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 intrauterine device (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.The nurse communicated an estimated blood loss amount to the anesthesia provider and surgeon.After the patient 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 Ringer's Lactate 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?

Question

Quizplus · Accepted Answer

The perioperative nurse is responsible for accurately monitoring hysteroscopy fluid intake and output during the procedure.Monitoring may be manual (i.e.,calculating the difference between inflow and outflow)or may be automatically calculated on commercially available hysteroscopy pumps,which decrease the chance of human error.If a discrepancy of 1 to 1.5 L or more occurs (less for patients who have compromising medical conditions),the surgeon and anesthesia provider are alerted,and consideration is given to terminating the procedure.At the end of the procedure,the hysteroscopy deficit should be communicated to the surgeon,anesthesia provider,and the PACU nurse during the hand-off report,and documented in the patient's perioperative record.

A 32-Year-Old Gravida 2 Para 2 Is Scheduled for a Hysteroscopy