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Flashcards in BODY POSITIONING QUESTIONS Deck (22)
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1
Q

What nerves are at highest risk of damage in the lateral recumbent position and what are the signs and symptoms of those nerve(s) damage?

A

Brachial Plexus Nerve: burning sensation and weakness in arm and hand

2
Q

The Brachial Plexus includes what three nerves?

A

Musculocutaneous, Ulnar, Median

3
Q

What physiological change would you expect to see in a patient who is in the lateral recumbent position?

A

Increase in heart rate and SVR
decrease in cardiac output, systolic BP, and MAP. Pulmonary - ventilation perfusion mismatch to dependent lung and decrease functional residual capacity

4
Q

A prudent SRNA would anticipate the patient to be in a lateral decubitus position for what surgical procedure(s)?

A

Temporal lobe craniotomy,
skull base and posterior fossa procedures, retroperitoneal, thoracic, and thoracolumbar spine are common procedures for the lateral decubitus position.

5
Q
  1. While the patient is in the prone position, proper padding and rotation of the arms is essential for prevention of what major complication?
A

Ulnar nerve compression

6
Q
  1. Expected physiological changes while the patient is in the prone position might include which of the following
A

Increased FRC

7
Q

An Arkansas State SRNA’s primary (most important) responsibility while planning to move a patient from supine to prone while intubated would include which of the following?

A

Securing airway

8
Q

Which answer is not a known complication of the supine position?

a) Backache
b) Ulnar nerve compression
c) Aortocaval compression
d) Reduces FRC
e) Injury to the sciatica and perineal nerves

A

Injury to the sciatica and perineal nerve

9
Q

What is a possible complication associated with the supine position in pregnancy?

A

Aortocaval syndrome

10
Q

How would you prepare a patient to prevent ulnar nerve damage? CHOOSE 2

A

Avoid excessive pressure on the post condylar groove of the humerus

Hand and forearm position will need to be either supinated and/or in neutral position

11
Q

The most significant complication from the sitting position is..

A

Venous Air Embolism

12
Q

Invasive arterial blood pressure should be monitored at what level?

A

External auditory meatus to optimize cerebral perfusion pressure

13
Q

As a SRNA you are well aware of the risk factors associated with the sitting position, so when your patient develops a venous air embolism, you remain calm and do the following. Select three that apply

A

Discontinue N2O immediately and deliver 100% oxygen with anesthetic inhalation

Attempt to aspirate central venous catheter to retrieve entrained air

Implement Bilateral jugular vein compression

14
Q

What are the various physiological effects of the Trendelenburg position at 1 minute, at 10 minutes, and in longer procedures? What steps can be taken to prevent them?

A

1 Min: 9% increase in Cardiac Output

10 Min: C.O. returns to baseline

Overall: Functional Residual Capacity decreases,
Pulmonary Compliance Decreases;
Increased Intraocular Pressure & Intracranial Pressure

15
Q

Identify the surgical procedure for which Trendelenburg position is used - Select 2

A

Cholecystectomy

Robot-Assisted Laparoscopic radical Prostatectomy

16
Q

Compression or stretch injury to the brachial plexus is common in Trendelenburg positions. What safety steps must be implemented to reduce the risk of brachial plexus neuropathy?

A

Proper padding and fitting of shoulder braces to prevent injury.

17
Q
  1. There is a 32 year old male going in for a transurethral prostate resection. What surgical position will be most beneficial for this patient and type of surgery?
A

Lithotomy position

18
Q

Why is it beneficial and important to position the patient in the lithotomy position? Choose three

A

Prevents peripheral nerve damage

prevents skin and deep tissue injury

sedation eliminates patient sensation

19
Q

What specific lithotomy position is used for procedures that require simultaneous access to the perineum and the abdomen?

A

Low lithotomy position

20
Q

supine position is also known as?

A

dorsal decubitus

21
Q

where is the head in trendelenburg and reverse trendelenburg

A

Trendelenburg is head down

Reverse is head up (highest part of body)

22
Q

what trendelenburg position reduces the chance of air embolism?

A

Normal trendelenburg with the head down.