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Flashcards in unit V exam 2 Deck (98)
1

Intraoperative period

Time enter OR until go to PACU

2

What is the main concern for periopertive nurses?

Pt safety & advocacy

3

What are the 4 fundamental purpose of physical environment of OR?

Geographic isolation
Bacteriological isolation
Centralize equipment
Centralized trained personnel

4

Located in separate area to restrict flow of people traffic and decrease contamination

Geographic isolation

5

What area can you wear street clothes, point of entry for pt's.

Unrestricted

6

What area is for authorized personnel must wear scrubs

Semi restricted

7

What area is the OR, scrub sink, clean core?

Restricted

8

Who are the biggest risk for contamination

People

9

Who are the biggest risk for contamination

People

10

What contains all equipment to facilitate safe & effective surgery

Centralized of equipment

11

Teamwork in an isolated, restricted environment

Centralized of trained personnel

12

Why is fresh filtered air circulated in the OR

Infection control
Prevent accumulation of anesthetic gases

13

Why is the OR kept at low humidity and low temperature

Decreases bacterial growth

14

How many air exchanges must occur every hour in the OR

25

15

A group of people who recognize common goals & coordinate efforts to achieve them

OR team concept

16

Who is on the scrub team? Are they sterile or unsterile?

Surgeon
Assisting surgeon
Scrub nurse & technician

Sterile

17

Who is on the unscrubbed team? Are they sterile or unsterile?

Anesthesiologist
Circulating nurse
X-ray
Patho

Unsterile
Do not enter sterile field

18

Who administers agents during surgery, monitors cardiac/respiratory function

Anesthesiologist

19

Who sets up sterile field, assists with preparation of room count sponges, needles & instruments. Are they sterile or unsterile?

Scrub nurse
Sterile

20

Who coordinates, oversees & participates in care, counts sponges, needles, instruments. Pt advocacy & safety. Are they sterile or non sterile?

Circulating nurse
Non sterile

21

When is TIME OUT done

Done before anesthesia, skin incision, pt leaves the OR

22

When is TIME OUT done

Done before anesthesia, skin incision, pt leaves the OR

23

Is time out required on all surgeries?

Yes

24

Who is involved in a time out?

Involves the entire OR team

25

What does the time out do?

Finial verification of pt, procedure, site

26

What is the primary concern in positioning pt

Safety

27

What is the criteria for positioning?

exposure of surgical site, avoids body injury

28

Name the 3 basic positions used in the OR

supine, prone, lateral

29

What are some devices that may be used to maintain corrct position and prevent injury

arm boards, belts, sand bags etc.

30

What is the main reason for safety in the OR

create, maintain & control an optimally therapeutc enviorment in the OR

31

Who does all the documentation in the OR

Circulating Nurse

32

All specimens and cultures must have?

name, date, time, initial of RN

33

What is the biggest risk in the OR

infection

34

What is the name of the grounding pad to prevent electrial shock and burns

Electrocautery

35

Endogenous

contamination from within the PT (skin, hair, blood, respiratory, GI, GU)

36

Exogenous

contamination from outside the pt
(ppl, enviorment)

37

essence of aseptic technique consists of eliminating all modes and sources of contamination to the extent that is possible

aseptic technique

38

name some sources of contamination

scrub team skin, pt skin, pts circulating blood, linens

39

name some modes of contamination

direct contact, indirect contact, circulating air, brak in sterile field

40

what is the center of the sterile field

the incision on the pt

41

how far does sterile equipment and non sterile equipment have to be from each other

at least one foot

42

if a sterile item touches non sterile it becomes?

sterile

43

only sterile can touch

sterile

44

what is work to maintain aseptic technique in the OR

surgical attire
sterile gown, mask, hat, gloves shoe covers

45

what determines the effectivenessin the surgical hand scrub

the length of time (at least 5 minutes)
fingers, hands, arms to elbows

46

what kind of bacteria is limited to exposed skin and easily removed by mechanical cleansing

transient bacteria

47

what kind of bacteria inhabits deep structures of dermis, sweat glands and hair follicles

resident bacterial

48

when should a pt be shaved for the OR

immediatley prior to surgery
time between pre op shave and surgery has direct effect on would infection rates
done by circulating nurse

49

what is the sterile area of the scrub team

gown front from chest to table level and sheeves to 2 inches above the elbow

50

if a sterile field is left unattended is it sterile

NO

51

what antimicrobial agents disinfect skin

cholor-prep (blue)

52

what kind of drapes are applied directly to the skin, used in orthopedic procedures to decrease splattering and trasmissions of organisms

plastic incisional drapes

53

how can the surgical specimens be sent to pathology

fresh, in saline or in a preservation solution, can also be frozen

54

what does hemostatsis do

control bleeding to prevent hemorrhage, allow visulization of surgical field, and promote wound healing

55

hemostasis

stop bleeding

56

how much blood do you have in your body

5 liter

57

what are the two ways we stop blood loss

natural (thrombin, fibrin, platelets)
artificial (head, pressure, bonewax, tourniquets)

58

wounds involvinga break in skin or mucous membranes

open wound (external)

59

wound involving no break in skin integrity

closed wound (internal)

60

what is the cause for a wound resulting from therapy

intentional wound

61

what is the cause for a wound that occurs unexpectedly

unintential wound

62

what kind of wound involves only epidermal layer of skin

superficial wound

63

what kind of wound involving break in epidermal skin layer as well as dermis and deeper tissues or organs

penetrating wound

64

what kind of penetrating wound in which foreign object enters and exits an internal organ

perforating wound

65

what is the degree of contamination of a closed surgical wound that did not enter the gastrointestinal, respiratory, or GU tract

clean wounds

66

what is the degree of contamination of a wound entering gastrointestinal, respiratory, or GU tract

clean/contaminated wounds

67

what is the degree of contamination of a open, traumatic wound; surgical wound with break in asepsis

contaminated wounds

68

what is the degree of contamination of a wound site with pathogens present. signs of infection

infected wounds

69

name the types of incision closures

sutures, staples, retension sutures, steri strips, incision glue

70

what type of staples must be removed before healing is complete

non absorbable

71

what type of incision closure are large rubber encased wire sutures

retention sutures (secondary sutures)

72

how long do absorbable sutures take to disappear

7-10 days

73

what protects from microorganisms, aides hemotasis and promotes healing

surgical dressing

74

Who ID's the pt (name & DOB)

Circulating nurse

75

The surgical dressing is made up of how many layers

3

76

Name the three layers of the surgical dressing

Contact or primary dressing
Absorbent layer
Outer layer

77

What do drains do

Provide exit for serum, blood & bloody secretions, unexpected bile, intestinal or vascular leaks

78

Low pressure, used when large amount drainage (ortho)
Self suction drain

Hemovac

79

Gentle pressure, small collapsible bulb

JP or Blake drain

80

No suction, open drainage

Penrose

81

Placed in common bile duct for bile drainage

T-tube

82

Allows healing from base of wound

Gauze wick (iodoform)

83

Negative pressure allow lung expansion

Chest tube

84

General anesthesia

Total loss of all sensation & consciousness and protective reflexes

85

Disadvantages of general anesthesia

Vital function depression
Fears & anxiety
Long term effects
Risk of death

86

Advantages of general anesthesia

Vital functions regulated
Adjustable to surgery
Age
Physical status

87

What stage is operative anesthesia done at

3

88

Regional anesthesia

Not unconscious
Interruption of nerve impulses to a specific area of body

89

Minimal depression of consciousness, airway maintained, quick emergence

Conscious sedation

90

Name the three phased of anesthesia

Induction
Maintenance
Emergence

91

Complications of general anesthesia

OD, hypoventilation, aspiration,hypotension

92

Complications with regional anesthesia

Nerve damage, hematoma at injection site, spinal HA

93

Complications of local anesthesia

Safe with rare complications

94

Genetic reaction to general anesthesia. Increase temperature, heart rate, muscle rigidity
Genetic

Malignant hyperthermia

95

What affects can surgery have on the elderly

Blood loss
Fluid loss
Hypothermia
Pain
Issues with anesthesia

96

What kind of teaching can be done

About anesthesia
Treatment of symptoms
Explore pts fears & feelings
Advantages & disadvantages

97

Goal of PACU

Promote I eventful recovery from anesthesia & the immediate effects of surgery

98

Special clothing & footware
Separate water supply, Airflow system, Laundry & disposal systems

Bacterial isolation