Perioperative Medications Cheat Sheet

When delegating tasks to a surgical technologist, the perioperative nurse must understand the legal boundaries of unlicensed assistive personnel. In this scenario, the technologist can safely accept the medication onto the sterile field and must participate in verbally verifying the drug name, strength, and expiration date with the nurse. However, injecting local anesthetics into the patient is strictly a provider function and outside the technologist's scope. Documenting the total volume in the official perioperative nursing record is a nursing responsibility, as is assessing the patient for any physiological reactions like systemic toxicity. The nurse retains accountability for the medication until it is handed to the surgeon, making verbal verification the only appropriate and legally sound action for the technologist to perform in this context.

In an emergency combined with a system failure, accurate documentation of medication administration is critical to prevent overdose or duplicate dosing. The nurse must immediately document the medication administration on the approved downtime form. Option B is highly unsafe because high-stress situations severely impair memory, making it likely the nurse will forget exact dosages or administration times before the system recovers. Option C is incorrect because a sterile drape is not a permanent or legal record, and the information will be lost when the room is turned over. Option D inappropriately shifts the documentation burden to the scrub person, who is focused on maintaining the sterile field and assisting the surgeon. Using the official downtime form ensures a permanent, accurate record is maintained for later electronic reconciliation.

The maximum safe dose of lidocaine with epinephrine is 7 mg/kg. For a 50-kg patient, the total allowable dose is 350 mg. A 1% lidocaine solution contains 10 mg per milliliter. Dividing the total dose of 350 mg by 10 mg/mL yields a maximum volume of 35 mL. Option A (25 mL) and Option B (30 mL) are under the maximum limit but do not represent the actual threshold. Option D (40 mL) would deliver 400 mg, exceeding the safe limit and increasing the risk of toxicity.