Ornaments should be removed prior to surgery to prevent?

AIIMS Delhi NO - 2018

Medical Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO - 2018

Explanation

The primary reason for removing ornaments is to prevent patient injury, which is the most immediate and severe risk in the operating room.
Metal jewelry can conduct electricity from electrosurgical units (cautery), acting as an exit point for the current and causing deep, severe burns.
Rings pose a significant risk of constricting blood flow to a finger if swelling (edema) occurs during or after surgery, potentially leading to tissue necrosis.
Ornaments can also cause pressure injuries or skin tears if they get caught or pressed against the body during patient positioning.

Option B: While jewelry can harbor microorganisms and increase the risk of surgical site infection, this is considered a secondary concern compared to the immediate and severe danger of physical injury from burns or constriction.
Option C: Preventing the loss of a patient's valuable items is an important administrative and legal responsibility, but it is not a clinical or medical reason. Patient safety always takes priority over property protection.
Option D: Similar to the risk of loss, preventing damage to a patient's property is a matter of good practice and liability avoidance, not a primary patient safety concern. The clinical team's focus is on preventing harm to the patient's body.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Preoperative patient safety protocols as background academic context rather than a clinical decision trigger.
The nurse's role is to educate the patient on why jewelry must be removed, ensure all items are taken off, and document their removal and safe storage according to hospital policy.
This is a key component of the preoperative safety checklist and a 'never event' prevention strategy.
What if? A patient refuses to remove a wedding ring for religious or sentimental reasons. The nurse must inform the surgeon and anesthesia provider immediately. If hospital policy allows, the ring may be secured to the finger with non-conductive tape, and this deviation from standard protocol must be clearly documented. The team must be aware of the increased burn risk if cautery is used near that extremity.

How to Approach the Question

First, identify the core subject of the question: preoperative safety measures.
Analyze the options provided: injury, infection, loss, and damage.
Prioritize the options based on the principles of patient care. Clinical safety (preventing harm to the patient) always takes precedence over administrative or logistical concerns (protecting property).
This eliminates 'loss' and 'damage' as the primary reason.
Compare the remaining clinical risks: 'injury' and 'infection'.
Evaluate the immediacy and severity of each risk. Burns from electrocautery or circulatory compromise from a constricting ring are acute, immediate, and potentially severe injuries. While infection is a serious risk, it is typically a postoperative complication, whereas the risk of injury is intraoperative.

Concept Tested & Keywords

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