Surgical Nursing Flashcards
What 7 things are the responsibility of the nurse once the animal has been brought to the practise for surgery?
- Go through the paperwork and consent with the client. Make sure its understood and signed by the client and they have a copy.
- Explain the surgery very simply with the client and be happy they fully understand it and its implications
- Make arrangements/ instructions for collection / update.
- Weigh the patient
- Assist vet with pre-op checks and administration any medication
- Maintain the animals records
- Monitor induction for Surgery
What factors contribute to the decision of whether to clip the patient pre- or post- induction?
Depends on patient compliance Causing additional stress Access to the surgery site Staff numbers How long until the surgery GA time Clip time
What 7 things should be done when clipping a patient?
- Clip wide enough margin, but not too much
- Ensure clippers in good working order
- Coat existing surgical sites with KY Jelly
- First clip in same direction as hair and then in opposite direction and pull skin tight
- Clip in prep room, not OR to increase sterility of OR
- Look after the blades e.g. sharpening (pros and cons)
What are the WHOs 3 guidelines for safe surgery?
- Anything applied to skin should be sterile, even water
- Use enough pressure to work with the top few layers of skin
- Use alcohol gel as well to reduce microbial count
What is the aim of skin prep?
To significantly reduce the number of bacteria present without damaging the skin itself.
What two properties should a cleansing agent have?
Detergent and Antiseptic
What are the 7 recommended steps for skin prep?
- Wear appropriate PPE
- Using lint-free swabs, wash surgery site with appropriate solution
- Work from incision site outwards. Once get to edge, disguard swab
- Continue until swab appears clean
- Move patient to OR and position for surgery
- 2nd skin prep done aseptically exactly same method
- Apply alcohol-based solution
What are the ideal properties of a cleansing agent?
Broad spectrum Lasting residual effect Effective in presence of organic matter Easy and quick to apply Safe and economical
Give 2 examples of cleansing agents and their pros and cons
- Hibiscrub
- 4% Chlorhexadine gluconate
- Used most commonly
- Residual effect of 6 hours
- Effective in presence of organic material - Povidone-iodine
- used for mucous membranes and eye surgery
What are the 2 types of draping?
- Fenestrated Drape - has window
2. Four corner plain drape - four drapes applied in square to leave window in middle
What are the 3 types of drape? What are their pros and cons?
Fabric and Disposable and adhesive.
Fabric are reuseable, conform to patient, cheaper in long run. BUT are porous and leak, time consuming to maintain and may have loose threads.
Disposable are water resistant, less labour intensive and time consuming and are always in perfect condition. BUT they are expensive.
Adhesive are VERY sterile, keep patient insulated and are waterproof.
Describe the 9 step process for draping a patient for orthopaedic surgery
- Position the patient appropriately
- In a sterile manner, wrap the foot in sterile wrap
- Raise the foot and limb by lifting the foot with a piece of gauze and clipping it to a drip stand.
- Clip leg allowing large margin
- Clean leg using appropriate scrubbing technique and solution near the foot. The do it from surgical site outwards.
- Move patient to OR and perform 2nd skin prep in sterile manner by a scrubbed nurse and then apply antiseptic solution.
- Place drape on table
- Stockinette covers leg and is lowered
- Drape the patient using fenestrated drape and use towel clips. Can then use adhesive drape.
