Surg 102--Final Flashcards
Who is responsible for the patient’s head and maintaining airway when transferring.
anesthesia care provider
When transporting pediatric patients, where can parents accompany child to?
to the holding area or in the operating suite until induction of anesthesia
True or False: Teamwork creates smooth step by step coordination.
true
_____ is placed on the patient’s legs before long procedures or on patients predisposed to clot formation.
Antiembolism stockings or sequential compression device (SCD)
During inflation of a sequential compression device the cuffs push venous blood toward the _____ and during deflation, the vessels refill.
heart
A sequential compression device reduces blood pooling (stasis) and _____.
thrombous formation
- variation of supine, table is tilted foot down
- unobstructed access to the upper peritoneal cavity and lower esophagus
- instruments must be secured by a magnetic pad or pocket holders
Reverse Trendelenburg position
In the lithotomy position, how are the legs removed from stirrups?
requires 2 people, release feet from stirrup, slowly bring the knees to the midline and gradually extend the hip and knees
- orthopedic procedures
- used for facial, cranial, or reconstructive breast surgery
Sitting (Fowler) position
- simultaneous head-down and foot-down posture
- anorectal surgery
Jackknife (Kraske) position
What is the most common type of catheter for continuous drainage?
Foley catheter
What are the two primary risks of catheterization?
infection and trauma to the genitourinary track
What is the most common cause of hospital acquired infection in the US
urinary catheterization
When normal or transient flora are introduced into the surgical wound they cause a _____.
surgical site infection (SSI)
What is the body’s primary defense against infection?
skin
Hair is not removed unless _____ requests it.
surgeon
Hair is removed as close to the time of _____ as possible
surgery
Hair is removed with a _____, electric clippers or chemical depilatory
razor
Hair should be removed in an area _____ where the surgery is performed.
away from
Hair removal for cranial procedures:
- Cranial procedures are often performed with minimal hair removal
- If its required to be removed, the hair is returned to the patient after surgery
- The surgeon usually removes the hair in this case
If you were prepping for Coronary Artery bypass and you are taking saphenous vein. How would you prep?
2 prep kits required and you would start with the saphenous vein prep first
Can’t use _____, _____, or _____ to prep ears
alcohol, iodophor, or chlorhexidine
What is the prep for radical mastectomy?
mastectomy prep boundary the includes the neck , shoulder of the affected side, and thorax to the operating table surface, and mid pelvis region
During breast and thorax prep, how should tissue suspected to be cancerous should be prepped?
prepared gently, painted with little friction and pressure as possible
When prepping abdomen what is done first?
umbilicus is prepped
What is used to hold blue towels in place when draping?
nonpentrating towel clips
What is general anesthesia?
Anesthesia associated with state of unconsciousness. It is not a fixed state of unconsciousness, but rather ranges along a continuum from semiresponsiveness to profound unresponsiveness.
What is a pulse oximeter and what does it do?
a monitoring device that measures the patients hemoglobin oxygen saturation by means of spectrometry
Removal of the artificial airway (tube)?
extubation
Muscle relaxation required during general anesthesia?
neuromuscular blockade
When is Desflurane used and what does it cause that makes it a poor induction agent?
used for rapid emergence, poor induction because it irrating the upper respiratory track that can cause gagging, coughing, and bronchospasm
What do Benzodiazepines do and how long does it last?
causes antegrade amnesia (loss of recall of events) for 6 hrs
Laryngospasms are treated with positive-pressure administration of oxygen or, in severe cases, administration of _____.
succinylcholine to paralyze the muscles
What is a common depolarizing muscle relaxant used in surgery?
succinylcholine
Patients at risk for aspiration are given preop meds to suppress gastric acid production and _____.
reduce nasuea
What does a regional block do?
provides loss of sensation without effecting consciousness
Septic shock is caused by _____, which results in hypovolemia.
severe infection
_____ infection most often cause of septic shock.
bacterial
Who is PACU staff and who trains them?
critical care nurses trained in postoperative recovery and emergency treatment
How is the PACU arranged?
One large room with separate patient stations along two or more perimeter walls.
Does the PACU have a special place for patients with active infections?
patients with active infections are kept in isolation area
Included in the handover information, what is needed to determine if a transfusion is needed
estimated blood loss
How are respiratory sounds assessed?
auscultation
When is the sponge, sharp and instrument count performed?
- Before surgery
- Before closure of hollow organ
- Before closure of body cavity
- Before skin closure
- Whenever suspicion arises
- Permanent change in personnel
Sponges and x-rays are impregnated with what?
radiopaque strip
When handling and passing instruments, are they passed open or closed.
closed
Rough or excessive handling of tissue can lead to what?
bruising, swelling and ischemia
When using irrigation, what is the ST’s responsibility to keep up with?
the ST must keep track of the amount of irrigation used in the wound so that the estimated blood loss can be calculated
What are the 2 types of cultures commonly taken during surgery?
aerobic and anaerobic bacterial specimens
Has round shaft, used for suturing, and blunt dissection of friable tissue and organs that are soft and spongy, ex..liver, spleen, kidneys.
blunt needle
Round body that tapers to a sharp point, punctures tissue, suturing soft tissue, ex. Muscle, subcutaneous, fat, peritoneum, dura and gastrointestinal.
tapered needle
Has a cutting edge, used on fibrous connective tissue such as skin, joint capsule, and tendons.
cutting needle
Inert suture causes little or no _____.
bioactivity
Individually placed suture.
interrupted suture
Also called running suture, is a single long suture that is anchored at one end.
continuous suture
Special continuous suture used for closing the end of a tubular structure.
purse-string suture
Used on mucous membranes or any tissue that bleeds easily (spleen or kidneys).
smooth forceps
Used on connective tissue such as the skin.
toothed forceps
Prevents puncturing of blood vessels but provides friction to hold.
vascular forceps
What do synthetic tissue adhesives do?
join wound edges without using sutures, it encourages the body’s natural coagulation and healing process
Phase of wound healing that begins about day 4 or 5 and continues for approx. 2 weeks. During this phase fibroblast synthesizes collagen
proliferative stage
A collection of blood that forms in the surgical wound because of incomplete hemostasis during surgery.
hematoma
The protrusion of abdominal viscera through a wound or surgical incision.
evisceration
A band of scar tissue between the abdominal or pelvic organs and the peritoneum.
adhesion
Not compatible with life.
embryo
In utero after 3 months of gestation.
fetus
- Gestational age more than 24 weeks
- Birth-weight more than 500g
- Capable of sustaining life outside uterus
potentially viable
- Gestational age less than 37 weeks
- Birth-weight 2500g or less
true preterm
- Gestational age less than 38 weeks
- Birth-weight more than 2500g
large preterm
- Gestational age 38-40 weeks
- birth-weight greater than 2500g
term neonate
-Gestational age extended by more than 8 weeks
postterm
-First 28 days of extra-uterine life.
neonatal period
-28 days to 18 months
infant
-18 - 30 months
toddler
-2.5 - 5 years
preschool age
-6 - 12 years
school age
-13 - 18 years
adolescent
Neonate blood volume.
75 - 80 mL/kg
6 weeks - 2 years blood volume.
75 mL/kg
2 years - puberty
72 mL/kg
Heart rate for newborns
100-170 (100-180 in book)
Anorectal malformation occurs when?
between 4th and 12th week
Fusion or 2 or more fingers or toes.
syndactyly
Pulmonary ventilation is established when?
Birth/1st breath
What valves allows normal blood flow between the right atrium and ventricle?
tricuspid valve
_____, financial, educational, and subjective influences shape the prototype of the older adult’s place in society.
geographic
Laboratory values important when assessing geriatric patients?
weight
Multiple vaginal births can cause _____.
uterine and bladder prolapses
At what temp is elderly at risk for hypothermia?
96.8
