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Intermediate Nursing - class notes > Chapter 31 - Intraoperative techniques book notes > Flashcards

Chapter 31 - Intraoperative techniques book notes Flashcards

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1
Q

Attention to _____ during hemostasis and suturing can lead to improved surgical ____.

A

detail, outcomes

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2
Q

_____ handles or sterile ____ covers should be placed after the patient has been draped.

A

Light, light

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3
Q

What is used to attach tubing (used for suction during surgery) to the surgical drapes?

A

Allis tissue forceps

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4
Q

What instrument is used to attach a scalpel blade onto the scalpel handle?

A

needle holder

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5
Q

Three primary grips, may be used to hold the scalpel?

A

pencil grip, fingertip grip, and palm grip

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6
Q

The scalpel blade should be passed with the blade ____ from the surgeon’s hand to prevent accidental injury.

A

away

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7
Q

What does ligate mean?

A

tie up

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8
Q

Hemostasis can be achieved through a variety of techniques; what are they?

A
  • applying pressure via gauze sponges may be sufficient for certain bleeding vessels
  • blot instead of wiping when using gauze
  • hemostats can be placed directly onto a vessel when the vessel is being removed
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9
Q

When gauze is used, it is critical to ____ rather than _____ the area of interest, because wiping removes blood clots that have been established.

A

blot, wipe

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10
Q

The ____ of hemostats should be used to clamp the vessel to prevent clamping a nontarget vessel.

A

tip

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11
Q

With vessels that are slightly larger, the use of ____ ligation, ____ clips, or ______ may be warranted.

A

ligation
vascular
electrocautery

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12
Q

When ligating a blood vessel, hold the vessel ___ from the body (using _____ or _____) to allow surgeon access the vessel with suture.

A

away
hemostats
forceps

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13
Q

Gentle ____ of the vessel is necessary to prevent ____ of the vessel or release of the vessel back into the surgical wound.

A

manipulation

tearing

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14
Q

Vascular clips can be placed with the use of a ____ applier.

A

clip

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15
Q

_____ of blood vessels via _____ is an excellent technique for controlling blood loss and decreasing surgical time.

A

Cauterization, electrocautery

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16
Q

What is electrocautery?

A

a process by which heat is conducted through a metal probe by an electrical current with the goal of destroying bleeding time.

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17
Q

Electrocauterization can be performed with ____ or ____coagulation devices.

A

monopolar or bipolar

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18
Q

What does monopolar electrocautery involve?

A

the use of a handpiece that passes a current through the target tissue (bleeding vessel) and disperses the current through the patient to a ground pad underneath the patient’s body

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19
Q

When monopolar electrocautery is used, the patient is acting as part of the ____ circuit.

A

electrical

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20
Q

Monopolar electrocautery are equipped with both ____ and _____ modes.

A

cutting

coagulation

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21
Q

For best functioning of monopolar electrocautery, a _____ surgical site is necessary.

A

dry

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22
Q

Removing ___ first allows monopolar electrocautery to work with greater efficiency.

A

blood

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23
Q

What does a bipolar electrocautery do?

A

passes a current between two tip forceps. the current is controlled by a foot switch

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24
Q

Several hemostatic agents have been designed to assist with control of intraoperative bleeding, what are they?

A 
Bone wax
Gelatin foams (Gelfoam)
Oxidized cellulose (Surgicel)
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25
Q

What is bone wax?

A

a mixture of beeswax, parraffin, isopropyl palmitate, and a wax-softening agent that can be applied to actively bleeding bone

26
Q

Bone wax functions by?

A

occluding the bleeding channel from medullary bone or from within a cut bone

27
Q

Where can gelatin foams be placed?

A

in regions of bleeding and provide a framework for the initiation of clotting

28
Q

Gelatin foams can be cut or torn into ____ that can be place more effectively into a ____ site.

A

pieces

bleeding

29
Q

Gelatin foams are ____ over time.

A

absorbed

30
Q

How is Oxidized cellulose made?

A

it is made into a sheet that can be laid on organ surfaces and cut to specific sizes. It most likely works by generating artificial clots

31
Q

The ___ of ____ scissors should be used to prevent trauma to adjacent normal tissue.

A

tips

suture

32
Q

Lavage fluids should be ____ and _____.

A

sterile

iso-osmotic

33
Q

What are some examples of lavage fluids?

A

lactated Ringer’s and normal strength saline

34
Q

Suction tubing can be attached to suction tips that have different configurations and functions, what are they?

A

Poole tip

Frazier tip

35
Q

What is a Poole tip and what does it do?

A

A large suction tip with multiple holes.

Are effective for suctioning large amounts of fluids that may accumulate in the abdominal area or thoracic cavity

36
Q

What is a Frazier tip and what does it do?

A

smaller suction tip with a single end-on hole.

May be used for more focal suctioning, such as that required during many neurosurgeries

37
Q

The liver is fairly ____ organ consisting of ___ major lobes.

A

mobile

six

38
Q

The pancreas consists of ___ and ___ limbs.

A

right and left

39
Q

The right limb of the pancreas is easily visible because of its close up association with the _____.

A

duodenum

40
Q

The left limb of the pancreas is lcoated?

A

caudal to the stomach and can be viewed by entering the omental bursa

41
Q

The spleen can vary in size even within the same animal because it can ___ and ____.

A

contract and expand

42
Q

The spleen is a?

A

highly mobile organ and can often be lifted out of the abdomen

43
Q

Surgical gloves should be ____ when abdominal organs are touched.

A

wet

because dry gloves can cause drying of the organs or tearing of the serosal layer

44
Q

It is the surgical assistant’s responsibility to not let _____-____ intestinal contents get into the abdominal cavity.

A

microbe-rich

45
Q

What are stay sutures?

A

sutures that are placed into the lumen of a hollow organ , such as the stomach or the bladder, to allow that organ to be manually manipulated.

46
Q

When stay sutures are used, the assistant is responsible for ____ the free ends of the suture together with a _____ and cutting the suture ends for removal.

A

clamping

hemostat

47
Q

Over-manipulation of the heart or lungs can result in ____ - _____ consequences.

A

life-threatening

48
Q

Large ____ (such as malleable ____) are often used in the thorax.

A

retractors

retractors

49
Q

Assistant should surround the malleable retractor with a ______ laparotomy pad to decrease the chance of _____ trauma to intrathoracic organs

A

moistened

iatrogenic

50
Q

What is iatrogenic?

A

of or relating to illness caused by medical examination or treatment.

51
Q

What are some examples of permanent implants?

A

plates, pins, wires, and screws

52
Q

______ are likely the most common temporary implant used in veterinary medicine.

A

Drains

53
Q

What are drains?

A

devices inserted into post-surgical wounds or body cavities to allow for drainage of fluid accumulations and to help eliminate dead space

54
Q

Drains are classified as?

A

passive or active

55
Q

Drains are not ____, and when present in tissue, they may stimulate ____ production.

A

benign

fluid

56
Q

Passive drains are used most often to?

A

drain subcutaneous wounds

57
Q

Passive drains should never be used to drain the _____.

A

abdomen

58
Q

What is the most common passive drain?

A

Penrose - made of soft latex and in a variety of sizes

59
Q

Passive drains are ____ dependent, requiring that they be in a dependent location.

A

gravity

60
Q

Active drains use ____ pressure to suction fluid and air from a wound.

A

negative

61
Q

What is the drain of choice for abdominal drainage?

A

active drain

62
Q

Both passive and active drains need to be ____ to the skin to prevent premature removal.

A

secured

Intermediate Nursing - class notes (16 decks)

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