Care and Patient Safety Flashcards

During a laparoscopic procedure, the screen suddenly goes blank. Which of the following is NOT a potential cause of this problem?

Answer: Incorrect settings on the FRED (Fluorescence-Enhanced Real-time Imaging Device)

Explanation: A blank screen during a laparoscopic procedure could be caused by several issues such as faulty cables, insufficient gas supply, or a malfunctioning light panel. However, the settings on the FRED device are not typically associated with causing a blank screen.

Before exiting the abdomen at the end of a laparoscopic procedure, which of the following should be checked?

Answer: All of the above

Explanation: Ensuring all these areas are checked helps prevent complications and ensures patient safety.

All of the following are preoperative checks except:

Answer: Muscle relaxation

Explanation: Muscle relaxation is monitored and maintained during the procedure, not as a preoperative check. Preoperative checks include ensuring ancillary equipment is available, having a spare CO2 tank, and making sure all power sources are on.

What should be included in the initial consultation for laparoscopic surgery?

Answer: Possibility of conversion to open surgery

Explanation: The initial consultation for laparoscopic surgery should include discussing the possibility of conversion to open surgery with the patient. This ensures informed consent and preparedness for potential complications or challenges during the procedure.

Which of the following is a relative contraindication for laparoscopic surgery?

Answer: Previous abdominal surgery

Explanation: Previous abdominal surgery is a relative contraindication for laparoscopic surgery due to potential adhesions and altered anatomy, which may increase the complexity and risk of complications during the procedure. However, it does not necessarily preclude laparoscopic surgery and may require careful consideration and planning by the surgical team.

Which of the following is NOT an absolute contraindication for laparoscopic surgery?

Answer: Bowel obstruction

Explanation: While bowel obstruction presents challenges for laparoscopic surgery, it is not an absolute contraindication. Laparoscopic techniques can often be used to diagnose and treat bowel obstructions, although careful patient selection and surgical expertise are required to minimize risks.

Which laparoscopic procedure can be performed with local anesthesia alone?

Answer: Diagnostic laparoscopy

Explanation: A diagnostic laparoscopy, which involves a visual examination of the abdominal cavity, can be performed with local anesthesia alone. It is often used to diagnose various abdominal conditions and does not typically require general anesthesia.

Why is patient positioning important in laparoscopic surgery?

Answer: All of the above

Explanation: Patient positioning is crucial in laparoscopic surgery to achieve multiple goals, including preventing deep vein thrombosis (DVTs), facilitating visualization of target anatomy, and minimizing position-related complications such as nerve injuries or pressure ulcers. All of these factors contribute to the safety and success of the surgical procedure.

When should checking for venous bleeding be performed during laparoscopic surgery?

Answer: All of the above

Explanation: Checking for venous bleeding should be performed at multiple points during laparoscopic surgery to ensure early detection and prompt management. This includes the final inspection of the abdomen, when releasing abdominal pressure, and during trocar removal. By conducting checks at these stages, surgeons can identify and address any venous bleeding to prevent complications and ensure patient safety.

What should you check before exiting the abdomen at the end of a laparoscopic procedure?

Answer: All of the above

Explanation: Before exiting the abdomen, it's important to check the operative field for any missed instruments or sponges, inspect dependent portions of the abdomen for any pooled blood or fluids, and examine the abdominal wall at each previous trocar site for any signs of bleeding or herniation. By conducting thorough checks of all these areas, surgeons can ensure that the procedure is completed safely and without complications.

Which of the following will be decreased by pneumoperitoneum during laparoscopic surgery?

Answer: Cardiac index (CI)

Explanation: Pneumoperitoneum during laparoscopic surgery can decrease cardiac index (CI) due to factors such as increased intra-abdominal pressure, reduced venous return, and altered cardiovascular dynamics. This reduction in CI can impact overall cardiac function during the procedure.