After a complete abdominal surgery. The OT nurse needs to do which of the following activities first before s… - NORCET 1 - 2020

NORCET 1 - 2020

Medical & Surgical Nursing

Easy

Appeared in: NORCET 1 - 2020

Explanation

The primary responsibility of the OT nurse before the closure of a major body cavity is to ensure patient safety by preventing retained surgical items (RSIs).
This is achieved by conducting a meticulous count of all sponges, sharps, and instruments with the surgical team.
This count is a mandatory, high-priority step that takes precedence over other tasks at this specific phase of the surgery.
An incorrect count requires immediate action, including a recount and potentially an intraoperative X-ray, before the patient is closed.

Option B: Cleaning instruments is a post-operative task performed by the central sterile supply department (CSSD) or OT staff after the surgery is completely finished and the patient has left the room.
Option C: Changing a gown is not a routine priority before suturing. It is only done if the gown's sterility is compromised (e.g., through a tear or significant contamination).
Option D: Disinfection of the OT is performed after the patient has been transferred out of the operating room, in preparation for the next case or as part of terminal cleaning.

Visual 1: Infographic: Timeline of a surgical procedure, highlighting the key checkpoints for surgical counts (pre-procedure, pre-cavity closure, pre-skin closure).
Visual 2: Diagram: Showing the roles of the scrub nurse and circulating nurse during a surgical count, emphasizing the 'look and listen' verification process.
Visual 3: Chart: Listing common types of retained surgical items and their potential complications to underscore the importance of the count.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Intraoperative nursing responsibilities and surgical safety protocols in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Preventing Retained Surgical Items (RSIs) is a major National Patient Safety Goal. A correct count is a legal and ethical nursing responsibility.
An incorrect count is considered a 'never event' and must be reported. It can have serious legal ramifications for the hospital and the surgical team.
What if the count is incorrect before closure? The surgeon must be notified immediately. The team stops all other activity to perform a recount. If the item is still missing, a search of the room, drapes, and trash is conducted. An intraoperative X-ray may be ordered to locate the missing item before the final closure is completed.

How to Approach the Question

Identify the core of the question: It asks for the first priority action at a specific time point (after the main part of an abdominal surgery, but before suturing the cavity closed).
Analyze the options based on the principles of patient safety and the logical sequence of events in an operating room.
Prioritize actions that directly prevent immediate and severe harm to the patient. Preventing an object from being left inside a patient is a top-tier safety priority.
Eliminate options that are performed at different times in the surgical workflow (e.g., post-operative cleaning, disinfection) or are situational rather than routine (e.g., changing a gown).
Recognize that 'checking counts' is a critical, non-negotiable safety stop before any major body cavity is closed.

Concept Tested & Keywords

Concept Tested: Intraoperative nursing responsibilities and surgical safety protocols.
Stem keywords: abdominal surgery, OT nurse, before suturing, first
Lead-in keywords: first

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