A nurse is assisting with a surgical procedure that requires a large number of instruments and supplies. Which of the following strategies should the nurse use to facilitate counting and prevent foreign body retention? (Select all that apply.)

Use a standardized counting method and sequence for each procedure.

Separate sponges into groups of five or ten and count them as one unit.

Keep instruments and supplies on separate trays according to their function.

Use a white board or paper to record the counts and update them as needed.

Discard any unused items before the final count.

Answer and Explanation

Correct Answer : A,B,D

Choice A reason:

Using a standardized counting method and sequence for each procedure helps to ensure consistency and accuracy in the counting process. It also reduces the risk of confusion or miscommunication among the surgical team members. This is a recommended standard of practice by the Association of Surgical Technologists (AST)

Choice B reason:

Separating sponges into groups of five or ten and counting them as one unit helps to facilitate counting and prevent foreign body retention. It also allows for easier identification of missing sponges in case of an incorrect count. This is another recommended standard of practice by the AST.

Choice C reason:

Keeping instruments and supplies on separate trays according to their function does not necessarily facilitate counting or prevent foreign body retention. It may help to organize the surgical field, but it does not address the issue of counting or documenting the items used during the procedure. Therefore, this is not a correct answer.

Choice D reason:

Using a white board or paper to record the counts and update them as needed helps to facilitate counting and prevent foreign body retention. It provides a visual reference for the surgical team members and allows for easy verification of the counts at any time during the procedure. It also helps to document any discrepancies or changes in the counts. This is another recommended standard of practice by the AST.

Choice E reason:

Discarding any unused items before the final count does not facilitate counting or prevent foreign body retention. It may actually increase the risk of losing track of the items used during the procedure or leaving some items inside the patient. Therefore, this is not a correct answer.

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Correct Answer is C

Explanation

Choice A reason:

This is incorrect because a curved needle with a cutting edge is used for general closure of skin, subcutaneous tissue, and other tissues that are tough or difficult to penetrate A cutting edge needle has a triangular point that can cause more tissue damage and scarring than a tapered point needle.

Choice B reason:

This is incorrect because a straight needle with a tapered point is used for easily accessible tissues, such as mucous membranes, gastrointestinal tract, or blood vessels A tapered point needle has a round body that gradually tapers to a point, allowing it to pierce through tissues without cutting them.

Choice C reason:

This is correct because a half-circle needle with a reverse cutting edge is used for suturing at sites that have limited space and require precise placement of stitches, such as ophthalmic, plastic, or cardiovascular surgery A reverse cutting edge needle has a triangular point with the cutting edge on the outer convex curvature of the needle, which helps prevent the suture from tearing through the tissue.

Choice D reason:

This is incorrect because an eyed needle with a blunt point is used for suturing tissues that are easy to separate, such as liver, kidney, or spleen A blunt point needle has a round body that ends in a blunt tip, which pushes aside the tissue fibers rather than cutting them An eyed needle has an eye at the end of the needle where the suture thread is inserted, which can cause more drag and tissue trauma than a swaged needle that has the suture attached to the end of the needle.

A. It allows optimal exposure of the abdominal cavity. B. It prevents injury to the spinal cord and nerves. C. It facilitates drainage of secretions from the mouth and throat. D. It enhances circulation and oxygenation to the brain.

Correct Answer is C

Explanation

Choice A reason:

This is incorrect because the supine position does not allow optimal exposure of the abdominal cavity. The supine position is used for surgeries involving the anterior surface of the body, such as cardiac, thoracic, and cranial surgeries. For abdominal surgeries, other positions such as Trendelenburg or lithotomy may be used to improve access and visualization of the abdominal organs.

Choice B reason:

This is incorrect because the supine position does not prevent injury to the spinal cord and nerves. In fact, the supine position may cause nerve damage or pressure ulcers if the patient's arms, legs, and head are not properly supported and padded. The patient's arms should be abducted less than 90 degrees and the palms should face up to avoid stretching or compressing the brachial plexus and ulnar nerves. The patient's legs should be uncrossed and the heels should be padded to prevent pressure on the peroneal nerve and the skin. The patient's head should rest on a pad or pillow and the neck should be in a neutral position to avoid injury to the cervical spine and nerves.

Choice C reason:

This is correct because the supine position facilitates drainage of secretions from the mouth and throat. The supine position is commonly used during induction and emergence of anesthesia, which can impair the patient's ability to clear their airway. By lying on their back with their face up, the patient can benefit from gravity-assisted drainage of secretions from the mouth and throat, reducing the risk of aspiration or airway obstruction.

Choice D reason:

This is incorrect because the supine position does not enhance circulation and oxygenation to the brain. The supine position may actually decrease the functional residual capacity (FRC) of the lungs, which is the amount of air remaining in the lungs after a normal expiration. This can lead to reduced oxygenation and ventilation of the blood. Additionally, the supine position may cause venous congestion in the head and neck, which can impair cerebral perfusion and increase intracranial pressure. To enhance circulation and oxygenation to the brain, other positions such as reverse Trendelenburg or sitting may be used.

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A nurse is assisting with a surgical procedure that requires a large number of instruments and supplies. Which of the following strategies should the nurse use to facilitate counting and prevent foreign body retention? (Select all that apply.)

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