NIEVE 2015

DECEMBER 2016 NURSING LICENSURE

EXAMINATION
Operating Room Nursing Notes
Blaise B. Nieve, RN, MAN (UE)

ANESTHESIA Is a state of narcosis (severe CNS depression produced by pharmacologic agents),

analgesia, relaxation, and reflex loss.
TYPES OF ANESTHESIA
1. GENERAL ANESTHESIA(inhaled or i.v.)
- Refers to drug-induced depression of the CNS that produces analgesia, amnesia, and
unconsciousness
- Affects whole body
- Has 4 stages:
Stage I : Beginning Anesthesia
- warmth, dizziness and detachment may be experienced
Stage II : Excitement
- characterized variously by struggling, shouting, talking, singing, laughing or crying
- pupils dilate but contract if exposed to light
- pulse rate is rapid
- respirations may be irregular
Stage III : Surgical Anesthesia
- patient is unconscious and lies quietly on the table
- pupils are small but contract when exposed to light
- respirations are regular
- pulse rate and volume are normal
- skin is slightly flushed
Stage IV : Medullary Depression
- reached when too much anesthesia has been administered
- respirations become shallow
- pulse is weak and thready
- pupils become widely dilated and no longer contract when exposed to light
- cyanosis develops and without prompt intervention, death rapidly follows
2. REGIONAL ANESTHESIA
- Is a form of local anesthesia that in which an anesthetic agent is injected around the
nerves so that the area supplied by these nerves is anesthetized.
- Client remains awake
- E.G. Procaine (novocaine)
Tetracaine(Pontocaine)
Lidocaine(Xylocaine)
Bupivacaine(Marcaine)
3. SPINAL ANESTHESIA
- type of extensive conduction nerve block that is produced when a local anesthetic is
introduced into the subarachnoid space at the lumbar level(between L4 and L5)
- Produces anesthesia of the lower extremities, perineum and lower abdomen.
- Nausea, pain anmd vomiting may occur during surgery when this kind of anesthesia is
used.
- Headache may be an after effect of spinal anesthesia
4. CONDUCTION BLOCK
- Blocks sensation and motion on various groups of nerves such as:
- epidural block anesthetic into space around the dura mater
- brachial plexus block produces anesthesia of the arm
- paavertebral block produces anesthesia of the chest, abdominal wall and extremities
- transsacral or caudal block anesthesia of the perineum.
5. LOCAL INFILTRATION ANESTHESIA
Operating Room Nursing
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 NIEVE 2015

DECEMBER 2016 NURSING LICENSURE

EXAMINATION

- The injection of a solution containing the local anesthetic into the tissues of the planned
incision site.
- Often combined with a local regional block by injecting the nerves supplying the area
SURGICAL POSITIONS
DORSAL RECUMBENT/ SUPINE
- Flat on bed
- One arm is positioned at the side of the table, with the hand placed palm down; the other hand is
carefully positioned on an arm board
- Used for most abdominal surgery
- Used for other examinations including an internal autopsy, palpitation and auscultation of the
abdominal organs, and cardiovascular assessment- A position of the body; lying down with the
face up, as opposed to the prone position, which is face down.
TRENDELENBURG POSITION
- Flat on bed but head and body are lowered
- The patient is held in position by padded shoulder braces.
- Used for surgery on lower abdomen and pelvis to obtain good exposure by displacing the
intestines into the upper abdomen
- Used when needed to tilt the abd. viscera away from the pelvic area
- O.R. bed is tilted so the patient's head is lower than the trunk
- A position in which the patient is on his back with the head and chest lowered and the legs
elevated.
LITHOTOMY POSITION
- Flat on back with legs and thighs flexed
- Position is maintained by placing stirrups.
- Used for nearly all perineal, rectal, and vaginal surgical procedures.
- Patient's buttocks rest along the break between the body & leg sections of the O.R. bed
- A supine position in which the hips and knees are fully flexed with the legs spread apart and
raised and the feet resting in straps. Also called dorsosacral position.
SIMS OR LATERAL POSITION
- Patient is placed on non-operative side with air pillow 12.5-15 cm thick under the loin; the upper
leg extended; the lower leg is flexed at the knee
- Used for kidney, chest, and hip surgery
- This position is a variation of lateral position with the patient on the left side, left leg extended
and right leg flexed. This position is often used for rectal examination and treatments and
enemas.- A position in which the patient lies on one side with the under arm behind the back and
the upper thigh flexed, used to facilitate vaginal examination. Also called lateral recumbent
position.
PRONE POSITION
- Face-down position
- Head is turned to one side
- Used in back and spine surgery
- A position of the body lying face down. It is opposed to the supine position which is face up
JACKKNIFE POSITION
- Patient begins in supine position and is log-rolled onto abdomen.
- OR table flexed to approximately 90 degrees.
- Arms on armboards or at sides
- Used almost exclusively for rectal surgery
THYROIDECTOMY POSITION
Operating Room Nursing
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DECEMBER 2016 NURSING LICENSURE

EXAMINATION

NIEVE 2015

- A surgical procedure in which all or part of the thyroid gland is removed. The thyroid gland is
located in the forward part of the neck (anterior) just under the skin and in front of the Adam's
apple.
- Surgical removal of the thyroid gland

Operating Room Nursing

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