Tui Nyguen,a 32-year-old gravida 2 para 2,is scheduled for a hysteroscopy for heavy bleeding of 2 weeks' duration,and possible retrieval of a displaced IUD.She is tired and weak from blood loss and has marked anemia.During the vaginal prep the perioperative nurse noted several large blood clots.She communicated an estimated blood loss amount to the anesthesia provider and surgeon.After Tui was draped,the circulating nurse connected the hysteroscopic insufflator,pressure-infusion pump,and a video camera,light source,and monitor.The uterine cavity was distended with 32% dextran 70 in dextrose (Hyskon)at a continuous pressure through the hysteroscopic pump into the irrigating channel of the hysteroscope.The circulating nurse was relieved for lunch after she gave a hand-off report to her relief nurse.What patient safety information relevant to the hysteroscopy should be given to the receiving relief nurse before the circulating nurse leaves for lunch? Select all that apply.

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Hysteroscopy can be performed for evaluation of abnormal uterine bleeding (with possible endometrial ablation),location and removal of "lost" intrauterine devices (IUDs),evaluation of infertility,diagnosis and surgical treatment of intrauterine adhesions,or verification of submucous leiomyomas or endometrial polyps.A significant potential complication related to hysteroscopy is the intravasation of the fluid used to distend the uterine cavity.Intravasation can lead to hyponatremia.Signs and symptoms of hyponatremia may include bradycardia,hypertension followed by hypotension,nausea,vomiting,headache,visual disturbances,agitation,confusion,and lethargy.The perioperative nurse is responsible for accurately monitoring fluid intake and output during hysteroscopy.Discrepancies of 500 ml or more must be communicated to the surgeon and the anesthesia provider.

Tui Nyguen,a 32-Year-Old Gravida 2 Para 2,is Scheduled for a Hysteroscopy