's family history of anesthesia reactions. Malignant hyperthermia (MH) is a valid concern
because the patient's father appears to have had a reaction to surgery. The ACP needs to be
notified immediately rather than waiting for a sticker to be noticed on the chart. Administering
acetaminophen may not prevent MH. General anesthesia can be administered to patients with
MH if precautions to avoid MH are taken and preparations are made to treat MH if it does occur.
- ANS-While in the holding area, a patient reveals to the nurse that his father had a high fever
after surgery. What action by the nurse is a priority?
a. Place a medical alert sticker on the front of the patient's chart.
b. Alert the anesthesia care provider of the family member's reaction to surgery.
c. Give 650 mg of acetaminophen (Tylenol) per rectum as a preventive measure.
d. Reassure the patient that his temperature will be monitored closely after surgery.
Answer: b. Make surgical incisions and suture as needed.
Rationale: The role of the RNFA includes skills such as making and suturing incisions and
maintaining hemostasis. The other actions should be delegated to other staff members such as
the circulating nurse, scrub nurse, or surgical technician. The anesthesia care provider should
adjust the doses of anesthetics for patients, not the RNFA. - ANS-Which nursing action should
the operating room (OR) nurse manager delegate to the registered nurse first assistant (RNFA)
when caring for a surgical patient?
a. Adjust the doses of administered anesthetics.
b. Make surgical incisions and suture as needed.
c. Provide postoperative teaching about coughing.
d. Coordinate transfer of the patient to the operating table.
Answer: b. Pass sterile instruments and supplies to the surgeon and scrub technician.
Rationale: The education and certification for a surgical technologist includes the scrub and
circulating functions in the OR. Patient teaching, communication with other departments about a
patient's condition, and the admission assessment require registered nurse (RN) level education
and scope of practice. A surgical technologist is not usually trained to interpret ECG rhythms. -
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller AnswersCOM. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
