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Surgery > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Define asepsis

A

Series of techniques and procedures aimed at excluding all pathogenic organisms from the surgical site

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2
Q

Define sterilization

A

All forms of life and spores are destroyed

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3
Q

Define disinfection

A

Only some forms of life are destroyed (inanimate objects, large objects)
ie floors and tables

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4
Q

Define asepsis

A

Only some forms of life are destroyed (animate objects)
ie animals skin, human hands

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5
Q

Aseptic technique

A

Applied to the surgical suite and patient
Always clean from ceiling to floor and towards exits
Patient and staff prep in other room

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6
Q

Aseptic technique prevents contamination from :

A

Animals skin and fur
Surgeon
Instruments
Room air

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7
Q

Define strike through

A

Microbes gain access to sterile objects via water
Everything in surgery must be dry and cool
Water is the enemy of sterility

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8
Q

OR conduct

A

Talking should be limited
Movement should be limited
Imaginary line of sterile field

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9
Q

What is antiseptic?

A

Prepped animal skin
Scrubbed human skin

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10
Q

What items are considered sterile?

A

Drapes
Instrument field
Gown and linen field (hip to hip, shoulder to shoulder)
Surgical gown and gloved hands
Suture material and blades
Sterile saline
Inside of animal

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11
Q

What is considered disinfected?

A

Items in contact with a disinfectant
ie surgical site

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12
Q

What is considered contaminated?

A

Cap and mask
Gown below waist, back, and wear chin can touch
Outside of packs
Undraped parts
Surgical lights
Anything sterile that touches unsterile
Any item dropped, punctured, or wet

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13
Q

What can sterile surgical assistance do?

A

Receive sterile equipment
Keep table clean and organized
Pass instruments
Maintain homeostasis for the surgeon

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14
Q

Prepping packs and linens

A

Minimal detergent and rinse again before use
Pans and trays for instruments
Box locks and ratchets in open position
Items used first are placed on top (scalpel, towel clamps)

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15
Q

Linens

A

Surgical gowns
Lap sheets
Drapes
Towels

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16
Q

Wrapping packs

A

Size no more than 30cm x 30cm x 50cm
Weigh no more than 5.5 kg
Space between packs ~ 2.5-7.5cm
Wrap TIGHT
Sterile for 2 months if stored correctly

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17
Q

What is written on indicator tape?

A

Contents of pack
Date sterilized
You initals
Group # and letter
2 strips on each pack

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18
Q

Sterilization pouches

A

Paper or plastic
Individual items
Sterilize upright for steam and dry
Sterile for 1 year if stored properly

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19
Q

Types of sterilization monitors

A

Chemical indicator strips
Bowie-dick test
Biological indicators

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20
Q

Chemical indicator strips

A

Change colour when steamed
Place in the centre of packs
Check the strip before the pack is used

21
Q

Bowie-dick test

A

Pre-purchased dense pack with indicator tape in the centre
Place the pack in the most inaccessible location in the auto clave
Verifies steam penetration

22
Q

Biological indicators

A

Used periodically to test sterility and effectiveness of the autoclave
Tests for the most heat resistant bacteria

23
Q

Cotton sterilization

A

Must be double layered and use 2 wraps

24
Q

High thread count sterilization

A

Use 2 single layered wraps

25
Q

Open shelving

A

Items on open shelving stay sterile for 3 weeks

26
Q

Disposable paper sterilization wraps

A

Can be cut to size
Crepe or non-crepe
More durable
Expensive
Single wrapped 2 way

27
Q

Infrequently used sterile items

A

Wrap and store in pouches for up to 1 year in a closed cabinet

28
Q

Ethylene oxide

A

Can prolong shelf life

29
Q

Cleaning and setting up surgical suite

A

Warm the fluid bag in the autoclave sink
Circulating nurse cleans suite before and after lab
Move all floor items to near scrub sink before cleaning floors
Set up supplies after floor is dry

30
Q

Cleaning the surgical suite after

A

Circulating nurse’ job
Check and restock supplies (expiration dates, refill bottles when 2/3-3/4 empty and new WHMIS label)
Order suture materials when 5 packs remain

31
Q

Whose responsibility is patient care during surgery?

A

The anesthetist

32
Q

Ways we maintain patient temperature

A

Warm fluids
Fluid warmer during surgery
White heating pad on induction table
Hotdog warmer in surgical suite
Bubble wrap and socks
Bair hugger postop

33
Q

What does the circulating nurse check before moving patient to surgical suite?

A

Heating pads
Troughs
Table ties ready
Socks and bubble wrap laid out

34
Q

Once the patient is in surgery :

A

All legs are tied in a quick release knot and double loop to leg
Single loop on the catheter leg
Adjust light and table

35
Q

Whose job is it to drape the patient?

A

Assistant surgeon

36
Q

Controlled drug log - how many mL is each poke in hub loss

A

0.10mL hub loss

37
Q

Controlled drug important info

A

No larger than a 22g needle (leakage)
Spills are found are signed by witness and calculated by auditing the remaining volume

38
Q

How can instruments be damaged when being cleaned?

A

By using cleaning solutions that are too alkaline or acidic can cause corrosion
Blood can cause corrosion
Use of tissue scissors to cut anything other than tissue
Use of needle drivers or hemostats to twist wire

39
Q

How can instrument damage be detected?

A

Close the jaws and check for alignment
“Sprung” should be thrown out (don’t close or align)
All scissor should cut through 4 layers of gauze

40
Q

What materials are used to clean instruments?

A

Neutral pH to prevent spotting and corrosion
Detergent
Rinse with hot water
Distilled water for cleaning instruments

41
Q

Why is ultrasonic cleaning useful?

A

Removes small debris and microorganisms by mechanical energy
Formation, expansion, and collapse of air bubbles (16x more effective than manual cleaning)

42
Q

Basic principles of steam sterilization

A

Heat produced by steam under pressure will coagulate proteins in bacteria and spores
Must be adequately packed
Instruments are autoclaved open, but closed if they are sharp
Packs and trays are placed on their edges so steam can flow downwards

43
Q

Standard time and temperature for steam sterilization

A

15 minutes at 121°C (250°F)
3 minutes unwrapped at 121°C for emergencies
Open autoclave door halfway for 15 minutes to allow drying time
Our autoclave runs for 45 minutes and 60 minutes to dry

44
Q

How is cold sterilization used?

A

Chemical disinfectant
Effectiveness varies with system, some may approach true sterilization, but never reach it
Use has diminished due to instability of solution after 24 hours

45
Q

Procedure for cleaning instruments at UGRC

A

Soak in hot water and detergent for 5 minutes
Scrub jaws, box, and rings, then rinse with hot water
Place in ultrasonic cleaner for 5 to 10 minutes then rinse with tapwater
Place an instrument milk for 5 minutes, then place on drying rack (change milk every 7 days minimum)

46
Q

Suture material options

A

Cassettes
Individually wrapped packages
Packaged in alcohol
Spools

47
Q

Suture materials - cassettes

A

Cheap but may not guarantee sterility
Comes without a needle

48
Q

Suture material - individually wrapped packages

A

Expensive
Comes with or without needle

49
Q

Suture material - spools

A

Don’t come with a needle
Can be re-sterilized with gas or steam
Only certain material available in spools (nylon, stainless steel, silk)

Surgery (3 decks)

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