Surg 126--Chapter 4

Question 1

Administration of drugs from the sterile field is a _____.

Answer 1

team effort

Question 2

Who is responsible for passing medication to the surgeon for administration during the surgical procedure?

Answer 2

the scrub

Question 3

Who obtains correct the medications (as specified on the surgeon’s preference cards)?

Answer 3

the circulator

Question 4

Who delivers medications to the sterile field using aseptic technique?

Answer 4

the circulator

Question 5

Who documents the medications used from the sterile field during an operation?

Answer 5

the circulator

Question 6

Who correctly identifies and accepts medications from the circulator and immediately labels?

Answer 6

the scrub

Question 7

Accurate _____ and immediate _____ of all drugs accepted onto the sterile field is crucial.

Answer 7

identification

labeling

Question 8

The scrub must clearly state the _____ and _____ of a medication when passing it to the surgeon.

Answer 8

name and strength

Question 9

What are the five “rights” of medication administration?

Answer 9

1. Right drug
2. Right dose
3. Right route
4. Right patient
5. Right time

Question 10

“What drug is required?”

Answer 10

right drug

Question 11

“How much of the drug is required in what concentration?”

Answer 11

right dose

Question 12

“How will the drug be administered?”

Answer 12

right route

Question 13

“Who will receive the drug?”

Answer 13

right patient

Question 14

“When will the drug be administered?”

Answer 14

right time

Question 15

Drugs that are routinely needed on the sterile field during a procedure should be _____ preference card.

Answer 15

clearly specified on the surgeon’s preference card

Question 16

Medication must be carefully identified by both the _____ and _____.

Answer 16

circulator and scrub

Question 17

Scrub must always state the _____ and _____ of the drug aloud as he hands it to the surgeon.

Answer 17

name and strength

Question 18

Why must the scrub always state the name and strength of the drug aloud as he hands it to the surgeon?

Answer 18

Serves as confirmation that the medication is correct

Question 19

True or False: The name should be spoken aloud even if the syringe (or other delivery container) is labeled

Answer 19

True

Question 20

All empty _____ and _____ should be kept in the room during the procedure as evidence that the proper medication has been delivered to the field.

Answer 20

medication vials and bottles

Question 21

The actual dose of a medication is a factor of both its _____ and its _____.

Answer 21

amount (volume) and its strength (concentration)

Question 22

This information (volume and concentration) must be clearly _____.

Answer 22

understood

Question 23

It is especially important to understand the drug volume and concentration when the must must be mixed or diluted on _____

Answer 23

the sterile back table

Question 24

Most medications administered in surgery are given _____.

Answer 24

intravenously

Question 25

Medications may also be _____ or _____ by the surgeon at the surgical site

Answer 25

injected or applied topically

Question 26

Different administration routes may require different _____ and _____ of a medication

Answer 26

preparations and concentrations

Question 27

All surgical patients must be _____ before being transported into the OR.

Answer 27

accurately identified

Question 28

Name two documents used in the OR to ensure that the correct surgical procedure will be performed on the correct patient.

Answer 28

TJC Universal Protocol and the WHO’s Organization’s Surgical Safety Checklist

Question 29

Relevant information about the patient such as history of _____ or _____ to a particular drug should also be checked.

Answer 29

drug allergies or hypersensitivity

Question 30

A surgical safety _____ is conducted just prior to the incision to further verify that the intended surgical procedure is being performed on the correct patient.

Answer 30

“time out”

Question 31

The _____ administers all medications at the surgical site.

Answer 31

surgeon (or as delegated to the surgical first assistant)

Question 32

It is crucial that medications given from _____ are accurately recorded in the operative record.

Answer 32

the sterile back table

Question 33

The _____ will document all medications delivered to the field.

Answer 33

circulator

Question 34

The _____ will verbally provide a final total of the amount of each medication administered for the circulator to note in the record.

Answer 34

scrub

Question 35

When a medication is repeatedly administered during a procedure the scrub must also maintain _____ being used throughout the procedure.

Answer 35

an accurate ongoing total of the amount of medication

Question 36

Both the _____ and _____ are responsible for correctly identifying medications delivered to and used from the sterile field.

Answer 36

scrub and circulator

Question 37

What are the six steps is medication identification?

Answer 37

Step 1-Circulator reads the label
Step 2-Circulator reads labels aloud to the scrub
Step 3-Circulator shows label to the scrub
Step 4-Scrub states medication information aloud
Step 5-Scrub accepts medication
Step 6-Scrub labels medication containers immediately

Question 38

All medication delivered to the sterile field must be _____.

Answer 38

labeled immediately

Question 39

Principles of _____ must be followed when delivering and receiving medications into the sterile field

Answer 39

asepsis

Question 40

Medication may be packaged in different types of containers including _____ and _____.

Answer 40

vials and ampules

Question 41

The _____ varies by type of container.

Answer 41

aseptic delivery methods

Question 42

One of the most common containers is a _____.

Answer 42

glass or plastic vial with a rubber stopper encased in a metal cap

Question 43

Procedures for a glass or plastic vial are:

Answer 43

1. The metal cap is peeled away, so the circulator can draw up the drug with a syringe and hypodermic needle
2. The contents are then emptied into a sterile medicine cup held by the scrub
3. The circulator may hold the vial in an inverted position while the scrub withdraws the drug from the vial with a syringe and needle

Question 44

If a drug is in powder form in a vial, the circulator must _____.

Answer 44

reconstitute it (mix it with an appropriate liquid, such as saline solution)

Question 45

If a syringe is used to draw up and inject the reconstituting agent and to withdraw the mixture, care must be taken not to _____.

Answer 45

touch the sides of the plunger

Question 46

The rubber top of a vial may be removed _____ and the solution poured directly into a medicine cup.

Answer 46

aseptically

Question 47

Medications may be added to a _____.

Answer 47

bag of IV solution

Question 48

Disposable spouts, called _____, may be used to deliver the solution to the sterile field aseptically.

Answer 48

bag decanters

Question 49

Some medications are available in an _____ (a sealed glass container with a narrowed neck).

Answer 49

ampule

Question 50

The top of an _____ and a sterile needle attached to a syringe is inserted to aspirate and withdraw the medication.

Answer 50

ampule is broken off at the neck

Question 51

While not technically considered a medication, _____ is often delivered to the sterile field from a pour bottle.

Answer 51

saline irrigation

Question 52

The following steps should be followed when using bottled saline:

Answer 52

1. The bottle cap should be lifted straight up and off
2. The entire contents should be poured immediately
3. Unused portions should not be saved for later use, as sterility cannot be assured

Question 53

To avoid potential contamination, the circulator must take care not to _____ when delivering medications or solutions.

Answer 53

lean over the sterile field

Question 54

The scrub should hold containers _____ or place containers at the table edge.

Answer 54

away from the sterile table

Question 55

Medication must be labeled _____.

Answer 55

immediately

Question 56

The most accurate medication labeling method is the use of _____.

Answer 56

preprinted medication labels available from sterile supply manufacturers

Question 57

A _____ may be used to write on blank labels.

Answer 57

sterile skin marking pen

Question 58

Improper or inadequate labeling of drugs may be considered _____.

Answer 58

negligent

Question 59

_____ and _____ are used frequently in surgery to draw up, measure, and administer medications.

Answer 59

Syringes and hypodermic needles

Question 60

Disposable syringes are made of _____, but reusable _____ syringes may be indicated for specific situations.

Answer 60

plastic

glass

Question 61

The most common sizes of syringes routinely used in surgery range from _____.

Answer 61

1mL to 60mL

Question 62

Three basic parts of a syringe are:

Answer 62

1. The barrel (outer portion)
2. The plunger (inside portion)
3. The tip

Question 63

The most common type of syringe tip used in surgery is the _____.

Answer 63

Luer-loc tip

Question 64

Hypodermic needles are used to _____ and _____.

Answer 64

draw up and administer drugs

Question 65

Three basic parts of a hypodermic needle:

Answer 65

1. The hub (which fits onto a syringe)
2. The shaft
3. The tip (the beveled end of the shaft)

Question 66

Needles vary in _____ and _____.

Answer 66

diameter (gauge) and length (measured in inches)

Question 67

The larger the gauge of a needle, the smaller the _____ (inside channel).

Answer 67

diameter of the lumen

Question 68

The most common needle length in surgery is _____.

Answer 68

1 ½ inches

Question 69

Standard precautions state that used needles must _____.

Answer 69

never be recapped

Question 70

Why must a needle never be recapped?

Answer 70

Most needle punctures injuries are the result of attempting to recap a used needle.