After a complete abdominal surgery. The OT nurse needs to do which of the following activities first before suturing?

Appeared in: NORCET 1 - 2020

Explanation

The primary responsibility of the OT nurse before the closure of a major body cavity is to ensure all surgical items are accounted for.
This action, known as the surgical count, is a critical safety measure to prevent Retained Surgical Items (RSIs), which are considered a 'never event'.
RSIs can lead to severe complications like infection, pain, and the need for re-operation, making the count a top priority over all other listed activities.
This count is performed collaboratively by the scrub and circulating nurses and must be confirmed as correct before the surgeon proceeds with final closure.

Option B: Instrument cleaning and sterilization are essential post-operative activities performed after the surgical procedure is fully completed and the patient has left the OR.
Option C: A surgical gown is only changed intraoperatively if its sterile barrier is compromised (e.g., it is torn or significantly contaminated). It is not a routine step before wound closure.
Option D: Disinfection and cleaning of the operating theater (known as terminal cleaning) occur after the patient has been transferred out of the room to prepare for the next surgical case.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Intraoperative Nursing Safety Procedures in the correct sequence, documenting the action clearly, and monitoring for the expected response.
The surgical count is a cornerstone of perioperative patient safety, directly reflecting the nurse's role as a patient advocate in preventing a 'never event'.
Failure to perform an accurate count has significant legal and ethical implications for the nurse and the entire surgical team.
What if the surgical count is incorrect before closure? The nurse must immediately inform the surgeon. All surgical activity stops (except for essential life support) while a thorough search of the surgical field, drapes, floor, and trash is conducted. If the item remains missing, an intraoperative X-ray is typically ordered before the patient leaves the OR to rule out an RSI.

How to Approach the Question

This is a priority-setting question within a specific clinical context (intraoperative care).
First, identify the key phrase: 'first before suturing.' This establishes a precise point in the surgical timeline.
Analyze each option based on the standard workflow of an operating room.
Ask yourself: 'Which of these actions directly prevents an immediate, severe complication for the patient at this specific moment?'
Eliminate options that are performed at different times (e.g., after the surgery is completely over).
The action related to preventing a retained foreign object (a 'never event') will almost always be the highest priority before closing a body cavity.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 189-191

Practise the full NORCET 1 - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.