Unit 5 - Intra Op

Question 1

Intraoperative Period

Answer 1

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

Question 2

Main concern for perioperative nurses

Answer 2

Patient Safety and Advocacy

Question 3

physical environment of OR

4 fundamental purposes

Answer 3

geographic isolation
bacteriological isolation
centralize equipment
centralize trained personnel

Question 4

geographic isolation of OR

Answer 4

restrict flow of people traffic and decrease contamination

Question 5

3 Distinct Areas of OR

Answer 5

Unrestricted
Semi-restricted
Restricted

Question 6

Unrestricted

Answer 6

street clothes-point of entry for patients

Question 7

Semi-restricted

Answer 7

Authorized personnel must wear scrubs

Question 8

Restricted

Answer 8

OR, scrub sink, clean core

Question 9

biggest risk for contamination

Answer 9

PEOPLE

Question 10

Bacteriological Isolation

Answer 10

Primary

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

Question 11

Processing rooms

Answer 11

utility rooms for clean-up, instrument prep, storage

Part of Clean Core

Question 12

Centralization of Equipment

Answer 12

contains all equipment to facilitate safe & effective surgery

clean core

Question 13

Centralization of Trained Personnel

Answer 13

teamwork in an isolated, restricted environment

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

Question 14

Scrubbed sterile team

Answer 14

enter sterile field

Question 15

Scrubbed sterile team includes

Answer 15

operating surgeon
assisting surgeons
scrub nurses and technicians

Question 16

Un-scrubbed, unsterile team:

Answer 16

Do NOT enter sterile field

anesthesiologist, circulating nurse, x-ray, patho

Question 17

Surgeon’s Responsibilities

Answer 17

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

Question 18

Surgeon assistant

Answer 18

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

Question 19

of gas exchanges per hour in OR

Answer 19

25

Question 20

Anesthesiologist/ CRNA

Answer 20

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

Question 21

Three phases of anesthesia

Answer 21

Induction
Maintenance
Emergence

Question 22

Induction

Answer 22

Administration of agent

Question 23

RNFA

Answer 23

Registered Nurse, First Assistant

Question 24

CRNA

Answer 24

Must work under supervision of anesthesiologist or surgeon

Question 25

Scrub Nurse | sterile

Answer 25

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

Question 26

Holding Area Nurse

Answer 26

ensures patient ready for surgery

Question 27

Ensures needed are available & sterile

Answer 27

Circulating Nurse

Question 28

Receives and identifies pt

Answer 28

Circulating Nurse

Question 29

Completes the intraoperative record

Answer 29

Circulating Nurse

Question 30

Counts syringes, needles, instruments with scrub nurse

Answer 30

Circulating Nurse

Question 31

Endogenous

Answer 31

from within the patient

Question 32

Exogenous

Answer 32

from outside the patient

Question 33

Essence of Aseptic Technique

Answer 33

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

Question 34

Two Types of Contamination

Answer 34

Endogenous | Exogenous

Question 35

Modes of Transmission

Answer 35

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

Question 36

Surgical hand scrub

Answer 36

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

Question 37

If sterile item touches non-sterile

Answer 37

it becomes contaminated!! | Only Sterile can touch Sterile

Question 38

Contact Contamination

Answer 38

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

Question 39

surgical conscience

Answer 39

Specific principles of aseptic technique must be followed

Question 40

Margin of safety between sterile and unsterile

Answer 40

at least 1 foot

Question 41

Supine

Answer 41

On back, face UP

Question 42

Prone

Answer 42

ON belly | Used for laminectomy, hemorrhoidectomy

Question 43

Position used for total hip, femoral, chest surgeries

Answer 43

lateral

Question 44

Lateral Kidney Position

Answer 44

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

Question 45

Lithotomy

Answer 45

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

Question 46

Hematogenous

Answer 46

contaminated from pt blood

Question 47

Jackknife

Answer 47

back and rectal procedures | high risk of skin breakdown

Question 48

Time Out

Answer 48

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

Question 49

First Stage of General Anesthesia

Answer 49

Analgesia, relaxation, sedation

Question 50

Prepare instrument table & organize equipment

Answer 50

SCRUB NURSE

Question 51

Count sponges, needles, and instruments

Answer 51

SCRUB NURSE

Question 52

preop h & p

Answer 52

Surgeon's

Question 53

OR consent form

Answer 53

Surgeon's