SURGICAL POSITIONING

Question 1

• Surgical Positioning

Answer 1

the practice of placing a patient in a particular physical
position during surgery

Question 2

Factors that would determine the patient’s surgical
position:

Answer 2

o The type and length of the surgical procedure to be
performed.
o The existing physical condition of the patient.
o The surgeon’s preference in consultation with the
anesthetist.

Question 2

Aim of optimal positioning for surgery

Answer 2

– to provide the
best surgical access while maintaining patient safety and
minimizing potential risk to the patien

Question 2

Goals Of Proper Patient Positioning

Answer 2

o Maintain the patient’s airway and circulation
throughout the procedure
o Prevent nerve damage
o Allow surgeon accessibility to the surgical site as well
as for anesthetic administration
o Provide comfort and safety to the patient
o Prevent soft tissue or musculoskeletal and other
patient injury

Question 3

Introducing anesthesia:

Answer 3

done SUPINE.

Question 4

SUPINE OR DORSAL RECUMBENT POSITION

Answer 4

the usual position for induction of general anesthesia, for
entering the major body cavities and for doing most surgery
of the abdomen such as laparotomy, bowel resection,
mastectomy, herniorrhaphy, and appendectomy.

Question 5

PRONE

Answer 5

Patient is lying on his abdomen
* used for surgical procedures that are performed on the back
(spinal surgeries), shoulders, neck, or back of the head.
* Compromises lung expansion

Question 6

if the patient undegoing prone position in surgery, the lungs will be compromised, what will be ur nursing intervention?

Answer 6

NI: put rolled towels on the side

Question 7

TRENDELENBURG

Answer 7

• involves a head-down tilt, feet up position. Patient is in
  supine position and OR table is tilted on a 15–30 degree
  incline so that the patient’s head is lower than his feet by 1-
  5 degrees.

Question 8

TRENDELENBURG

generally used for

Answer 8

lower abdominal surgeries and pelvic
surgeries and operations on the bladder, prostate gland,
colon, female reproductive system, or for any operation in
which it is desirable to tilt the abdominal viscera away from
the pelvic area for better exposure or optimal visualization
or in some lower extremity surgery for hemostasis.

Question 9

REVERSE TRENDELENBURG

Answer 9

places the body supine on an incline but with the head being
elevated.
* generally used for surgeries on the neck, such as
thyroidectomy, and for certain upper abdominal surgery,
such as liver or gallbladder operations (by gravity, keeps the
intestines mostly in the lower part of the abdomen)

Question 10

JACKNIFE OR KRASKE

Answer 10

Modified Knee Chest or Kraske position.
* Patient lies on his abdomen, with the hip joint over the break
of the OR table.
* Used in gallbladder and kidney surgery, in the absence of a
lumbar bridge, the back and buttocks are folded to form an
arch to replace the lumbar bridge or in gluteal muscle and
anal (rectal) surgery such as excision of pilonidal sinus

Question 11

LATERAL OR MODIFIED SIMS POSITION

Answer 11

involves positioning the patient on the unaffected surgery
side to provide access to the chest, kidney, or hip area

Question 12

LATERAL OR MODIFIED SIMS POSITION

Generally used for surgeries of the

Answer 12

chest, kidney or hip such
as thoracoplasty, pneumonectomy, lobectomy or hip
replacement surgery. (except kidney transplant;supine

Following induction while in the supine position, the patient
is moved and safety positioned. Arms are placed on padded
arm boards positioned on one side of the patient. Padding is
applied to the elbows to minimize ulnar nerve injury.

Question 13

SITTING POSITION

Answer 13

Fowler’s (sitting), modified Fowler’s, and beach chair
position involves placing the patient in a sitting position on
the operating room table.
* utilized in surgical procedures for which the patient sits
upright such as operations on the nose and throat, as well
as some plastic surgical procedures

Question 14

LITHOTOMY

Answer 14

involves a modification of the supine position. The patient’s
lower extremities are elevated, abducted, and placed into leg
holders or stirrups.
* used for surgeries rectal or in the perineal area, such as
hemorrhoidectomy, drainage of rectal abscesses and
perineal prostatectomies, and for gynecological surgery
such as vaginal hysterectomy

Question 15

POSITIONING CHALLENGES

Answer 15

Obesity
* Lack of proper support or positioning devices
* Inadequate number of staff to provide appropriate
assistance
* Lack of knowledge in proper surgical positioning

Question 16

GOWNING AND GLOVING

sterile drapings

Answer 16

Sterile Draping
o Kinds of Linens:
▪ Towels
▪ Whole or half sheets
▪ Fenestrated or slit drapes

Question 17

INSTRUMENTATION AND SUTURES

Cutting

Answer 17

• such as scalpel, knife, scissors

Question 18

INSTRUMENTATION AND SUTURES

Grasping or Holding

Answer 18

• such as allis, and tissue
  forceps

Question 19

INSTRUMENTATION AND SUTURES

Ligating and Grasping

Answer 19

• such as hemostats

Question 20

INSTRUMENTATION AND SUTURES

Exposing

Answer 20

• retractors

Question 21

INSTRUMENTATION AND SUTURES

Suturing

Answer 21

• needle holders and needles

Question 22

INSTRUMENTATION AND SUTURES

Accessory

Answer 22

endoscopic instruments; bore drills

Question 23

TYPES OF SUTURE MATERIALS: Absorbable Sutures

Answer 23

- e.g., chromic, plain, vicry

Question 24

TYPES OF SUTURE MATERIALS: Nonabsorbable Sutures

Answer 24

e.g. silk, cotton, nylon

Question 25

COMMON SKIN CLOSURE SUTURING METHODS:

Answer 25

Plain, interrupted o Mattress- continuous o Subcuticular or buried

Question 26

Q: What is the nurse’s role when the client arrives at the surgical suite?

Answer 26

🔸 Meets the client in the holding area and identifies themselves as the circulating nurse who will stay with the client.

Question 26

🔹 Q: What document is reviewed by the nurse in the OR?

Answer 26

🔸 The preoperative checklist and client’s chart.

Question 26

🔹 Q: What client conditions are assessed by the circulating nurse?

Answer 26

🔸 The emotional and physical status of the client.

Question 27

Q: What kind of assessment is done quickly before surgery?

Answer 27

🔸 A rapid assessment focusing on factors that increase surgical risk (e.g., allergies, vital signs, comorbidities).

Question 28

🔹 Q: When does assessment continue during the intraoperative phase?

Answer 28

🔸 During transfer to the OR table, anesthesia induction, and draping.

Question 29

Q: Does the nurse assess during the surgery itself?

Answer 29

Yes, ongoing assessment is done throughout the surgical procedure.

Question 30

Q: What does the nurse monitor to ensure safety?

Answer 30

Equipment that supports client safety (e.g., monitors, suction, cautery tool

Question 31

Nursing management for the older surgical patient in the intraoperative period includes the following

Answer 31

Application of intraoperative warming techniques to reduce unintentional hypothermia Careful transfer and positioning on the OR bed. Protect pressure points and bony prominences with extra padding. Support the back and neck to prevent stiffness while maintaining respiratory and circulatory support Use of antiembolic stockings or a sequential compression device to prevent VTE formation Careful fluid and electrolyte monitoring via accurate blood loss measurement, urinary output, and blood gases