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Marissa Blanca,a 48-Year-Old Woman with Degenerative Rheumatoid Arthritis,is Having a Two-Joint

Question 28

Multiple Choice

Marissa Blanca,a 48-year-old woman with degenerative rheumatoid arthritis,is having a two-joint metacarpophalangeal implant of her left hand.The pneumatic tourniquet is applied to Marissa's upper left arm and has been inflated to 280 mm Hg for 38 minutes.The surgery is advancing as planned and the surgeon is preparing to insert the second implant.Celeste,the perioperative nurse circulator,has set the time threshold for 60 minutes.During her preoperative assessment with Marissa,she noted no contraindications to pneumatic tourniquet use.While the surgery is going well and Celeste is confident that the second implant will be inserted and the wound closed before the tourniquet alarms,what risk reduction strategy would be appropriate for Celeste to employ?


A) Be prepared to increase the time threshold to 90 minutes.
B) Suggest a let-down procedure to resanguinate the limb at 60 minutes if the second implant is not yet inserted.
C) Wait until the 60-minute alarm sounds.
D) Gently remind the team when the 30-,45-,and 60-minute marks are reached.

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