AORN Periop 101 Final Exam
n n n n
Indemnityn Paymentn -n answerPaymentn maden onn behalfn ofn then policyn holder
Liabilityn -n answerAn legaln responsibility
Negligencen -n answerAnn actn orn failuren ton actn thatn deviatesn fromn then standard n ofn care
Nursing n Malpracticen -
n answerAn nurse'snnegligencenornanynintentionaln actnthatn causesn physical, n financial, nemotional,n psyc
hosocial,n and/orn cognitiven damagen ton then personn inn then nurse'sn care
Respondeatn Superiorn -
n answerAn n employer n isn legallyn responsiblen for n then nursen employeen onlyn when:
o Then nursen actsn withinn then scopen ofn practice
o Anyn allegationsn broughtn againstn then nursen occurred n during n then nurse'sn employment
o Then nurse'sn actionsn weren withinn then employer'sn bestn interests.
Tortn -n answerAn breachn ofn dutyn ton anothern personn asn outlined n byn law
Whatn aren then fourn elementsn ofn malpractice? n -n answer•nDuty
• Breachnofnduty
• Thenbreachnofndutyncaused nanninjury
• Theninjurynwasnharmfulntonthenpatient
Elementsn ofn Informed n Consentn -
n answer• nMustnbenobtained nbynthenlicensed n professionaln whon isn performing n then procedure
,• Thenpatientnmustngivenconsentnvoluntarilynwithnthenfullnunderstanding nofnallnimplications
• Mustninclude
o Diagnosis
o Proposed n treatment
o Treatmentn alternatives
o Consequencesnofn accepting n orn declining n then proposed n treatment
Fiven Rightsn ofn Delegationn -
n answerRightn taskn Rightn circumstance
Rightn person
Rightncommunicationnandndirectionn Righ
tn supervisionn and n evaluation
Fourn typesn ofnpatientn privacyn healthncarenprovidersnandnpersonnelnhavenannethicalnandnlegalnresponsibilit
yn ton alwaysn maintainn -n answer•nMedicalninformation
• Physicalnexposure
• Personalnprivacy
• Electronicnprivacy
Eightnfactorsn ton considern beforen determining n whatn anestheticn ton usen forn an particularn patientn -
answer•nPatient'snage
• Lengthn&ntypenofnsurgery
• Patientn&nsurgeonnpreferences
• Patient'snco-existingn diseases
• Patient'snmentaln&npsychologicalnstatus
• Patient'snpreviousnexperiencesnwithnanesthesia
• Plansn&nprotocolsnfornpostoperativenpainn management
,• Positionnofnthenpatientnduring nsurgery
Then Americann Societyn ofn Anesthesiologist'sn NPOn Guidelinesn -n answer•nClearnliquidsn-
n stopn 2n hoursn beforen surgery
• Breastnmilkn-n stopn 4n hoursn beforen surgery
• Infantnformulan-n stopn 6n hoursn beforen surgery
• Lightnmealn(toastn&nanclearnliquid) n-n stopn 6n hoursn beforen surgery
• Fried nfoods,nfattynfoods,nmeatn-n stopn 8n hoursn beforen surgery
Circulatorn RNndutiesn duringnInductionn ofnanesthesianandnassistingnanesthesian professionalnwithnCric
oid n Pressuren -
n answer• nCricoid npressurenapplication nisn notnreleasedn untiln thenendotrachealn(ET)n tuben cuff n isn inflate
d,n tuben placementnisn confirmed,n and nanesthesian providernhasn givennan verbaln confirmationn tonthennur
sen thatn then cricoid n pressuren cann ben released.
• Ifnintubationnorn ventilationn ofnthenpatientn becomesndifficult,nthenperioperativen nursenshouldn
retrieven additionaln airwayn equipmentn and n supplies.
Generaln anesthesian -n answer•nAndrug-induced n reversiblen staten ofn unconsciousness
• Resultsninnamnesia,nanalgesia,nandnlossnofnresponsiveness,n decreased nstressnresponse,n and nlossnofn
skeletaln musclen reflexesn ton an varying n degree
Regionaln anesthesian -n answer•nAnninjectionnofnlocalnanestheticsnnearnnervenfibersnthatncauses
reversiblen lossn ofn sensationn overn ann arean ofn then body
• Examplesnincluden spinal,n epidural,n and n peripheralnnerven blocks.
Monitored n anesthesian caren (MAC) n -
n answerAn n anesthesian provider nmonitorsnthenpatient, n administersnsedativesnandnother nagentsn asn ne
eded,n and n providesn medicaln servicesn asn required.
Moderaten sedationn -n answer•nThenadministrationnofnsedative,nanalgesic,nand/ornanxiolyticnagentsnby
an physiciann orn byn an nursen undern physiciann supervision
• Depending nonnstatenlawsnand nhospitalnpolicies,nannRNnmaynadministernmoderatensedation.
, Localn anesthesian -
n answer• nTheninfiltration n or n topicaln administration n of n agentsn ton anesthetizen an partn of n then body
• Thenperioperativennursenprovidesnpatientnmonitoring nand nsupportivencare.
Phasesn ofn generaln anesthesian -n answer•nPhasenI:nInduction
o IVn medicationsn and n inhalationaln agentsn aren administered n byn then anesthesian provider.
• PhasenII:nMaintenance
o Medicationsnand n inhalationaln agentsn aren administered n ton keepn then patientn anesthetized.
• PhasenIII:nEmergencenonAtnthenendnofnthenprocedure,nthenanestheticnagentsnarendiscontinued no
rn reversed n ton allown then patientn ton waken up.
Anesthesian Reversaln agents:n Musclen relaxants:n -n answer1.n neostigmine
2.n edrophonium.
Note:n Theren isn non reversaln agentn forn succinylcholine
Anesthesian Reversaln agents:n Sugammadex:n -
n answerreversaln agentn for n rocuronium, n vecuronium, n and n pancuronium
AnesthesianReversaln agents:n Benzodiazepines:n Midazolamn -n answerFlumazenil
AnesthesianReversaln agents:n Narcotics:n Fentanyl:n -n answerNaloxone
Patientsn atn Increased n Riskn forn Hypothermian -n answer•nOldernadults
• Infantsnand nchildren
n n n n
Indemnityn Paymentn -n answerPaymentn maden onn behalfn ofn then policyn holder
Liabilityn -n answerAn legaln responsibility
Negligencen -n answerAnn actn orn failuren ton actn thatn deviatesn fromn then standard n ofn care
Nursing n Malpracticen -
n answerAn nurse'snnegligencenornanynintentionaln actnthatn causesn physical, n financial, nemotional,n psyc
hosocial,n and/orn cognitiven damagen ton then personn inn then nurse'sn care
Respondeatn Superiorn -
n answerAn n employer n isn legallyn responsiblen for n then nursen employeen onlyn when:
o Then nursen actsn withinn then scopen ofn practice
o Anyn allegationsn broughtn againstn then nursen occurred n during n then nurse'sn employment
o Then nurse'sn actionsn weren withinn then employer'sn bestn interests.
Tortn -n answerAn breachn ofn dutyn ton anothern personn asn outlined n byn law
Whatn aren then fourn elementsn ofn malpractice? n -n answer•nDuty
• Breachnofnduty
• Thenbreachnofndutyncaused nanninjury
• Theninjurynwasnharmfulntonthenpatient
Elementsn ofn Informed n Consentn -
n answer• nMustnbenobtained nbynthenlicensed n professionaln whon isn performing n then procedure
,• Thenpatientnmustngivenconsentnvoluntarilynwithnthenfullnunderstanding nofnallnimplications
• Mustninclude
o Diagnosis
o Proposed n treatment
o Treatmentn alternatives
o Consequencesnofn accepting n orn declining n then proposed n treatment
Fiven Rightsn ofn Delegationn -
n answerRightn taskn Rightn circumstance
Rightn person
Rightncommunicationnandndirectionn Righ
tn supervisionn and n evaluation
Fourn typesn ofnpatientn privacyn healthncarenprovidersnandnpersonnelnhavenannethicalnandnlegalnresponsibilit
yn ton alwaysn maintainn -n answer•nMedicalninformation
• Physicalnexposure
• Personalnprivacy
• Electronicnprivacy
Eightnfactorsn ton considern beforen determining n whatn anestheticn ton usen forn an particularn patientn -
answer•nPatient'snage
• Lengthn&ntypenofnsurgery
• Patientn&nsurgeonnpreferences
• Patient'snco-existingn diseases
• Patient'snmentaln&npsychologicalnstatus
• Patient'snpreviousnexperiencesnwithnanesthesia
• Plansn&nprotocolsnfornpostoperativenpainn management
,• Positionnofnthenpatientnduring nsurgery
Then Americann Societyn ofn Anesthesiologist'sn NPOn Guidelinesn -n answer•nClearnliquidsn-
n stopn 2n hoursn beforen surgery
• Breastnmilkn-n stopn 4n hoursn beforen surgery
• Infantnformulan-n stopn 6n hoursn beforen surgery
• Lightnmealn(toastn&nanclearnliquid) n-n stopn 6n hoursn beforen surgery
• Fried nfoods,nfattynfoods,nmeatn-n stopn 8n hoursn beforen surgery
Circulatorn RNndutiesn duringnInductionn ofnanesthesianandnassistingnanesthesian professionalnwithnCric
oid n Pressuren -
n answer• nCricoid npressurenapplication nisn notnreleasedn untiln thenendotrachealn(ET)n tuben cuff n isn inflate
d,n tuben placementnisn confirmed,n and nanesthesian providernhasn givennan verbaln confirmationn tonthennur
sen thatn then cricoid n pressuren cann ben released.
• Ifnintubationnorn ventilationn ofnthenpatientn becomesndifficult,nthenperioperativen nursenshouldn
retrieven additionaln airwayn equipmentn and n supplies.
Generaln anesthesian -n answer•nAndrug-induced n reversiblen staten ofn unconsciousness
• Resultsninnamnesia,nanalgesia,nandnlossnofnresponsiveness,n decreased nstressnresponse,n and nlossnofn
skeletaln musclen reflexesn ton an varying n degree
Regionaln anesthesian -n answer•nAnninjectionnofnlocalnanestheticsnnearnnervenfibersnthatncauses
reversiblen lossn ofn sensationn overn ann arean ofn then body
• Examplesnincluden spinal,n epidural,n and n peripheralnnerven blocks.
Monitored n anesthesian caren (MAC) n -
n answerAn n anesthesian provider nmonitorsnthenpatient, n administersnsedativesnandnother nagentsn asn ne
eded,n and n providesn medicaln servicesn asn required.
Moderaten sedationn -n answer•nThenadministrationnofnsedative,nanalgesic,nand/ornanxiolyticnagentsnby
an physiciann orn byn an nursen undern physiciann supervision
• Depending nonnstatenlawsnand nhospitalnpolicies,nannRNnmaynadministernmoderatensedation.
, Localn anesthesian -
n answer• nTheninfiltration n or n topicaln administration n of n agentsn ton anesthetizen an partn of n then body
• Thenperioperativennursenprovidesnpatientnmonitoring nand nsupportivencare.
Phasesn ofn generaln anesthesian -n answer•nPhasenI:nInduction
o IVn medicationsn and n inhalationaln agentsn aren administered n byn then anesthesian provider.
• PhasenII:nMaintenance
o Medicationsnand n inhalationaln agentsn aren administered n ton keepn then patientn anesthetized.
• PhasenIII:nEmergencenonAtnthenendnofnthenprocedure,nthenanestheticnagentsnarendiscontinued no
rn reversed n ton allown then patientn ton waken up.
Anesthesian Reversaln agents:n Musclen relaxants:n -n answer1.n neostigmine
2.n edrophonium.
Note:n Theren isn non reversaln agentn forn succinylcholine
Anesthesian Reversaln agents:n Sugammadex:n -
n answerreversaln agentn for n rocuronium, n vecuronium, n and n pancuronium
AnesthesianReversaln agents:n Benzodiazepines:n Midazolamn -n answerFlumazenil
AnesthesianReversaln agents:n Narcotics:n Fentanyl:n -n answerNaloxone
Patientsn atn Increased n Riskn forn Hypothermian -n answer•nOldernadults
• Infantsnand nchildren
