Intra-Op

Question 1

Intraoperative period

Answer 1

time enter the OR until you go to the PACU

Question 2

Main concerns of perioperative nurses

Answer 2

patient safety and advocacy

Question 3

4 fundamental purposes of physical environment of operating room

Answer 3

geographic isolation
bacteriological isolation (infection control, priority)
centralize equipment (all equip ready to go)
centralize trained personnel

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

Question 4

3 distinct areas:

Answer 4

unrestricted, semi-restricted, restricted

Question 5

unrestricted area

Answer 5

street clothes, point of entry for patients

Question 6

Semi-restricted

Answer 6

authorized personnel must wear scrubs

Question 7

Restricted area

Answer 7

OR, scrub sink, clean core

Question 8

Bacteriological isolation

Answer 8

special clothing & footwear

separate water supply, airflow system, laundry, and disposal systems

Question 9

Biggest risk for contamination

Answer 9

PEOPLE

Question 10

Centralization of equipment

Answer 10

contains all equipment to facilitate safe and effective surgery

Question 11

Centralization if trained personnel

Answer 11

teamwork in an isolated, restricted environment

Question 12

Operating room

Answer 12

4 designs
interior walls, ceiling, floors = smooth, nonporous surface (no windows, waterproof, soundproof, fire resistant)
doors: double or sliding to decrease air currents
fresh filtered air for infection control and to prevent accumulation of anesthetic gases (~25 air exchanges per hour)
low humidity (30-60%) and temp (68-75)

Question 13

4 basic designs of OR

Answer 13

central corridor or “hotel plan”
double central corridor/clean core plan
peripheral corridor/ racetrack plan
grouping or cluster

Question 14

processing rooms

Answer 14

utility rooms for clean-up, instrument prep, storage, communication system

Question 15

OR team concept

Answer 15

• a group of people who recognize common goals & coordinate efforts to achieve them
• positive outcome for patient
• delivery of psychologically & physiologically prepared patient to surgery

Question 16

Scrubbed sterile team

Answer 16

-enter the sterile field

Operating surgeon, assisting surgeons, scrub nurses and techs

Question 17

Unscrubbed, unsterile team

Answer 17

DO NOT enter sterile field

-anesthesiologist, circulating nurse, x-ray, patho, etc

Question 18

Only sterile can touch…

Answer 18

STERILE

Question 19

Surgeon

Answer 19

(sterile, scrub team)
Responsible for: pre-op H&P, assessment/management, OR consent form, pt safety & management in OR, performing surgery, & post-op management of pt

Question 20

Surgeon assistant

Answer 20

(MD, PA, or RNFA) sterile scrub, assists surgeon during procedure.

• may perform portions of the procedure under supervision
• assist with hemostasis and suturing

Question 21

Anesthesia Care provider (non-sterile), Anesthesiologist/CRNA

Answer 21

• administer agents during surgery, monitor cardiac/resp func.
• supervise post-anesthesia recovery in PACU (for first 24 hrs post-op)
• supervise PCEA for duration of use

Question 22

Scrub nurse

Answer 22

(sterile)

• Sets up sterile field, assists with prep of room
• scrub, gown, & glove self and others
• prep instrument table & organize equip
• assist w/ draping
• pass instruments
• keep count of sponges, needles, instruments
• monitor aseptic technique

Question 23

Circulating Nurse

Answer 23

(non-sterile)

• oversees/participates in care
• check equip(available & sterile) & environmental factors
• insert foley, IV, NG, labels specimens
• monitor aseptic technique & blood loss
• count equip w/ scrub nurse
• complete intra-op record
• gives report to PACU RN

Question 24

Other surgical team members

Answer 24

holding area nurse- ensures pt ready for surgery (verifies documentation, assess pt, coordinates manages care in pre-surg holding area)
specialty nurses- trained in particular type surgery