Developers create unique surgical teaching gown

AORN Journal,  April, 2008  

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Developers have created an educational surgical gown that can be worn by medical students to give them a sense of what it feels like to be a surgical patient, according to a January 30, 2008, news release from Durham University, Durham, England. The gown has nine zippers that represent the locations where surgeons make cuts in the body for various procedures.

Made of silk, the gown feels more like human tissue and was designed to better simulate actual surgery. The gown also can be used to explain procedures to patients. The gown was developed to supplement the traditional plastic models of the human body commonly used as teaching aids.

Art and medicine meet to make the world's first "operation" gown [news release]. Durham, England: Durham University; January 30, 2008. http://www.dur.ac.uk/news /newsitem/?itemno=6115. Accessed January 31, 2008.

Examination

The Breastfeeding Surgical Patient

PURPOSE/GOAL

To educate perioperative nurses about the nursing concerns of caring for a surgical patient who is breastfeeding.

BEHAVIORAL OBJECTIVES

After reading and studying the article on the breastfeeding surgical patient, nurses will be able to

1. identify myths associated with breastfeeding,

2. describe the advantages of breastfeeding over feeding with artificial milk,

3. discuss medication concerns pertinent to the breastfeeding surgical patient and her breastfed infant, and

4. describe perioperative nursing care of the surgical patient who is breastfeeding.

QUESTIONS

1. Common myths associated with breastfeeding include that

1. breast milk can be replaced with formula feedings without ill effect on the breastfed infant.

2. breastfeeding can be resumed without difficulty after the mother has ceased breastfeeding for a considerable amount of time.

3. breast milk is one of two equally nutritive infant feedings.

4. the patient must cease breastfeeding for 24 hours to seven days after a surgical procedure.

a. 1 and 3

b. 2 and 4

c. 1, 2, and 3

d. 1, 2, 3, and 4

2. Medications that are of concern because they have the potential to transfer into breast milk and subsequently to the nursing infant include

1. anesthesia-related medications.

2. antibiotics.

3. hemostatic agents.

4. postoperative pain medications.

a. 1 and 3

b. 2 and 4

c. 1, 2, and 4

d. 1, 2, 3, and 4

3. The identified risks of feeding an infant artificial milk rather than breast milk include increased rates of acute diseases, such as

1. bacteremia.

2. diarrheal illness.

3. meningitis.

4. otitis media.

5. respiratory infections.

6. sudden infant death syndrome.

a. 1, 3, and 4

b. 2,5, and 6

c. 1, 2, 3, 4, and 5

d. 1, 2, 3, 4, 5, and 6

4. Compared to breast milk, artificial milk increases an infant's ingestion of lead, aluminum, manganese, iodine, and other heavy metals up to

a. 80 times.

b. 60 times.

c. 40 times.

d. 20 times.

5. In determining medication uses for a breastfeeding patient, pertinent considerations include the medication's

1. dosing frequency.

2. half-life.

3. lipodensity.

4. molecular weight.

5. oral bioavailability.

a. 2 and 3

b. 1, 4, and 5

c. 1, 3, 4, and 5

d. 1, 2, 3, 4, and 5

6. According to Nitsun et al, the amount of midazolam, propofol, and fentanyl excreted into milk within 24 hours of induction of anesthesia

a. clearly indicates that breastfeeding should be stopped for three to five days after surgery.

b. provides insufficient justification for interrupting breastfeeding.

c. supports the decision to wean the baby from breastfeeding before surgery is considered.

7. The preoperative nurse should encourage the patient to breastfeed or express breast milk

a. immediately before the nurse administers preoperative medications.

b. immediately before the patient is transported to the OR.

c. as soon as the patient arrives in the preoperative area.

8. The circulating nurse should prepare to express the patient's breast milk if surgery is anticipated to last longer than

a. four hours.

b. three hours.

c. two hours.

d. one hour.

9. When caring for a postoperative patient who has a breastfeeding infant, the postanesthesia care unit nurse should

1. offer the postoperative patient the opportunity to breastfeed.

2. assist the patient in using the electric breast pump to express milk, if breastfeeding is not an option.

3. discourage the patient from breastfeeding because medication transfers from the patient's blood system to breast milk.

a. 1

b. 3

c. 1 and 2

d. 1, 2, and 3

10. Medications that may result in sedation, somnolence, or respiratory depression in the breastfed infant, include

1. alfentanil.

2. diazepam.

3. lorazepam.

4. meperidine.

5. morphine.

a. 2 and 3

b. 1, 4, and 5

c. 2, 3, 4, and 5

d. 1, 2, 3, 4, and 5

The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from the author, Deborah Dumphy, RN, MSNed, IBCLC, RLC, and Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.