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CNAMB Exam Format | CNAMB Course Contents | CNAMB Course Outline | CNAMB Exam Syllabus | CNAMB Exam Objectives

- Perioperative Patient Assessment and Diagnosis

- Informed consent or waivers

- surgical

- anesthesia

- blood

- photographs

- visitors



- Collect, analyze, and prioritize patient data

- vital signs

- pain exam

- allergies

- lab values

- other medical conditions

- medical conditions for which they would need clearance

- previous relevant surgical management

- chart review

- NPO status

- family history of anesthesia problems



- Use age and sociocultural appropriate health exam techniques to evaluate patient status

- interview

- observation

- communication barriers

- Conduct medication reconciliation

- preoperative meds

- home meds

- alternative/herbal meds

- medical marijuana

- alcohol use

- recreational drug use



- Conduct physical exam

- skin integrity

- mobility

- body piercings

- implants/foreign objects

- Antibiotic stewardship

- Pain management

- ERAS

- multi-modal

- regional blocks



- Advance directives ( DNR, AND (Allow Natural Death) processes)

- Selection criteria

- BMI

- ASA

- sleep apnea

- infectious disease

- age



- Pre-surgery risk exam

- medications

- previoussurgeries

- special needs

- comorbidities

- preop instructions



- Discharge needs

- home care

- durable medical equipment

- transportation

- care giver

- medications

- rehab

- Approved nursing diagnoses

- North American Nursing Diagnosis Administration [NANDA]

- Perioperative Nursing Data Set [PNDS]



- Preoperative Plan of Care

- Physiologic responses: Risk of infection

- Physiologic responses: Altered tissue perfusion

- Physiologic responses: Thermal regulation

- Behavioral responses



- Transcultural nursing theory

- cultural and ethnic influences

- family patterns

- spirituality and related practices

- Identify and plan for expected patient outcomes/postoperative needs

- responsible supervision

- transportation

- sleep apnea



- Community networking and institutional resources

- supplies

- equipment

- patient transfer agreements

- courierservice

- emergency services

- Conduct site preparation

- hair removal

- skin antisepsis

- Preoperative patient preparation

- IV

- removal of jewelry

- hair removal



- Intraoperative Care

- Optimize physiological responses of the patient

- Normothermia

- Infection prevention/control

- Perfusion

- Surgical procedure

- Wound healing

- Monitor and maintain patient and personnel safety

- Maintain the dignity, modesty, and privacy of the patient



- Utilize ergonomics and proper body mechanics in performing patient care.

- Chemical

- Fire

- Hazardous materials

- Radiation

- Smoke plume

- Energy generating devices

- Positioning

- Potential complications

- Patient/personnel safety

- Ergonomics/body mechanics



- Optimize patient care based on behavioral responses

- comfort

- anxiety

- pain management

- sociocultural and/or ethical issues

- Select procedure-specific protective materials and equipment

- lead aprons

- laser goggles

- smoke evacuators

- extinguishers



- Identify and control environment factors

- humidity

- noise

- temperature

- traffic

- Maintain a sterile field using aseptic technique

- Ensure the sterility of surgical products and instrumentation

- expiration date

- package integrity

- Aseptic technique

- Wound classifications



- Verify and document specimens with surgical team

- Prepare, label, and transport specimens

- Confirm, present, and prepare implants

- Prepare explants for final disposition

- Monitor and evaluate the effects of pharmacological and anesthetic agents

- Assist with anesthesia management

- induction

- airway protection

- extubation

- cricoid pressure



- Adhere to Universal Protocol

- time out

- WHO checklist

- National Patient Safety Goals (NPSGs)

- Manage patient hemodynamic needs

- fluid replacement

- Prepare, label, and administer moderate and local sedation/analgesia with appropriate monitoring

- capnography

- pulse oximeter



- Communicate patientstatus and changes to interdisciplinary healthcare providers

- Utilize effective communication for continuity of patient care

- hand-off

- debrief

- Methods and requirements for reporting to interdisciplinary healthcare providers

- critical lab values

- medical condition

- medications

- allergies

- implants/implantable devices

- read back orders



- Information technology

- software applications

- security

- HIPAA

- Barriersto communication

- patient

- family

- team

- chain of command



- Interdisciplinary services for care coordination

- nutrition

- wound care

- social work

- referrals

- transportation

- convalescent center

- physical therapy

- Evaluate patient status to facilitate transfer to the next level of care

- PACU

- home

- rehab facility

- hospital

- 23-hour observation



- Document patient care

- Provide and document post-discharge follow-up communication according to regulatory guidelines

- Assist with management of:

- airway

- pain

- hemodynamic monitoring

- Pain management

- ERAS

- multi-modal

- regional blocks



- Select appropriate methods and products for processing

cleaning

disinfecting

packaging

sterilizing

transportation

storage

- Cleaning products and techniques

- manual washing

- ultrasonic

- Packaging techniques

- crates

- peel packs

- wraps



- Transportation of equipment, instruments, and supplies

- Perform and document disinfection procedures

- high-level disinfection

- decontamination

- Handle and dispose of hazardous materials

- chemo drugs

- radioactive materials

- Handle and dispose of biohazard materials

- blood

- tissue



- Perform and document sterilization procedures including biological and chemical monitoring

- load parameters

- steam sterilization

- low- temperature sterilization

- Perform and document immediate use steam sterilization (IUSS)

- Quality assurance testing

- washer-disinfector

- sterilizer

- Perform nursing interventions based on age-specific needs

- Coordinate members of the interdisciplinary healthcare team during internal/external emergency situations



- Preparation for and management of medical emergencies:

- Malignant Hyperthermia (MH)

- Preparation for and management of medical emergencies:

- Anaphylaxis

- Cardiac arrest

- Hemorrhage

- Roles ofthe interdisciplinary healthcare team during internal/external emergency situations

- triage

- FEMA

- EMS

- community resources



- Preparations for and management of environmental hazards and natural disasters

- fire

- toxic fumes

- natural disasters

- terrorism

- power outage

- active shooter



- Acquire equipment, supplies, and personnel

- Coordinate and document preventive maintenance of equipment

- Monitor availability and sterility of supplies

- Perioperative resource management

- equipment

- supplies

- staffing

- Supervise, educate, and mentor healthcare team members

- Delegate perioperative tasks to appropriate personnel within their scope of practice



- Supervise non-OR personnel

- vendors

- students

- visitors

- family

- Adjunct roles, assigned staff, and responsibilities

- medication safety

- laser safety

- employee health

- Privacy officer

- Facility officer

- Risk manager

- infection prevention



- Role of non-perioperative personnel

- vendor

- students

- visitors

- family

- medical records

- admissions

- Scope of practice for the interdisciplinary team per regulatory agencies: Nurse Practice Act

- Monitor and assist with implementation of cost-containment measures

- Implement environmental sustainability practices

- reprocessing

- recycling

- Waste management

- reprocessing to include single-use devices

- supply standardization



- Ensure use of Personal Protective Equipment (PPE)

- Oversee environmental cleaning

- spills

- room turnover

- terminal cleaning

- physical plant

- Track biological implants

- order

- reconstitute

- storage

- use/waste

- Radiation safety

- dosimetry badges

- time

- distance

- shielding

- lead protection



- Protect patient confidentiality

- Advocate for and protect patients rights

- Report unanticipated events and good catches

- Perform functions within scope of practice

- Comply with regulatory and accreditation guidelines

- life safety

- Local

- state

- federal regulatory requirements

- FDA

- CDC

- CMS

- OSHA

- DEA



- Demonstrate competency in perioperative nursing practice

- Acknowledge personal bias and limitations and seek assistance as needed

- Utilize standards and recommended practices

- AORN

- APIC

- AAMI

- IAHCSSM

- ASPAN

- Demonstrate evidence-based practice

- hand hygiene

- safe injection practices

- surgical attire



- Accreditation standards and organization guidelines

- AORN Guidelines for Perioperative Nursing

- Perioperative

- Explications for the ANA Code of Ethics for:

- Nurses

- ASPAN

- APIC

- AAMI

- EBP

- Hand hygiene

- Safe injection practices

- Surgical attire



- Identify and take appropriate action regarding behaviors that undermine a culture ofsafety

- disruptive behavior

- Participate in professional development activities

- shared governance

- staff education

- committees

- certifications

- advanced degrees

- professional Organizations



- Risk management

- eventreporting

- good catch

- disclosure of unanticipated events

- recalls

- Safe Medical Device Act

- Quality improvement processes

- research

- data collection

- evidence-based practice

- performance improvement

- CMS quality measure

- reimbursements

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