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Hi, Here is an example OR scenario that you can work on in class.

The final exam will have something similar to this with a focus on one patient undergoing a surgery. The exam scenario will be a bit more straight forward than this example in terms of just having the patient simply go from pre-op and into the theatre (no major problems like in the example scenario below). Paul is 35-year-old male is scheduled for a right ankle arthroscopy. He arrives in the holding area about 30 minutes prior to surgery. You are the circulating nurse and perform the patient verification, including identity verification with the chart, ID band, and verbally with the patient. The procedure and site are verified verbally with Paul along with the consent form, physician orders, and history and physical examination. As you wheel Paul into the OR theatre, your charge nurse stops you to inform you that the theatre is needed for an emergency neuro case from another surgeon that must be addressed immediately, thus postponing the ankle arthroscopy. Because of the delay, the surgeon instructs his resident to talk to Paul and leaves the operating room understanding that he will be contacted when the emergency surgery is complete and the ankle arthroscopy can proceed You bring Paul back to pre-op holding and inform him that he will likely be going back to the surgical unit to wait and that the resident will talk to him before he leaves the OR. You return quickly to the OR theatre as you have to switch the instruments and help the scrub nurse set up for a change in surgical procedure. The scrub nurse is new to the OR environment and becomes flustered and nervous at having to switch cases in the middle of setting up her OR table. While you are setting up for the new case, the charge nurse enters your theatre and informs you that Paul has been waiting in pre-op holding for the last 25 min and is quite upset that he has not yet spoken to a surgeon and is not sure what is going on. Pre-OP Diagnosis
Anxiety related to anesthesia, pain, disease, surgical procedure

Assessment

Planning and Outcome -nurse gathers supplies needed for the procedure according to the surgeons preference card, positioning equipment, and any special supplies needed as determined by the nurses assessment and

Implementation

Evaluation

the patients history. -remains at the bedside during the induction phase and holds the pts hand to help reduce anxiety. -reassure pt-provides warm blankets Alteration in nutrition less than body requirements related to NPO status.

During Diagnosis
Impaired gas exchange related to anesthesia, pain, and surgical procedure

Assessment

Planning and Outcome

Implementation -pt is instructed to take deep breaths before and after anesthesia to maintain oxygen saturation above 95%.

Evaluation

Post-Op Diagnosis
Potential for infection

Assessment

Planning and Outcome

Implementation -Strict aseptic

Evaluation

related to indwelling catheter and surgical procedure

and sterile technique are maintained

Activity intolerance related to pain