Perioperative Patient Assessment Flashcards

Which component of the preoperative assessment is specifically within the CRNFA's scope when functioning as first assistant?

Answer: Performing a focused preoperative nursing assessment and assisting with history and physical

The CRNFA performs a focused preoperative nursing assessment and collaborates with the surgical and anesthesia team — independently ordering labs or obtaining surgical consent is outside CRNFA scope in most states.

A patient undergoing elective hip replacement has a preoperative hemoglobin of 9.5 g/dL. The CRNFA's most appropriate action is to:

Answer: Notify the surgeon and anesthesiologist and document the finding

A hemoglobin of 9.5 g/dL represents anemia that increases transfusion risk; the CRNFA should notify the surgeon and anesthesiologist so they can decide whether to proceed or optimize the patient.

Which patient history finding should prompt the CRNFA to alert the surgeon about potential difficult airway management?

Answer: Short neck, limited cervical extension, and prior difficult intubation

Anatomical features such as short neck and limited cervical extension, combined with a history of prior difficult intubation, strongly predict difficult airway and must be communicated to the anesthesia team.

Which preoperative vital sign finding requires immediate escalation before a patient is brought into the OR?

Answer: Temperature of 38.9°C (102°F)

A fever of 38.9°C may indicate active infection, which is a contraindication to elective surgery and must be reported immediately.

When reviewing the preoperative checklist, which item related to NPO status is most critical for patient safety?

Answer: Patient had a full meal 2 hours before surgery

A full meal within 2 hours of surgery violates NPO guidelines (8 hours for solids) and places the patient at high risk for aspiration pneumonia under anesthesia.

A patient discloses herbal supplement use including garlic, ginger, and Ginkgo biloba. The CRNFA's primary concern is which potential intraoperative complication?

Answer: Increased bleeding due to antiplatelet effects of these supplements

Garlic, ginger, and Ginkgo biloba all have antiplatelet properties that can increase intraoperative and postoperative bleeding risk.