1-21-2016 Reading Material

Question 1

Define asepsis.

Answer 1

the absence of pathogenic organisms that cause infection

Question 2

Define surgical conscience.

Answer 2

the commitment of the surgical personnel to adhere strictly to aseptic technique and report and address/correct any break in aseptic technique

Question 3

How is asepsis maintained in the surgical area?

Answer 3

by practicing aseptic and sterile techniques

Question 4

What portion of the gown is considered to be the sterile field?

Answer 4

the scrubbed personnel’s gowns from the chest to the level of the sterile field, the sleeves two inches above the elbow to the top of the edge of the cuff

Question 5

What portion of the gown is not considered to be part of the sterile field?

Answer 5

the neckline, shoulders, and cuffed portion of the gown sleeves, the back of the gown, the cuffs of the gown

Question 6

Define strike through.

Answer 6

occurs when liquids soak through a drape from a sterile area to an unsterile area and vice versa

Question 7

How should a sterile field be monitored?

Answer 7

a sterile field should be monitored continuously and never left unattended

Question 8

How are sterile supplies opened?

Answer 8

unwrapping the flap farthest away first, the sides next and the nearest flap last

Question 9

How should sterile supplies be inspected for sterility?

Answer 9

make sure there are no tears or holes in the outer package and that the items ave gone though the proper sterilization by checking the sterile indicators

Question 10

What are the duties of the circulating nurse?

Answer 10

open packs, runner for the surgical team

Question 11

Why should surgical attire not be worn outside of the surgery area?

Answer 11

microorganisms could be transferred to the scrub suit

Question 12

Why should head covers be worn in the surgical area?

Answer 12

to prevent bacteria, dandruff, and 0ther contaminants from falling onto the scrub suits or into the surgical environment

Question 13

When should a mask be worn in the surgery room?

Answer 13

when open sterile supplies or scrubbed personnel are present

Question 14

When should shoe covers be changed, if they are worn?

Answer 14

if they become torn, wet or soiled, and when personnel reenter the surgical area

Question 15

What should be done with jewelry?

Answer 15

all jewelry and watches should be removed

Question 16

How should fingernails be kept?

Answer 16

fingernails should be shorter then the end o the finger, natural and free of polish

Question 17

Define surgical hand scrub.

Answer 17

the process of removing as many microorganisms as possible from nails hands and arms by mechanical washing and chemical antisepsis before a person participates in a surgical procedure

Question 18

Can skin be made sterile?

Answer 18

no

Question 19

What does the scrub procedure consist of?

Answer 19

mechanical removal of bacteria and debris and chemical antimicrobial/antiseptic skin cleansing agents

Question 20

What characteristics are desirable for a surgical scrub product?

Answer 20

FDA compliant, broad spectrum of activity, fast acting and effective, non irritating, and with persistent effects and cumulative activity

Question 21

What should the technician do in preparation for scrubbing?

Answer 21

remove all rings, watches and jewelry, remove all pens, nametags and other items from scrub top pockets

Question 22

When preforming a surgical hand scrub, how many times should each surface of the hand and skin be scrubbed?

Answer 22

ten times

Question 23

Describe the surgical hand scrub process.

Answer 23

• wash the hands and arms within 2 inches of the elbow using antimicrobial scrub
• apply antimicrobial scrub to wet hands and forearms
• brush each surface of the first hand ten times moving from fingertips -> 3 sides of fingers -> palm of hand -> back of hand -> four sides of arm
• follow same process on second arm
• rinse beginning at the fingertips keeping the hands above the elbows
• repeat until manufacturer contact time requirements are met

Question 24

What needs to take place after the surgical hand scrub?

Answer 24

hands and arms need to be thoroughly dried with a sterile towel

Question 25

How should gowns and gloves be opened?

Answer 25

on a dry flat surface away from other sterile supplies so that dripping water will not contaminate them

Question 26

How should the hands be dried using the sterile towel?

Answer 26

use one end of the towel to gently rub the fingers hands and arms in that order of the first hand, rubbing circumferential beginning at the wrist and moving to the elbow, then follow the same process with the other end of the towel on the other arm

Question 27

What should you do with the towel after drying your hands?

Answer 27

drop it on the floor without allowing your hands to drop below waist level

Question 28

How should the gown be put on?

Answer 28

lift the folded gown out of the package, hold the gown by the neckline and allow it to unfold, slide both arms into the sleeves by reaching and extending both arms at the same time, the circulating nurse will assist in fastening and tying the gown

Question 29

Where should the hands be during the gowning process?

Answer 29

inside the sleeves, the arms being held above the waist

Question 30

What are the three methods of gloving?

Answer 30

closed gloving, open gloving, and assisted gloving

Question 31

What is the advantage of the closed gloving technique?

Answer 31

closed gloving provides assurance against contamination because no skin is exposed in the process

Question 32

Describe the closed gloving technique.

Answer 32

with the left hand pick up the right glove by the folded cuff

extend the right hand still within the cuff with the palm facing upward

place the palm of the glove palm down against the palm of the hand with the thumb and fingers of the glove facing the body

through the gown cuff grasp the back of the glove cuff with the right hand

with the left hand pull and lift the cuff up and over the gown cuff and the right hand

with the left hand grasp both the top of the right cuff and the gown cuff and pul toward the elbow while pushing the hand through the gown cuff and into the glove

glove the left hand using the same technique

Question 33

When is the open gloving method used?

Answer 33

when one glove becomes contaminated in surgery and an assistant is not available to perform assisted surgical gloving

Question 34

Define assisted gloving.

Answer 34

when a sterile team member helps another scrubbed in team member glove

Question 35

What happens if gown becomes contaminated during surgery?

Answer 35

it must be removed

Question 36

What are the duties of the surgical nurse?

Answer 36

maintaining sterility and assisting the surgeon

Question 37

What are the duties of the surgical assistant?

Answer 37

accepting sterile packs and equipment from the circulating nurse, properly passing instruments to the surgeon, maintaining the instrument table, and insuring the working order of instrumentation throughout the procedure

Question 38

What tool is used to load a scalpel blade onto a scalpel handle?

Answer 38

a needle driver

Question 39

How are ring handled instruments passed to the surgeon?

Answer 39

they are held with the box lock between the thumb and index finger and the shaft of the instrument stabilized by the remaining fingers of the passing hand

Question 40

How should instruments without ring handles be passed to the surgeon?

Answer 40

similar to the ring handled instrument technique but with the tips facing the floor

Question 41

What is one of the most important guidelines of surgical assisting?

Answer 41

moist tissue is happy tissue

Question 42

Why is it important to avoid wiping or rubbing gauze sponges directly on tissue?

Answer 42

it irritates the tissue and promotes the formation of adhesions

Question 43

Why should bleeding tissue be blotted rather then wiped?

Answer 43

wiping may wipe away blood that has already clotted

Question 44

What is the purpose of the instrument count?

Answer 44

to document how many instruments are present at the outset of a procedure

Question 45

What is the purpose of the sponge count?

Answer 45

to document the initial quantity of sponges before any have been used

Question 46

What must be performed at the end of each surgical procedure?

Answer 46

a second instrument count and a second sponge count

Question 47

If an instrument or sponge is missing, must what be done?

Answer 47

it must be found

Question 48

If a sponge cannot be found inside or outside of the patient, what must be done?

Answer 48

the incident must be documented in the patient’s medical record

Question 49

What are the foundation principals regarding draping?

Answer 49

the edges where hands hold drapes should be folded over to protect sterile gloves from being contaminated by the patient’s skin or hair, a sterile person must never reach across a nonsterile field, personnel placing drapes must be careful not to contaminate gown sleeves or the front of the gown

Question 50

What order should the ground towels be placed?

Answer 50

closest to the person draping, the opposite side (after walking to the other side of the table), then the cranial drape

Question 51

Which side of the drape faces the patient?

Answer 51

the light side

Question 52

How are the drapes secured?

Answer 52

with nonpenetrating towel clamps

Question 53

When may a surgical assistant be involved with drug administration?

Answer 53

if the drug in question must be applied directly to the surgical site

Question 54

What are four responsibilities of the surgical assistant concerning sutures?

Answer 54

loading the needle holder, cutting the sutures once the veterinarian has completed placement, running the suture when the surgeon is placing a continuous pattern, recognizing suture patterns