Intra operative, operative, and Post op

Question 1

What parts of the surgical gown are considered sterile?

Answer 1

sleeves, fon from waist level to below neck opening

Question 2

What areas of the drapes are considered sterile?

Answer 2

top surface

Question 3

what are the main goals of a surgical assistant?

Answer 3

• Maintain sterility
• Manage the instrument table
• Pre-empt the surgeons needs
• Pass instruments – handle first
• Gentle tissue handling
• Maintain haemostasis
• Keep tissues moist
• Instrument and swab count
• Manage sharps (needles and scalpels)

Question 4

When do you count sterile swabs?

Answer 4

• 1) By the personnel who wrapped the surgical pack
• 2) By a sterile person immediately before surgery begins
• 3) By a sterile person again when the surgeon
  begins the skin closure

Question 5

What are the aims for post operative nursing?

Answer 5

• Successful recovery from anaesthetic
• Successful recovery from surgery
• Successful return home
• Uncomplicated, comfortable, stress-free and speedy return to normal

Question 6

What should be done before the patient leaves the operating table?

Answer 6

• Clean cage
• Soft/warm bedding
• Pre-warmed bedding
• Drip stands
• Medications

Question 7

What are some key task in post op nursing?

Answer 7

• Prepare the receiving cage
• Transport patient to receiving cage
• Extubation
• Adequate oxygenation
• Warmth
• Fluid therapy
• Pain Relief
• Ablutions
• Exercise and physiotherapy

Question 8

How do you transport an animal post op?

Answer 8

Trolley

Question 9

If patient has undergone a spinal surgery, what should you use?

Answer 9

Stiff board

Question 10

When extubation occurs in a patients, what is the SPO2, and what are key steps to take?

Answer 10

Extubation
* Ensure patent airway clear of fluids
* Leave tube in as long as animal will tolerate it
* Cough reflex occurs first, but wait for swallow reflex
* Observe another 5-10 minutes
* SPO2 > 95%

Question 11

how often should temp be taken?

Answer 11

every 30 minutes
mintor 2-4 hours
Maintain some warming modality for 12 hours

Question 12

What are the 4 stages after post op?

Answer 12

patient transport
pain relief
extubation
temp control

Question 13

How do you open gear in a sterile manner

Answer 13

• Open outer layer
• Usually a paper or plastic cover
• This layer forms a barrier between work
  surface and inner sterile wrapper
• Open the inner sterile wrapper
• Using one hand lift the distal flap up and away
  from package

Open the wrapper so hand does not pass over inside of sterile layer
* Use the inside of inner wrapper as sterile field
* The object that was wrapped is now located inside a sterile field
* Removed from the sterile field using sterile technique
* Edges of wrappers are not considered sterile

Question 14

How do you maintain sterile field

Answer 14

Only persons who are sterile should touch sterile items
All supplies for the sterile team members are provided by the circulator
* Unsterile persons protect sterility of items through use of wrappers on
sterile package

Sterile personnel should avoid reaching over an unsterile field

Question 15

How can you be a good assistant?

Answer 15

maintain homeostasis - Haemostats/other clamps, cautery, swabs(pressure), ligatures

Keep tissue moist by using warm sterile saline, lavage and suction, syringe or laparotmy sponges and keep drapes dry

blot with wet swabs
Be ready to give suture material to surgeon
Be ready to cut suture material for surgeon
Move retractors and hands as needed to provide best view for surgeon
adjust the light source
hold instruments correctly
pass instruments handle first

needle/instrument counting

counting sterile swabs 3x times

steady hands
cut with sissor tips

avoid bumping/leaning on the patient