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► Med Misc 49 > unit V exam 2 > Flashcards

unit V exam 2 Flashcards

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1
Q

Intraoperative period

A

Time enter OR until go to PACU

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2
Q

What is the main concern for periopertive nurses?

A

Pt safety & advocacy

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3
Q

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

A

Geographic isolation
Bacteriological isolation
Centralize equipment
Centralized trained personnel

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4
Q

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

A

Geographic isolation

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5
Q

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

A

Unrestricted

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6
Q

What area is for authorized personnel must wear scrubs

A

Semi restricted

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7
Q

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

A

Restricted

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8
Q

Who are the biggest risk for contamination

A

People

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9
Q

Who are the biggest risk for contamination

A

People

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10
Q

What contains all equipment to facilitate safe & effective surgery

A

Centralized of equipment

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11
Q

Teamwork in an isolated, restricted environment

A

Centralized of trained personnel

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12
Q

Why is fresh filtered air circulated in the OR

A

Infection control

Prevent accumulation of anesthetic gases

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13
Q

Why is the OR kept at low humidity and low temperature

A

Decreases bacterial growth

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14
Q

How many air exchanges must occur every hour in the OR

A

25

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15
Q

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

A

OR team concept

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16
Q

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

A

Surgeon
Assisting surgeon
Scrub nurse & technician

Sterile

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17
Q

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

A

Anesthesiologist
Circulating nurse
X-ray
Patho

Unsterile
Do not enter sterile field

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18
Q

Who administers agents during surgery, monitors cardiac/respiratory function

A

Anesthesiologist

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19
Q

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

A

Scrub nurse

Sterile

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20
Q

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

A

Circulating nurse

Non sterile

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21
Q

When is TIME OUT done

A

Done before anesthesia, skin incision, pt leaves the OR

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22
Q

When is TIME OUT done

A

Done before anesthesia, skin incision, pt leaves the OR

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23
Q

Is time out required on all surgeries?

A

Yes

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24
Q

Who is involved in a time out?

A

Involves the entire OR team

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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

► Med Misc 49 (29 decks)

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