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Examination VIDEO-ASSISTED THORACOSCOPIC RELLASES OF SCOLlOTlC ANTERIOR SPINES
1.Congenital scoliosis is the most common form of scoliosis in the United States and occurs at or near the onset of puberty. a. true b. false
7.Benefits of video-assisted thoracoscopic surgery (VATS) approaches versus open thoracotomy incisions for anterior spine releases during scoliosis surgery include 1. reduced surgical time and postoperative pain. 2. longer intensive care unit (ICU) stays but shorter hospital stays. 3. decreased blood loss and less tissue damage. 4. improved postoperative respiratory functions. a. 2 a n d 3 b. 1,3, and4 c. 1,2, and 3 d. all of the above
2.Treatments for scoliosis are based on the a. growth progress in adolescents. b. skeletal maturity of patients. c. degree and probable progression of spinal deformities. d. degree of chronic back pain experienced. 3.Physicians prescribe the use of body braces because they expect braces to correct curvatures that exist at the time of diagnosis. a. true b. false
8.Possible complications from VATS procedures include all of the following, except a. spinal cord and lymphatic injuries. b. dural tears and cerebral spinal fluid leaks. c. bleeding and lung tissue trauma. d. postoperative shoulder pain from retained carbon dioxide used during insufflation phase.
4.Anterior thoracic spine releases in conjunction with posterior spinal fusions are advocated for surgical patients who have 1. significant growth still remaining. 2. spinal deformities greater than 75 degrees. 3. skeletally immature scoliotic spines. 4. spinal deformities less than 20 degrees. a. 2 and 3 b. 1 and4 c. 1,3, and4 d. all of the above 5.Progressive spinal curvatures in patients with scoliosis can lead to all of the following, except a. psychosocial impairment. b. cardiopulmonary compromise. c. chronic back pain. d. enhanced respiratory function. 0.According to the article. scoliosis most commonly occurs in which region of the spine? a. lumbar b. cervical c. thoracic d. thoracolumbar
9.If a patient is scheduled for a VATS procedure for anterior release of the thoracic spine for right convex scoliosis, the circulating nurse places the patient in a a. left lateral decubitus position. b. Stryker frame. c. prone position. d. supine position. 1QThe surgeon creates the first portal for a VATS procedure along the anterior axillary line between the T2 and T4 intercostal spaces. a. true b. false 1l.According to the article, the average ICU stay for patients undergoing the VATS approach to anterior thoracic spine releases in scoliosis surgery is a. 24 hours. b. 48 hours. c. four to seven days. d. eight to 10 days. 576
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the anesthesia care provider administers a. absorbable gelatin sponges soaked in thrombin. b. lidocaine with epinephrine solution. c. corticosteroids. d. antibiotics.
12According to the article, the most important component of thoracoscopic equipment is the a. electrosurgical unit (ESU). b. suction and smoke evacuation system. c. intraoperative viewing system. d. videocassette recorder and printer. IbAccording to the article, the scrub person should prepare which of the following electrosurgical devices for use with the ESU? 1. bipolar forceps 2. laser probe 3. monopolar device 4. argon gas coagulator a. 1,2,and3 b. l a n d 3 c. 1,3, and4 d. all of the above 1 A T h e anesthesia care provider maintains the state throughout the patient in a VATS procedure to control blood loss. a. hypothermic b. hypoglycemic c. hypocarbonic d. hypotensive l&The circulating nurse ensures all of the following hemostatic agents are available for intraoperative use by the surgeon, except a. topical lidocaine cream. b. collagen hemostat. c. bupivacaine solution. d. topical thrombin. 1BAccording to the article, if somatosensory evoked potential (SSEP) monitoring reveals a spinal cord compromise during scoliosis surgery, AORN is accredited as a provider of continuing education in nursing by the American Nurses Credmtialing Center's Commision on Accreditation. AORN recognizes this activiv as continuing education for registered nurses. This recognition does not imply that AORN or the American Nurses Credentialing Center's Commission on Accreditation opproves or endorses any product included in the activiy.
17.Before thoracoscopic closure, the surgeon inserts an appropriate-sized chest tube through the most a. medial portal. b. proximal portal located between the T6 and T8 intercostal spaces. c. anterior portal. d. lateral portal. 1LSurgical unit nurses instruct patients and family members to call the scoliosis surgery coordinator immediately for 1. unexplained fevers or increases in pain. 2. persistent or recurring vomiting. 3. unusual drainage or foul odors at surgical sites. 4. failure to resume normal bowel and bladder functions within 10 days of discharge. a. 2 and 3 b. 1 and4 c. 1,2, and 3 d. all of the above 1QThe surgeon uses SSEP readings to measure the patient's neural transmissions during surgical manipulation of the spinal cord. a. true b. false =According to the article, patients who undergo scoliosis surgery are required to wear body braces for several months postoperatively. a. true b. false
AORN maintains the following provider numbers: Alabama ABNP0075, California BRN00667, Florida 27FO 177, Iowa 103. AORN is approved as a provider of continuing nursing education by the Kansas State Board of Nursing. This course offering is approved for two contact hours. The Kansas State Board of Nursing approved provider number is LTOl14-0316.
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Professional nurses ure invited to submit manuscripts for the Home Sivdy Program. Manuscripts or queries should be sent to the Editor, AORN Journal, 21 70 S Parker Rd, Suite 300, Denvec CO 8023 1-57 1 1. As with all manuscripts sent to the Journal, papers submitted for Home Study Programs should not have been previously published or submitted simultaneously to any other publication.
MARCH 1996, VOL 63, NO 3
Answer Sheet VIDEO-ASSISTED THORACOSCOPIC RELEASES OF SCOLlOTlC ANTERIOR SPINES
lease fill out the application and answer form below and the evaluation on the back of this page. Tear out the page from the Journal or make photocopies and mail to: AORN Customer Service c/o Home Study Program 2170 S Parker Rd, Suite 300 Denver, CO 8023 1-57 11
Mark only one answer per question.
Event # 96038 Session # 3337
Program offered March 1996. The deadline for this program is August 3 1, 1996.
1. Record your identification number in the appropriate section below. 2. Completely darken the space that indicates your answer to the examination starting with question one. 3. A score of 70%correct is required for credit. 4.Record the time required to complete the program.
5. Enclose fee: Members $8; Nonmembers $16.
10 AORN (ID) # Name Address City State Zip RN license # State Phone number ( ) If nonmember, please provide social security number.
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Learner Evaluation VIDEO-ASSISTLD THORACOSCOPIC R E W E S OF SCOUOTIC ANTERIOR SPINES
The following evaluation is used to determine the extent to which this Home Study Program met your leaming needs. Rate the following items on a scale of 1 to 5. OBJCcnVEs
To what extent were the following objectives of this Home Study Program achieved? (1) Discuss the diagnosis and treatment of scoliosis. (2) Describe perioperative care for patients undergoing video-assisted thoracoscopic releases of scoliotic anterior spines. (3) Discuss equipment preparations and surgical setups for video-assisted thoracoscopic releases of scoliotic anterior spines. (4) Describe perioperative nurses' roles when caring for patients undergoing video-assisted thoracoscopic releases of scoliotic anterior spines.
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(5) (5) (5) (5)
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(5) (5) (5)
(1) Did this article increase your knowledge of
(2) (3) (4) (5)
the subject matter? Was the content clear and organized? Did this article facilitate learning? Were your individual objectives met? Was the content of the article relevant to the objectives?
(1) Were they reflective of the content? ( 2 ) Were they easy to understand? (3) Did they address important points?
What other topics would you like to see addressed in a future Home Study Program? Would you be interested or do you know someone who would be interested in writing an article on this topic? Topic(s):
Author names and addresses:
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