Surg 126--Chapter 4 Flashcards
Administration of drugs from the sterile field is a _____.
team effort
Who is responsible for passing medication to the surgeon for administration during the surgical procedure?
the scrub
Who obtains correct the medications (as specified on the surgeon’s preference cards)?
the circulator
Who delivers medications to the sterile field using aseptic technique?
the circulator
Who documents the medications used from the sterile field during an operation?
the circulator
Who correctly identifies and accepts medications from the circulator and immediately labels?
the scrub
Accurate _____ and immediate _____ of all drugs accepted onto the sterile field is crucial.
identification
labeling
The scrub must clearly state the _____ and _____ of a medication when passing it to the surgeon.
name and strength
What are the five “rights” of medication administration?
- Right drug
- Right dose
- Right route
- Right patient
- Right time
“What drug is required?”
right drug
“How much of the drug is required in what concentration?”
right dose
“How will the drug be administered?”
right route
“Who will receive the drug?”
right patient
“When will the drug be administered?”
right time
Drugs that are routinely needed on the sterile field during a procedure should be _____ preference card.
clearly specified on the surgeon’s preference card
Medication must be carefully identified by both the _____ and _____.
circulator and scrub
Scrub must always state the _____ and _____ of the drug aloud as he hands it to the surgeon.
name and strength
Why must the scrub always state the name and strength of the drug aloud as he hands it to the surgeon?
Serves as confirmation that the medication is correct
True or False: The name should be spoken aloud even if the syringe (or other delivery container) is labeled
True
All empty _____ and _____ should be kept in the room during the procedure as evidence that the proper medication has been delivered to the field.
medication vials and bottles
The actual dose of a medication is a factor of both its _____ and its _____.
amount (volume) and its strength (concentration)
This information (volume and concentration) must be clearly _____.
understood
It is especially important to understand the drug volume and concentration when the must must be mixed or diluted on _____
the sterile back table
Most medications administered in surgery are given _____.
intravenously
Medications may also be _____ or _____ by the surgeon at the surgical site
injected or applied topically
Different administration routes may require different _____ and _____ of a medication
preparations and concentrations
All surgical patients must be _____ before being transported into the OR.
accurately identified
Name two documents used in the OR to ensure that the correct surgical procedure will be performed on the correct patient.
TJC Universal Protocol and the WHO’s Organization’s Surgical Safety Checklist
Relevant information about the patient such as history of _____ or _____ to a particular drug should also be checked.
drug allergies or hypersensitivity
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.
“time out”
The _____ administers all medications at the surgical site.
surgeon (or as delegated to the surgical first assistant)
It is crucial that medications given from _____ are accurately recorded in the operative record.
the sterile back table
The _____ will document all medications delivered to the field.
circulator
The _____ will verbally provide a final total of the amount of each medication administered for the circulator to note in the record.
scrub
When a medication is repeatedly administered during a procedure the scrub must also maintain _____ being used throughout the procedure.
an accurate ongoing total of the amount of medication
Both the _____ and _____ are responsible for correctly identifying medications delivered to and used from the sterile field.
scrub and circulator
What are the six steps is medication identification?
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
All medication delivered to the sterile field must be _____.
labeled immediately
Principles of _____ must be followed when delivering and receiving medications into the sterile field
asepsis
Medication may be packaged in different types of containers including _____ and _____.
vials and ampules
The _____ varies by type of container.
aseptic delivery methods
One of the most common containers is a _____.
glass or plastic vial with a rubber stopper encased in a metal cap
Procedures for a glass or plastic vial are:
- The metal cap is peeled away, so the circulator can draw up the drug with a syringe and hypodermic needle
- The contents are then emptied into a sterile medicine cup held by the scrub
- The circulator may hold the vial in an inverted position while the scrub withdraws the drug from the vial with a syringe and needle
If a drug is in powder form in a vial, the circulator must _____.
reconstitute it (mix it with an appropriate liquid, such as saline solution)
If a syringe is used to draw up and inject the reconstituting agent and to withdraw the mixture, care must be taken not to _____.
touch the sides of the plunger
The rubber top of a vial may be removed _____ and the solution poured directly into a medicine cup.
aseptically
Medications may be added to a _____.
bag of IV solution
Disposable spouts, called _____, may be used to deliver the solution to the sterile field aseptically.
bag decanters
Some medications are available in an _____ (a sealed glass container with a narrowed neck).
ampule
The top of an _____ and a sterile needle attached to a syringe is inserted to aspirate and withdraw the medication.
ampule is broken off at the neck
While not technically considered a medication, _____ is often delivered to the sterile field from a pour bottle.
saline irrigation
The following steps should be followed when using bottled saline:
- The bottle cap should be lifted straight up and off
- The entire contents should be poured immediately
- Unused portions should not be saved for later use, as sterility cannot be assured
To avoid potential contamination, the circulator must take care not to _____ when delivering medications or solutions.
lean over the sterile field
The scrub should hold containers _____ or place containers at the table edge.
away from the sterile table
Medication must be labeled _____.
immediately
The most accurate medication labeling method is the use of _____.
preprinted medication labels available from sterile supply manufacturers
A _____ may be used to write on blank labels.
sterile skin marking pen
Improper or inadequate labeling of drugs may be considered _____.
negligent
_____ and _____ are used frequently in surgery to draw up, measure, and administer medications.
Syringes and hypodermic needles
Disposable syringes are made of _____, but reusable _____ syringes may be indicated for specific situations.
plastic
glass
The most common sizes of syringes routinely used in surgery range from _____.
1mL to 60mL
Three basic parts of a syringe are:
- The barrel (outer portion)
- The plunger (inside portion)
- The tip
The most common type of syringe tip used in surgery is the _____.
Luer-loc tip
Hypodermic needles are used to _____ and _____.
draw up and administer drugs
Three basic parts of a hypodermic needle:
- The hub (which fits onto a syringe)
- The shaft
- The tip (the beveled end of the shaft)
Needles vary in _____ and _____.
diameter (gauge) and length (measured in inches)
The larger the gauge of a needle, the smaller the _____ (inside channel).
diameter of the lumen
The most common needle length in surgery is _____.
1 ½ inches
Standard precautions state that used needles must _____.
never be recapped
Why must a needle never be recapped?
Most needle punctures injuries are the result of attempting to recap a used needle.
