Ramos, Nicole Rosel C.

BSN-3B

Why I consider myself at operating room or delivery nurse at the future? Why yes? Why not?
For me, I didn’t see myself working in the operating room or even in the delivery room because, to be honest,
becoming a nurse was not really my first choice. When I was a child, I didn’t see myself as someone who would take
nursing because I knew from the start that it was hard and people’s lives were saved here. But when we had a pandemic,
everything changed. That’s when it came to my mind why don’t I go into nursing so that I can help other people take care
of them and save their lives. Now that I am a student nurse, I can say that one day I want to work in the ward or maybe in
the emergency department. I want to work in a ward because there is a diversity of patients encountered that will expose
me to a wide range of medical conditions, ensuring that my skills and knowledge will remain adaptable. This exposure to
different cases will help me to be challenged and stay updated with the latest advancements in healthcare and treatment
modalities. Furthermore, managing multiple patients with varying needs within a limited timeframe will enhance my ability
to make quick yet effective decisions. Another reason why I want to work in a ward is because of the exposure to various
specialties and patient demographics. Whether it’s medical-surgical, pediatric, geriatric, or other specialized wards, that
will help me gain valuable experience across different areas of nursing, which can be instrumental in shaping my career
trajectory.
Another special area in which I want to work is the emergency department. Ever since I saw someone on TV, she
said that she wants to be a nurse because every time she hears the sound of an ambulance, she always has hope that
there will be a new life that will be helped and saved. Since then, it has stuck in my mind and has not gone away. Another
reason is the exposure to a diverse and high-acuity patient population. Here, I can see patients with a wide range of
medical conditions, from minor injuries and illnesses to critical traumas and acute medical emergencies. This variety will
keep me engaged and continually learning, as each shift will bring me new challenges and opportunities to apply my skills
in a different scenario. The emergency department will also help me to think quickly, make rapid decisions, and prioritize
care based on the urgency of each situation. This will help me sharpen my critical thinking abilities and develop effective
strategies for managing complex and time-sensitive cases. For me, working in the emergency department provides a
sense of fulfillment and purpose. I am going to witness the direct impact of the interventions, often seeing patients improve
and recover due to timely and effective care. This sense of accomplishment, coupled with the ability to help save lives
during critical moments, creates a profound sense of satisfaction and meaning in my future work.
Ramos, Nicole Rosel C.
BSN-3B

Workshop Instructions:
Answer the following key questions.
1. Identify at least twenty (20) surgical instruments utilized during the procedure. Identify each one. (40 items)
• Tibial retractor – used to retract soft tissues around the knee joint during the total hip arthroplasty. This retractor
helps improve visibility and access to the hip joint, facilitating the surgeon's work during the surgery.
• Hohmann retractors - allows for accurate placement of prosthetic components, ensuring proper alignment and
functionality of the artificial hip joint. These retractors help protect surrounding structures and accommodate
anatomical variations, contributing significantly to successful outcomes in hip replacement procedures.
• Surgical scissors - enabling precise cutting of soft tissues and ligaments to access the hip joint. It helps to create
a clear surgical field, allowing surgeons to perform bone resection, remove damaged tissues, and prepare the
acetabulum and femoral canal for implantation of prosthetic components.
• Curved bone rasps - aiding surgeons in shaping and smoothing bone surfaces to prepare the acetabulum and
femur for the placement of prosthetic components. Their curved design allows for precise contouring of bone,
ensuring proper fit and stability of the implants.
• Reciprocating saw - utilized for precise and controlled bone cutting. It makes clean and controlled bone cuts
enhances surgical efficiency and ensures optimal fit and alignment of the artificial hip joint, contributing
significantly to the success of the procedure and patient outcomes.
• Metzenbaum scissors - facilitating meticulous dissection and trimming of soft tissues during surgery. Their
delicate design and sharp blades allow surgeons to achieve precise tissue handling, including the separation of
muscle layers and the removal of excess tissue, creating a clear and well-defined surgical field around the hip
joint.
• Sterile marker - ensure precise alignment and orientation during surgery, aiding in the optimal placement of
prosthetic components and achieving proper limb length and stability. The use of sterile markers enhances
surgical precision, reduces errors, and contributes to successful outcomes in hip replacement procedures.
• Allis tissue forceps - used for grasping and manipulating soft tissues. It aids in maintaining a clear surgical field,
enhancing visibility for precise bone preparation and prosthetic component placement.
• Taper wedge taper stem - allows for a secure and stable fit within the femoral canal, promoting optimal load
transfer and reducing the risk of implant loosening.
• Mayo scissors - utilized for precise cutting of tough tissues, sutures, and bandages
• Acetabular retractors - designed to provide optimal exposure and stability of the acetabulum (hip socket). It
securely holds soft tissues and muscles away from the surgical site, allowing for precise preparation of the
acetabulum for implanting the prosthetic cup.
• Mallet - employed for the controlled insertion of prosthetic components into the femur and acetabulum. Its use
ensures proper seating and alignment of implants, particularly the femoral stem and acetabular cup, contributing
to the stability and longevity of the artificial hip joint.
• Bone chisels - facilitating precise shaping and contouring of bone surfaces to prepare the femur and acetabulum
for implantation of prosthetic components. Their sharp edges and sturdy construction allow surgeons to perform
controlled bone resection and create smooth, anatomically fitting surfaces, ensuring optimal alignment and
stability of the artificial hip joint.
• Suction - utilized for maintaining a clear surgical field by removing excess fluids, blood, and debris during the
procedure. Its efficient suctioning capability aids in enhancing visibility for the surgeon, allowing for precise bone
preparation, implant placement, and soft tissue management.
 • Adson retractor - designed to retract soft tissues and provide optimal exposure of the surgical site. Its delicate
yet sturdy prongs enable surgeons to gently hold tissues aside, allowing for precise bone preparation and
implantation of prosthetic components in the acetabulum and femur.
• Needle holder - employed for suturing and securing soft tissues and incisions during surgery. Their precision grip
and robust design enable surgeons to handle needles with accuracy and control, facilitating the closure of surgical
wounds and reinforcement of tissue layers.
• Cautery -helps by assisting surgeons in achieving hemostasis and controlling bleeding during the procedure. Its
precise application of heat helps coagulate blood vessels, reducing the risk of excessive bleeding and providing
a clear surgical field.
• Suture scissors - utilized for cutting and removing sutures during wound closure. Their sharp and fine-tipped
blades enable surgeons to perform precise and clean incisions, facilitating the secure closure of surgical wounds
and ensuring optimal healing.
• Femoral trial head - to assess the fit, stability, and range of motion of the hip joint before final implantation of the
prosthetic femoral head.
• Sterile drapes - helps prevent contamination and infection during surgery. They cover the patient's body and
create a sterile field around the surgical site, reducing the risk of introducing harmful microorganisms.
• Self-retaining retractor system - designed to maintain consistent and reliable retraction of soft tissues
throughout the surgical procedure.

2. Identify at least five (5) nursing considerations during pre-operative phase, intraoperative phase, and post-
operative phase with rationale.
Pre-operative phase
Nursing Considerations Rationales
1. Conduct a thorough assessment of the patient’s overall 1. This helps in identifying any potential risks or
health status, including medical history, allergies, current contraindications for surgery.
medications, vital signs, and physical examination.
2. Educate the patient about procedure, expected 2. This empowers the patient to actively participate in their
outcomes, potential complications, and post-operative case and promotes better adherence to pre-operative
care. instructions.
3. Evaluate the patient’s nutritional status to ensure they 3. Malnutrition can lead to delayed wound healing and
are well-nourished before surgery. increased risk of infections.
4. Review the patient’s medication. 4. To ensure appropriate adjustments are made before
surgery, such as discontinuing medications that increase
bleeding risk and optimizing pain management strategies.
5. Implement infection control measures. 5. To reduce the risk of surgical site infections.
6. Assess the patient’s baseline mobility and functional 6. To develop an individualized rehabilitation plan post-
status. surgery and it includes pre-operative exercises to improve
muscle strength and joint mobility.
7. Instruct the patient to shower with an antiseptic soap the 7. To reduce the risk of surgical site and maintaining good
night before or on the morning of surgery. skin hygiene and avoiding skin trauma or irritation before
surgery.
 Intraoperative phase
Nursing Considerations Rationales
1. Assist in positioning the patient correctly on the 1. To ensure optimal surgical access and minimize the risk
operating table. of nerve damage, pressure injuries, or joint dislocation
during surgery.
2. Ensure proper surgical site preparation by adhering to 2. This helps reduce the risk of surgical site infections.
aseptic technique, including skin sterilization, draping, and
maintaining a sterile field.
3. Continuous monitoring of vital signs. 3. It allows early detection of any physiological changes
or complications, enabling prompt intervention and
preventing adverse outcomes.
4. Familiarize with the surgical instruments and equipment 4. To facilitate efficient instrument handling, anticipate the
required. surgeon’s need, and maintain a smooth workflow in the
operating room.
5. Maintain open and effective communication with the 5. To coordinate patient care, anticipate potential
surgical team. challenges, and respond promptly to any intraoperative
concerns.
6. Assist the anesthesia team in administering anesthesia 6. To monitor the patient’s response to anesthesia and
and ensuring the patient’s comfort and safety during assist with airway management as needed.
surgery.
7. Implement blood conservation strategies. 7. To minimize blood loss and reduce the need for
allogeneic blood transfusions.
8. Adhere safety protocols. 8. To prevent wrong-site surgery and other preventable
errors.
 Post-operative phase
Nursing Considerations Rationales
1. Monitor and manage post-operative pain effectively and 1. Adequate pain control promotes early mobilization and
patient education on pain management techniques. improves patient comfort.
2. Continuously monitor vital signs. 2. To detect any signs of post-operative complications
such as infection, hypotension, or respiratory distress.
3. Perform regular neurovascular assessments. 3. To monitor for signs of neurovascular compromise or
deep vein thrombosis.
4. Monitor the surgical incision site for signs of infection, 4. Timely detection and management of wound
hematoma, or dehiscence. Follow the prescribed wound complications reduce the risk of infection and promote
care protocol, including dressing changes and skin optimal wound healing.
assessment.
5. Initiate early mobilization and rehabilitation exercises 5. To promote joint range of motion, muscle strength, and
under the guidance of physical therapists. functional independence.
6. Monitor the patient’s nutritional status and provide 6. To promote healing and prevent malnutrition-related
appropriate nutritional support. complications.
7. Administer medications as prescribed and educate 7. Optimal medication management prevents
patients about medication adherence, potential side complications, manages symptoms, and supports
effects, and the importance of follow-up. recovery postoperatively.
8. Provide emotional support, education, and counseling 8. Psychosocial support enhances patient coping
to patients and their families regarding the surgical mechanisms, improves adherence to treatment plans, and
procedure, recovery process, and expectations. promotes overall well-being during the recovery phase.
9. Educate patients about postoperative care instructions, 9. Patient education empowers individuals to actively
activity restrictions, signs of complications, and the participate in their recovery, promotes adherence to
importance of follow-up appointments. Provide written treatment plans, and reduces the risk of readmissions or
materials and resources for ongoing self-care and complications.
rehabilitation.