Unit 5 - Intra Op Flashcards Preview

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Flashcards in Unit 5 - Intra Op Deck (53):
1

Intraoperative Period

time enter OR until go to Post Anesthesia Care Unit (PACU)

2

Main concern for perioperative nurses

Patient Safety and Advocacy

3

physical environment of OR
4 fundamental purposes

geographic isolation
bacteriological isolation
centralize equipment
centralize trained personnel

4

geographic isolation of OR

**restrict flow of people traffic and decrease contamination**

5

3 Distinct Areas of OR

Unrestricted
Semi-restricted
Restricted

6

Unrestricted

street clothes-point of entry for patients

7

Semi-restricted

Authorized personnel must wear scrubs

8

Restricted

OR, scrub sink, clean core

9

**biggest risk for contamination**

PEOPLE

10

Bacteriological Isolation

Primary
special clothing & footwear, separate water supply, airflow system, laundry & disposal systems

11

Processing rooms

utility rooms for clean-up, instrument prep, storage

Part of Clean Core

12

Centralization of Equipment

contains all equipment to facilitate safe & effective surgery

clean core

13

Centralization of Trained Personnel

teamwork in an isolated, restricted environment

who recognize common goals & coordinate efforts to achieve them-->psychologically & physiological prepared pt to surgery

14

Scrubbed sterile team

enter sterile field

15

Scrubbed sterile team includes

operating surgeon
assisting surgeons
scrub nurses and technicians

16

Un-scrubbed, unsterile team:

Do NOT enter sterile field

anesthesiologist, circulating nurse, x-ray, patho

17

Surgeon's Responsibilities

preop h & p
assessment/management
OR consent form
patient safety & management in OR
performing surgical procedure
post-op management of patient

18

Surgeon assistant

(MD, PA or RNFA)
Sterile
assists surgeon during procedure

19

# of gas exchanges per hour in OR

25

20

Anesthesiologist/ CRNA

Non-sterile
Admin agents during surgery
Mont. cardiac/respiratory function -->Alert Surgeon to any problems
Post anesthesia recovery in PACU & first 24h post-op
Supervises PCEA for duration of use

21

Three phases of anesthesia

Induction
Maintenance
Emergence

22

Induction

Administration of agent

23

RNFA

Registered Nurse, First Assistant

24

CRNA

Must work under supervision of anesthesiologist or surgeon

25

Scrub Nurse
(sterile)

Establish sterile field/ assist w/ room prep
Scrub, gown, & glove self and others
Assist with draping
Pass instruments to surgeon & assistants
Monitor aseptic technique

26

Holding Area Nurse

ensures patient ready for surgery

27

Ensures needed are available & sterile

Circulating Nurse

28

Receives and identifies pt

Circulating Nurse

29

Completes the intraoperative record

Circulating Nurse

30

Counts syringes, needles, instruments with scrub nurse

Circulating Nurse

31

Endogenous

from within the patient

32

Exogenous

from outside the patient

33

Essence of Aseptic Technique

eliminating all modes and sources of contamination to the extent that is possible

34

Two Types of Contamination

Endogenous
Exogenous

35

Modes of Transmission

Contact (Direct/ Indirect)
Vehicle (Food, Water, Drugs, Blood)
Airborne
Vector (Insect, rodent, etc)

36

Surgical hand scrub

length of Time determines effectiveness
AT LEAST 5 minutes
Rinse from cleanest area to less

37

If sterile item touches non-sterile

it becomes contaminated!!
Only Sterile can touch Sterile

38

Contact Contamination

surgeon's back touching sterile basin
puncture of sterile glove
contact by circulating nurse to sterile field

39

surgical conscience

Specific principles of aseptic technique must be followed

40

Margin of safety between sterile and unsterile

at least 1 foot

41

Supine

On back, face UP

42

Prone

ON belly
Used for laminectomy, hemorrhoidectomy

43

Position used for total hip, femoral, chest surgeries

lateral

44

Lateral Kidney Position

- used fr=or nephrectomy/ nephrourectertomy
- can → eye, ear, ulner nerve damage, shoulder and neck pain, femoral head necrosis

45

Lithotomy

supine, feet in stirrup; used for vag. Hysterectomy, abdominal perineal resection, bladder procedures

46

Hematogenous

contaminated from pt blood

47

Jackknife

back and rectal procedures
high risk of skin breakdown

48

Time Out

Required on All procedures
Final verification of patient, procedure, site
Entire OR team
Correct pt, correct surgery, etc

49

First Stage of General Anesthesia

Analgesia, relaxation, sedation

50

Prepare instrument table & organize equipment

SCRUB NURSE

51

Count sponges, needles, and instruments

SCRUB NURSE

52

preop h & p

Surgeon's

53

OR consent form

Surgeon's