A 3 page summary of a case study offered by Macapagal (2004). This case study follows a surgical patient from pre-op through recovery and focuses on the responsibilities of the circulating nurse. This case study demonstrates the need for the nurse to act as an advocate for the patient, even when it means a delay in the procedure. Bibliography lists 1 source.
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the nurse to act as an advocate for the patient, even when it means a delay in the procedure. Ms. J, as a morbidly obese patient scheduled for posterior
lumbar decompression and fusion, presented the surgical team with problems concerning positioning her optimally on the spinal surgery and imaging table (SSIT). Preliminary activities included the circulating nurse obtaining patient
consent and verifying the patients understanding of the procedure; assessing the patients laboratory results to identify abnormalities and verifying that the availability of blood products, crossed and matched, due to
the significant blood loss typically occurred in this procedure (Macapagal, 2004). The first step in the surgical procedure was for the anesthesia care provider to complete intubation and place
venous and arterial lines. Then, the circulating nurse inserted the indwelling urinary catheter and applied antiembolism stockings and a sequential compression device (Macapagal, 2004). The patient was transferred to the
SSIT with six people assisting. She was turned using the log roll method and her head was placed face down on a foam prone pillow, which protected the pressure points.
The circulating nurse and the anesthesia care provider saw to it that Ms. Js arms, shoulders, and legs were properly positioned and aligned to prevent injury, minimize pressure and facilitate
ventilation. This included placing hip pads with egg crate foam under the patients iliac crest to prevent hyperextension of the lower back (Macapagal, 2004). Other precautions were taken as well,
such as the circulating nurse placing a padded safety strap about the patients thighs. Also a suspension sling and egg crate pads were placed under Ms. Js feet to protect
pressure points (Macapagal, 2004). After the procedure began, the anesthesia care provider expressed that he was no longer happy with the patients position. The circulating nurse verified that Ms.