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Perioperative > Chapter 4 > Flashcards

Chapter 4 Flashcards

1
Q

What are the three different types of SSI’s

A

superficial incisional infections
deep incisional
organ/space

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2
Q

When are deep incisional and organ/space infections typically diagnosed

A

before discharge

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3
Q

What does aseptic practice included

A

attire
environmental sanitation, scrubbing
gowning
gloving
setup and maintenance of the sterile field
prepping and draping of the patient
protection of the sterile field until the patient’s procedure is completed.

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4
Q

What pathogens are most commonly associated wiht SSI’s

A

Staphylococcus aureus
Staphylococcus epidermidis
coagulase-negative staphylococci
Enterococcus species.

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5
Q

What are some things that increase the risk for SSI’s

A 
(surgical time)
the presence of implants
the amount of ischemic tissue present.
age
poor nutritional status,
obesity
compromised immune system
preexisting disease (especially diabetes)
preexisting infection
burns
nicotine
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6
Q

Why does smoking increase the risk for infection

A

because it reduces the amount of oxygen that reaches the tissues which delays wound healing

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7
Q

Why is obesity a risk factor for SSI’s

A

because fatty tissue isnt very vascular and avascular tissue is suseptible to infections

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8
Q

What are some exogenous risk factors for SSI’s

A 
length of surgery 
type of procedure
surgical technique 
extended hospitalization 
number of people in the OR
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9
Q

What is a colonized individual

A

one that carries the organism but isnt infected

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10
Q

What is a consideration for fingernails and the OR

A

no nail polish ever

finger nails longer than a quarter inch have higher bacterial counts

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11
Q

What is the first thing a periop nurse needs to do when “opening” a room

A

wipe down all horizontal surfaces

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12
Q

Standard precautions of spreading infection when handling blood and body fluids covers what fluids

A

blood

all body fluids, secretions and excretions except sweat

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13
Q

What are the three types of transmission based precautions

A

airborne
contact
droplet

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14
Q

What is airborne precautions

A

pathogens 5 microns or smaller

and spread by the air

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15
Q

What are some examples of pathogens that require airborrne precaution s

A

TB
rubeola
varicella

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16
Q

What is a consideration with patients that are on airborne precau and they have an elective surgery

A

postpone the surgery

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17
Q

What if someone needs surgery immediately but they are on airborne precau

A

the surgery should have as few personnel in the room as possible and the room needs to remain vacant and closed after the surgery until the rooms air has been completely exchanged

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18
Q

What are droplet precau

A

5 microns or larger
require a mask for personnel wthin 3 ft of the patient
require that the patient be positioned at least 3 ft from other patients

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19
Q

What do droplet and airborne precau pats require during transport

A

a mask

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20
Q

What are pathogen examples that req droplet precau

A

the flu

mumps

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21
Q

What do contact precau req

A

wearing gloves and gown
wearing mask when their is a risk of aerosolized organisms
cleanign and disinfecting pat equipment

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22
Q

When do Masks with face shields or protective eyewear with side shields need to be worn

A

when splashes, splattering, or aerosolization of blood and body fluids is anticipated.

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23
Q

What is the periop nurses primary responsibility

A

to maintain aseptic practice Surgical attire
•Sterilization of instruments and equipment
• Hand hygiene
• Patient skin preparation
• Creation and maintenance of a sterile field
• Environmental hygiene

24
Q

Does hair removal increase risk of infection

A

yes

25
Q

When should hair around the site be removeed and where should it be removed

A

only when it interferes with the procedure and it should be done outside of the OR and as close to the time of surgery as possible

26
Q

What needs to be assessed before removing hair

A 
it should be assessed for 
rashes
moles 
warts
any conditions
27
Q

What can be used for hair removal

A

clippers and depilatory cream

28
Q

What should never be used to remove hair

A

razors

29
Q

Why should the hair be removed outside of the OR

A

to minimize the risk of contaminating the sterile field with microORGs on the hair

30
Q

What should the pat do for surgical site cleanliness the night before or right before the surg

A

shower

31
Q

What are the most commonly used skin prep solutions

A

CHG
Alc
iodophors
all at 60-90 percent

32
Q

What are some considerations for using CHG as a skin prep

A

dont use on mucous membranes

dont use near eyes or if their is risk of hitting the inner ear cause it can damage to eyes and ears

33
Q

What are some considerations for using alc based skin preps

A

dont use near eyes or mucous membranes

34
Q

What areas should be cleaned with skin prep

A

incision site and area around it
any anticipated additional incision sites
drain insertion sites

35
Q

What is an intervention for rpeventing pooling and thus chemical burns from skin prep

A

place towels around incision site and remove the towels before draping

36
Q

What are preps that include “dirty” areas that need special cleaning and explain their process

A

• The umbilicus is cleaned with cotton-tipped applicators before the skin prep begins.
• A colostomy or stoma is covered until the surrounding area is prepped, and then it is prepped with a separate sponge.
• In a perineal prep, the vagina and/ or anus is prepped last with a separate sponge.
In a shoulder prep, the axilla is prepped last.

37
Q

What should you do for unusual wounds or incision sites when it may be difficult to know where to begin

A

use good judgment to determine the approach that will minimize contamination at the incision site.

38
Q

What should be used to clean patients eyes and where should the cleaning begin

A

use cotton balls and start from the nose and continue outward

39
Q

What should be used to prep burned or denuded skin

A

normal saline

40
Q

What temp should you try to make skin prep solutions

A

warm

41
Q

What should be included in the documentation of a skin prep

A 
assessment of the site
hair removal (if any)
skin allergies/sensitivities
the prep agent
area prepped 
name of person performing the prep 
skin condition post-op
42
Q

If hair removal is done, what should be documented

A 
the site 
mehtod
time 
location 
and person doing it
43
Q

What sites are considered unrestricted

A

break rooms
waiting rooms
pre-op areas that allow family in street clothes

44
Q

What is considered semi-restricted areas

A

pre-op admission areas
PACU
and the peripheral support areas around the surgical room

45
Q

What is considered restricted areas

A

OR

46
Q

Where should hats or hoods be worn

A

supply areas

restricted areas

47
Q

Is it okay to take your mask off and let it hang around your neck or put it in your pocket

A

never

48
Q

How should masks be removed

A

only by the strings

49
Q

Do you need to wash your hands after removing a mask

A

yes

50
Q

What is a consideration with single use PPE and the OR

A

they need to be removed before leavign

51
Q

What type of personnel should not be in a scrub role

A

resp infection

has cuts or abrasions on arms

52
Q

should sterile gloves have powder

A

no

53
Q

What is a method of doning sterile gloves by yourself

A

closed gloving

54
Q

Where is the gown package opened

A

outside of the sterile field

55
Q

What are the steps for doning a sterile gown

A

open package and remove towel without spilling water on gown (if traditional surgical hand scrubbing was done)
when drying hands, dry with a blotting circular motion from hands to elbow
when finished with that hand, use other half of the towel on the other hand
insert arms into arm holes, step back from the table and let the gown unfold itself
after doning gloves wih closed technique hand cardboard tie to circ nurse and pivot around so the tie wraps around the body then pulls the tie off of the cardboard and tie the ends together

Perioperative (4 decks)

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