Patient Positioning and Physiological Monitoring Flashcards

When using a fracture table for a hip procedure, the well-leg stirrup must be positioned to avoid pressure on which structure?

Answer: Saphenous nerve at the medial knee

The saphenous nerve runs medially near the knee and is susceptible to compression injury from the well-leg stirrup post used with fracture tables.

Bispectral Index (BIS) monitoring in the perioperative setting is used primarily to:

Answer: Assess the depth of anesthesia and reduce awareness

BIS monitoring processes the EEG signal to provide a numeric index of anesthetic depth, helping clinicians titrate agents and reduce the risk of intraoperative awareness.

A patient in the supine position develops hypotension shortly after positioning. The anesthesia provider suspects aortocaval compression. This is MOST likely in which patient population?

Answer: Pregnant patients beyond 20 weeks gestation

In pregnant patients beyond 20 weeks, the gravid uterus can compress the inferior vena cava and aorta in the supine position, causing significant hypotension.

During intraoperative neurophysiological monitoring (IONM) for a spinal procedure, a significant loss of motor evoked potentials (MEPs) is noted. The FIRST priority of the scrub nurse should be to:

Answer: Alert the surgeon and pause or modify the surgical maneuver

A significant MEP change is a signal that the spinal cord may be at risk; the scrub nurse must immediately alert the surgeon so the surgical maneuver can be paused or modified.

Compartment syndrome can occur as a complication of which surgical position when procedures are prolonged?

Answer: Lithotomy with legs elevated in stirrups

Lithotomy position with elevated legs can impair venous drainage and arterial perfusion in the lower extremities, leading to well-leg compartment syndrome in prolonged cases.

A patient's peripheral oxygen saturation (SpO2) reading is consistently 2–3% lower on the right hand compared to the left hand. The anesthesia provider is concerned about which condition?

Answer: Right subclavian artery compression or thoracic outlet issue

A persistent SpO2 discrepancy between upper extremities suggests impaired perfusion to one limb, raising concern for subclavian artery compression or thoracic outlet syndrome in that position.

Which layer of padding is recommended FIRST when protecting bony prominences from pressure injury during surgery?

Answer: Soft absorbent material (e.g., cotton batting or foam) directly against the skin

Soft, non-adhesive padding material should be applied directly against the skin first to absorb moisture and cushion the bony prominence before additional supportive layers.