Unit 1

Question 1

Brand names

Answer 1

Is owed by a single manufacturer who obtained a patent, therefore costing more. The name of the manufacturer is the most prominent in the label. It is always capitalized and very visible.
We will always put the brand name in parentheses after the generic name

Question 2

Generic name

Answer 2

is not owned by a single company, therefore it is cheaper. The official name of the company is not capitalized.
Must be used by all manufacturers

Question 3

Chemical name

Answer 3

Specific to formula
Complicated and long
No clinical use for it; only to chemists
bupivacaine (Marcaine, Sensorcaine)

Question 4

LIST INFORMATION FOUND ON MEDICATION LABELS.

Answer 4

Drug name (brand and generic unless only in generic form)
Manufacturer’s name
Dosage / strength / volume
Form / administration route
Alerts / expiration date / lot #
Barcode / National drug code (NDC#)

Question 5

Which INFORMATION FOUND ON MEDICATION LABELs is important to us in surgery?

Answer 5

Drug name
Dosage / strength / volume
Form / administration route
expiration date

Question 6

Pharmacology studies

Answer 6

the interactions between chemicals and biological systems. Medications or drugs are chemicals used to treat diseases and as surgical technologist we should be able to understand information about these drugs.

Question 7

Topical

Answer 7

medication applied on or in the body. It is often applied on the skin or a mucous membrane-line cavity in the body

Question 8

Adverse effect

Answer 8

undesired harmful effects caused by medications or other types of interventions such as surgery.

Question 9

Agonist

Answer 9

a substance that binds to a receptor and triggers a response.

Question 10

Antagonist

Answer 10

a substances that binds to a receptor which blocks the activity of other agonist, this causes them to not have any effect or response.

Question 11

Contraindication

Answer 11

a situation when a drug or procedure should not be use since it might cause harm to the patient.

Question 12

Emulsion

Answer 12

a medication contained in a mixture of water and other liquids that are normally unmixable which is bound together with an emulsifier

Question 13

Idiosyncratic effect

Answer 13

a drug reactions that rarely occurs. It is a reaction where the cause is unknown or is not clearly understood.

Question 14

Indication

Answer 14

a reason why a certain medication is being used to treat a condition.

Question 15

Parenteral

Answer 15

a drug or solution is introduced into the body through a route other than the intestinal tract (mouth to the anus).

Question 16

Pharmacokinetics

Answer 16

study of how drugs affect the body.

Question 17

Reconstitute

Answer 17

mixing a powder with a liquid to form a solution

Question 18

Side effect

Answer 18

predictable but unintended effects of a drug.

Question 19

Solution

Answer 19

a liquid mixture of chemical substance fully dissolved in a liquid (usually water).

Question 20

Suspension

Answer 20

a mixture of undissolved drug particles floating in a liquid

Question 21

Bolus

Answer 21

a single dose of drug or other substance given all at once.

Question 22

List main sources of drugs

Answer 22

Natural sources
Chemical Synthesis
Biotechnology

Question 23

Example of natural drugs

Answer 23

Plants, animals and minerals
Digitalis obtained from the leaves of purple foxglove.
Morphine obtained from the seeds of opium poppy.
Silvadine cream (used for burn dressings)

Question 24

Examples of chemical synthesis drugs

Answer 24

drugs that are synthesized from laboratory chemicals.
Semisynthetic drugs are drugs that starts with natural substances that are extracted, purified, and altered by chemical processes, in other words they start as natural source; then modify.
Meperidine is made from chemicals which relieves pain similar to opium.
Penicillin derived from natural mold which is extracted and then purified in the chemical laboratory.

Question 25

Example of biotechnology drugs

Answer 25

genetically manipulating microorganism to produce antibiotics, hormones, and other medication. It is a concept where they genetically engineer and modify DNA of living organisms.
Hepatitis B Vaccine
Human Growth Hormone
Thyroid stimulating hormone (Thyrogen)

Question 26

List the different types of medication orders used in surgery.

Answer 26

Standing orders
Surgeon’s preference cards list the medications
Verbal orders
Usually regarding timing or a change during operation
STAT orders
is used when drugs are needed immediately during critical or life threatening situations. One time only.
PRN orders
medicines that are only used when needed for specific situations. On preference card; open when needed

Question 27

List 4 types of drug forms

Answer 27

Solids-drugs may be in capsule or tablet form (Pills are not used in the OR). Tablets are compressed powder, while capsules contain powder drugs encase in a gelatin case.
Powders are reconstituted during surgery
Semisolids-includes creams, foams, gels, and ointments.
Liquids-are stored in bottles, vials, syringes, IV bags, etc. Solute is dissolved in a solvent (such as water or saline).
Solutions
IVs, antibiotic irrigation, heparin irrigation
Suspensions
Emulsions
Gases-Medication meant to be inhaled. Some volatile liquid agents can be vaporized into a gas to be administered.
Inhalation anesthetic agents
Nitrous oxide

Question 28

gtts
soln
susp
ung

Answer 28

Drops; topical administration of a liquid drug form
Solution; a type of liquid drug form; drug molecules are dissolved in liquid
Suspension; a type of liquid drug form; drug molecules are NOT fully dissolved in liquid
Ointment; a semi-solid drug form

Question 29

List the different medication administration routes used in surgery

Answer 29

Oral Route
Intravenous Route
Topical Route
Intramuscular Route
Parenteral

Question 30

Oral Route

Answer 30

Levofloxacin antibiotic used to treat bacterial infections. It is usually used on people who has been exposed to anthrax or any other type of plague.

Question 31

Intravenous Route

Answer 31

Most common in surgery
Rocephin an antibiotic used to treat infections
Preoperative medications or some anesthetic agents

Question 32

Topical Route

Answer 32

used lots in surgery
Ointments, creams – often used as part of surgical dressings, antibiotic ointment
Silvadene cream for burn dressings
Bactroban ointment-an antibiotic that treats skin infections
Desoximetasone ointment- treat skin irritation, allergic reactions, and other skin problems.

Question 33

Intramuscular Route

Answer 33

Not very common in surgery

Testosterone-used to treat low testosterone levels

Question 34

Parenteral

Answer 34

Any route other than digestive tract

Topical, subcutaneous, IM or IV

Question 35

List the four processes of pharmacokinetics

Answer 35

Absorption
Distribution
Biotransformation (Metabolism)
Excretion

Question 36

Absorption

Answer 36

Medication is taken into the body during absorption.
Absorption time varies depending on the administration route and solubility of the drug
administering medication through an IV the body will instantly absorb it
When the drug is administered orally it is absorbed by the digestive system.
When the drug is administered through an IV it is absorbed by the vascular system
When the drug is administered topically (such as ointment) it is absorbed by the integumentary (skin) system
If the blood supply increases the rate of the absorption also increases.

Question 37

Distribution

Answer 37

Medication has arrived in the bloodstream and is carried throughout the body and to the site of action
Once the medication is absorbed it is distributed by the Vascular/circulatory system
Depends on blood supply to site of action
intravenous antibiotics often have little effect in treating bone infections because they have very little blood flow
the health of the patient’s circulatory system will have a significant effect on the drugs distribution.

Question 38

Biotransformation (metabolism)

Answer 38

All drug molecules will eventually get to the liver
The liver cells break down drug molecules into smaller and less toxic molecules that are easier to excrete
Once the medication is distributed it is metabolized by the biliary system.
Drugs gets to the live through the hepatic portal circulation
Liver “health” affects biotransformation
Diseases in the kidney or the patient’s age and nutritional status will effect the body’s ability to metabolize the drugs

Question 39

Excretion

Answer 39

Occurs when drug molecules eliminated from the body through the urinary system
Some drugs may be reabsorbed
Kidneys must be working properly to eliminate drug molecules
diseases influence the quality of filtration and drug absorption.

Question 40

Boiling water

Answer 40

212 degrees Fahrenheit

100 degrees Celsius

Question 41

Normal Body Temperature

Answer 41

98.6 degrees Fahrenheit

37 degrees Celsius

Question 42

Freezing point of water

Answer 42

32 degrees Fahrenheit

0 degrees Celsius

Question 43

1 kilogram to lb

Answer 43

2.2 pounds

Question 44

1 ounce to grams

Answer 44

30 grams

Question 45

1 liter to qt

Answer 45

1 quart

Question 46

1 gallon to pt

Answer 46

4 pint

Question 47

1 fluid ounce to mL

Answer 47

30 milliliters

Question 48

1 meter to in

Answer 48

39.37 inches

Question 49

1 yard to in

Answer 49

3 feet or 36 inches

Question 50

1 inch to cm

Answer 50

2.54 centimeters

Question 51

I liter to mL

Answer 51

1000 milliliters

Question 52

1 grams to mg

Answer 52

1000 milliligrams

Question 53

1 kilogram to g

Answer 53

1000 grams

Question 54

1 milliliter to g or cc

Answer 54

I gram or 1 cubic centimeter

Question 55

1 pint to mL

Answer 55

500 milliliters

Question 56

I meter to mm

Answer 56

1000 millimeters

Question 57

Fahrenheit to celsius

Answer 57

C=(5/9)(F-32)

Question 58

Celsius to Fahrenheit

Answer 58

F=(9/5)C+32

Question 59

tasks required for Circulating in medication administration

Answer 59

iObtains the medications according to the surgeon’s reference card, then they deliver it to the sterile field, and finally they document the medications used during the operation based on the institutional policy.
They need to ensure that they have the exact medicine and strength. Also, they must always check the medicine container and the expiration date.
1. Obtain
2. Deliver
3. Document

Question 60

tasks required for first scrub (STSR) in medication administration

Answer 60

They must correctly identify and accept the medication provided by the circulator, then immediately labels those medications, and finally pass those medications to the surgeon during the surgery.
Accurately identifying the labeling the medication is a must if you are a first scrub role. If the medication is not accurately identified or mislabeled they must be immediately discarded and new ones should be obtained. To ensure no medical errors occurs the surgical tech must clearly state the name and strength of the medication to the surgeon when they pass it.
1. Identify
2. Accept
3. Label
4. Pass
5. Say

Question 61

Dose

Answer 61

volume (amount) x concentration (strength)

Question 62

steps of medication identification used in surgery.

Answer 62

Medication labels contains 4 very important information; the drug name, strength, amount, and the expiration date.
First, the circulator will carefully read the medication label.
Second, the circulator will read the medication label aloud and show it to the surgical technologist.
Third, the surgical technologist will repeat these information aloud.
Finally, the surgical tech will then accept and label the medication container immediately using these information.
If you are unsure or doubt the integrity of the container, the medication should not be used and must be immediately discarded.

Question 63

State the different aseptic techniques for delivery of medications to the sterile field.

Answer 63

Proper aseptic technique must be implemented when delivering or receiving medication into the sterile field
When opening a glass vial, the plastic cap is popped off, the circulator must ensure that they will not touch the rubber stopper and only touch the outside of the vial.
If a medication needs to reconstituted using a syringe we need to ensure that the plunger must not be touched.
When opening ampules, it must be opened by breaking it away from the body and a plastic protective cap must be used to prevent injury when opening it.
When pouring saline solutions the cap must be lifted straight up and off, and the entire contents should poured out immediately. Unused portions and recapped bottles are considered unsterile and should not be saved for later use because their sterility cannot be ensured.
Label any container that has fluid in it.

Question 64

Outline the procedure for labeling drugs on the sterile back table

Answer 64

Once the medication is delivered into the sterile field, it must be labeled immediately.
Every medication and liquids in the sterile table must be labeled.
You can label the medication containers using a preprinted medication labels available from your sterile supply. If they are not available you can use a sterile skin marking pen and blank labels to label the containers. Regardless of the method of labeling, it very important to label all of the medication in your sterile table to avid administration error.
There will are times when a surgical technologist is replaced during a surgery so it is very important that all medication is labeled and reported clearly to the new scrub. If you doubt the identity of the medication, do not use it and acquire new ones.
Unlabeled medications in your sterile back table are considered negligent. If you question or doubt the medication you can verify it with your surgeon before using it because you need to prevent harm to the patient.

Question 65

Supplies used in medication administration in surgery

Answer 65

Syringes and needles are the common ones used in surgery to draw, measure, and administer medications. Syringes has 3 basic parts; barrel, plungers, and tip. Also, syringes have different types of tips. The most common one used in surgeries is known as Luer-lock tip, which has a screw locking type mechanism that securely attaches a hypodermic needle.
Hypodermic needles are used to draw and administer medication. This needle has 3 basic parts; the hub, shaft, and tip. Needles varies in length and diameter, meaning the larger the gauge of the needle the smaller the diameter inside the channel.
An 18 gauge needle must be used when drawing medication from a vial.

Question 66

The five rights

Answer 66

Right Drugs
Right Dose
Right Route
Right Patient
Right Time
Right Documentation

Question 67

Right Drugs

Answer 67

Most of the time the surgeon will specify a medication on their preference card.
Information in the electronic preference card must be accurate, in other words they must have the right medications name spelling and strength. Also, if the preference card is handwritten, the writing must be eligible to avoid confusion.
Additionally, every surgical technologist must always clarify the name of the medication to avoid error, since there are many medication names that sounds and spells similarly.
When the medication is delivered to the sterile table, both the circulator and the scrub must identify the medication by clearly stating the name, strength, and the expiration date. After, identifying the medications the scrub tech must accurately and immediately label the drug container.
If you are unsure of the identity or the integrity of the medication, discard of it immediately and acquire a new one. The new medication must be obtained, identified, and labeled correctly.
1. Read the preference card very carefully and determine whether or not the patient has any allergies.
2. When in doubt, ask for further clarifications.
3. Read medicine label very carefully to verify that it is the right drug.
4. Accurately label drug containers immediately

Question 68

Right Dose

Answer 68

The dose of a medication involves both the amount (volume) and the strength (concentration). This information must be clearly stated in the surgeon’s preference card and must be clearly understood by the surgical tech.
Surgical techs we must understand the reason behind the strengths of some medications because we help prevent the administration of the wrong dosage of medication. We need to ensure that before we hand the medication to the surgeon we perform a final safety check by stating out loud and clearly the name, strength, and the expiration date of the medicine.
Dose = volume (amount) x concentration (strength)

Question 69

Right Documentation

Answer 69

Every medication placed in the sterile table must be accurately documented. The circulator will document all of the medication delivered to the back table and the surgical tech will clearly state the final total amount of medication administered during the surgery to the circulator, so that they can document it. Also, as surgical technologist we must keep an ongoing total of the amount of medication used throughout the procedure if a certain medication, such as local anesthetics, is being repeatedly administered.

Question 70

List the different options used to prevent injury due to unsheathed hypodermic needles in the sterile field.

Answer 70

Needles must never be recapped because most injuries is caused when someone attempts to recap a used needle.
Surgical technologist can do a one-handed recapping technique.
First, place the cap on a flat surface like the table or counter.
Second, hold the syringe with the needle attached in one hand, then slip the needle into the cap without using the other hand.
Finally, you can use both of your hands to “seat” the cap onto the needle firmly.
Techs can also use a recapping device or self-shielding needles available from the sterile field.
Recapping device, reusable rubber needle recapping device and it can be autoclaved.
Self-shielding needles, allows you to automatically shield/ cap the needle one handedly.