Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Medical & Surgical Nursing
Medium
Identify the image procedure name:
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- The image shows a needle inserted into the subarachnoid space in the lumbar region of the spine, which is the correct site for spinal anesthesia.
- A syringe is being prepared to connect to the needle, indicating the injection of a substance, which in this context is an anesthetic agent.
- This procedure is performed to provide anesthesia for surgeries involving the lower abdomen, pelvis, or lower limbs.
- Spinal anesthesia is also known as a spinal block or subarachnoid block.
Why Other Options Were Wrong
- Option B: A thoracotomy is a surgical incision into the chest cavity (thorax). The image clearly shows a procedure being performed on the patient's lower back (lumbar region).
- Option C: Local anesthesia is a broad term for numbing a small, localized area. Spinal anesthesia is a specific type of regional anesthesia, which is a more precise and accurate description of the procedure shown.
- Option D: A lumbar puncture (spinal tap) uses the same needle insertion technique, but its primary purpose is diagnostic—to withdraw cerebrospinal fluid (CSF) for analysis. Spinal anesthesia's purpose is to inject anesthetic.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of invasive medical procedures, specifically regional anesthesia techniques as background academic context rather than a clinical decision trigger.
- Post-procedure nursing care is critical. The nurse must monitor the patient's vital signs, especially blood pressure, as hypotension is a common side effect of spinal anesthesia due to sympathetic blockade.
- The nurse must assess for the return of sensory and motor function in the lower extremities. This is documented as the 'level of block' recedes.
- A key complication is a post-dural puncture headache (PDPH), caused by CSF leakage. Nursing interventions include keeping the patient flat, encouraging fluid intake, and administering analgesics as ordered.
How to Approach the Question
- First, carefully analyze the image to identify the anatomical location and the equipment being used. Here, it's the lower back (lumbar spine), a needle, and a syringe.
- Observe the action being performed or implied. A syringe is being brought to the needle, suggesting an injection.
- Eliminate options that are clearly incorrect based on the anatomical location. 'Thoracotomy' involves the chest, so it can be ruled out.
- Differentiate between the remaining, more similar options. 'Local anesthesia' is too general. The choice is between 'Spinal anesthesia' and 'Lumbar puncture'.
- Consider the primary purpose implied by the action. Injecting a substance is the primary action in anesthesia. Withdrawing fluid is the primary action in a diagnostic lumbar puncture.
- Select the most specific and accurate term that describes the procedure's purpose. 'Spinal anesthesia' best fits the visual evidence of preparing to inject medication for an anesthetic effect.
Concept Tested & Keywords
- Concept Tested: Identification of invasive medical procedures, specifically regional anesthesia techniques.
- Stem keywords: image procedure, identify
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Clinical cues: Image shows a needle in the lumbar spine, a key indicator for spinal procedures.
- Clinical cues: A syringe is being attached, suggesting injection of a substance.
Question ID
QeAeG_-UcisfHKGI3DS2xS
Reference Book
E6 Anatomy Applied Ashalatha 4e p. 423-425
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 162-164
Practise the full Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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