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► Med Misc 49 > unit V exam 2 > Flashcards

unit V exam 2 Flashcards

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1
Q

Intraoperative period

A

Time enter OR until go to PACU

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2
Q

What is the main concern for periopertive nurses?

A

Pt safety & advocacy

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3
Q

What are the 4 fundamental purpose of physical environment of OR?

A

Geographic isolation
Bacteriological isolation
Centralize equipment
Centralized trained personnel

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4
Q

Located in separate area to restrict flow of people traffic and decrease contamination

A

Geographic isolation

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5
Q

What area can you wear street clothes, point of entry for pt’s.

A

Unrestricted

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6
Q

What area is for authorized personnel must wear scrubs

A

Semi restricted

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7
Q

What area is the OR, scrub sink, clean core?

A

Restricted

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8
Q

Who are the biggest risk for contamination

A

People

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9
Q

Who are the biggest risk for contamination

A

People

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10
Q

What contains all equipment to facilitate safe & effective surgery

A

Centralized of equipment

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11
Q

Teamwork in an isolated, restricted environment

A

Centralized of trained personnel

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12
Q

Why is fresh filtered air circulated in the OR

A

Infection control

Prevent accumulation of anesthetic gases

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13
Q

Why is the OR kept at low humidity and low temperature

A

Decreases bacterial growth

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14
Q

How many air exchanges must occur every hour in the OR

A

25

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15
Q

A group of people who recognize common goals & coordinate efforts to achieve them

A

OR team concept

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16
Q

Who is on the scrub team? Are they sterile or unsterile?

A

Surgeon
Assisting surgeon
Scrub nurse & technician

Sterile

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17
Q

Who is on the unscrubbed team? Are they sterile or unsterile?

A

Anesthesiologist
Circulating nurse
X-ray
Patho

Unsterile
Do not enter sterile field

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18
Q

Who administers agents during surgery, monitors cardiac/respiratory function

A

Anesthesiologist

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19
Q

Who sets up sterile field, assists with preparation of room count sponges, needles & instruments. Are they sterile or unsterile?

A

Scrub nurse

Sterile

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20
Q

Who coordinates, oversees & participates in care, counts sponges, needles, instruments. Pt advocacy & safety. Are they sterile or non sterile?

A

Circulating nurse

Non sterile

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21
Q

When is TIME OUT done

A

Done before anesthesia, skin incision, pt leaves the OR

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22
Q

When is TIME OUT done

A

Done before anesthesia, skin incision, pt leaves the OR

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23
Q

Is time out required on all surgeries?

A

Yes

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24
Q

Who is involved in a time out?

A

Involves the entire OR team

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25
Q

What does the time out do?

A

Finial verification of pt, procedure, site

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26
Q

What is the primary concern in positioning pt

A

Safety

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27
Q

What is the criteria for positioning?

A

exposure of surgical site, avoids body injury

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28
Q

Name the 3 basic positions used in the OR

A

supine, prone, lateral

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29
Q

What are some devices that may be used to maintain corrct position and prevent injury

A

arm boards, belts, sand bags etc.

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30
Q

What is the main reason for safety in the OR

A

create, maintain & control an optimally therapeutc enviorment in the OR

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31
Q

Who does all the documentation in the OR

A

Circulating Nurse

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32
Q

All specimens and cultures must have?

A

name, date, time, initial of RN

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33
Q

What is the biggest risk in the OR

A

infection

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34
Q

What is the name of the grounding pad to prevent electrial shock and burns

A

Electrocautery

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35
Q

Endogenous

A

contamination from within the PT (skin, hair, blood, respiratory, GI, GU)

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36
Q

Exogenous

A

contamination from outside the pt

ppl, enviorment

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37
Q

essence of aseptic technique consists of eliminating all modes and sources of contamination to the extent that is possible

A

aseptic technique

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38
Q

name some sources of contamination

A

scrub team skin, pt skin, pts circulating blood, linens

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39
Q

name some modes of contamination

A

direct contact, indirect contact, circulating air, brak in sterile field

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40
Q

what is the center of the sterile field

A

the incision on the pt

41
Q

how far does sterile equipment and non sterile equipment have to be from each other

A

at least one foot

42
Q

if a sterile item touches non sterile it becomes?

A

sterile

43
Q

only sterile can touch

A

sterile

44
Q

what is work to maintain aseptic technique in the OR

A

surgical attire

sterile gown, mask, hat, gloves shoe covers

45
Q

what determines the effectivenessin the surgical hand scrub

A

the length of time (at least 5 minutes)

fingers, hands, arms to elbows

46
Q

what kind of bacteria is limited to exposed skin and easily removed by mechanical cleansing

A

transient bacteria

47
Q

what kind of bacteria inhabits deep structures of dermis, sweat glands and hair follicles

A

resident bacterial

48
Q

when should a pt be shaved for the OR

A

immediatley prior to surgery
time between pre op shave and surgery has direct effect on would infection rates
done by circulating nurse

49
Q

what is the sterile area of the scrub team

A

gown front from chest to table level and sheeves to 2 inches above the elbow

50
Q

if a sterile field is left unattended is it sterile

A

NO

51
Q

what antimicrobial agents disinfect skin

A

cholor-prep (blue)

52
Q

what kind of drapes are applied directly to the skin, used in orthopedic procedures to decrease splattering and trasmissions of organisms

A

plastic incisional drapes

53
Q

how can the surgical specimens be sent to pathology

A

fresh, in saline or in a preservation solution, can also be frozen

54
Q

what does hemostatsis do

A

control bleeding to prevent hemorrhage, allow visulization of surgical field, and promote wound healing

55
Q

hemostasis

A

stop bleeding

56
Q

how much blood do you have in your body

A

5 liter

57
Q

what are the two ways we stop blood loss

A

natural (thrombin, fibrin, platelets)

artificial (head, pressure, bonewax, tourniquets)

58
Q

wounds involvinga break in skin or mucous membranes

A

open wound (external)

59
Q

wound involving no break in skin integrity

A

closed wound (internal)

60
Q

what is the cause for a wound resulting from therapy

A

intentional wound

61
Q

what is the cause for a wound that occurs unexpectedly

A

unintential wound

62
Q

what kind of wound involves only epidermal layer of skin

A

superficial wound

63
Q

what kind of wound involving break in epidermal skin layer as well as dermis and deeper tissues or organs

A

penetrating wound

64
Q

what kind of penetrating wound in which foreign object enters and exits an internal organ

A

perforating wound

65
Q

what is the degree of contamination of a closed surgical wound that did not enter the gastrointestinal, respiratory, or GU tract

A

clean wounds

66
Q

what is the degree of contamination of a wound entering gastrointestinal, respiratory, or GU tract

A

clean/contaminated wounds

67
Q

what is the degree of contamination of a open, traumatic wound; surgical wound with break in asepsis

A

contaminated wounds

68
Q

what is the degree of contamination of a wound site with pathogens present. signs of infection

A

infected wounds

69
Q

name the types of incision closures

A

sutures, staples, retension sutures, steri strips, incision glue

70
Q

what type of staples must be removed before healing is complete

A

non absorbable

71
Q

what type of incision closure are large rubber encased wire sutures

A

retention sutures (secondary sutures)

72
Q

how long do absorbable sutures take to disappear

A

7-10 days

73
Q

what protects from microorganisms, aides hemotasis and promotes healing

A

surgical dressing

74
Q

Who ID’s the pt (name & DOB)

A

Circulating nurse

75
Q

The surgical dressing is made up of how many layers

A

3

76
Q

Name the three layers of the surgical dressing

A

Contact or primary dressing
Absorbent layer
Outer layer

77
Q

What do drains do

A

Provide exit for serum, blood & bloody secretions, unexpected bile, intestinal or vascular leaks

78
Q

Low pressure, used when large amount drainage (ortho)

Self suction drain

A

Hemovac

79
Q

Gentle pressure, small collapsible bulb

A

JP or Blake drain

80
Q

No suction, open drainage

A

Penrose

81
Q

Placed in common bile duct for bile drainage

A

T-tube

82
Q

Allows healing from base of wound

A

Gauze wick (iodoform)

83
Q

Negative pressure allow lung expansion

A

Chest tube

84
Q

General anesthesia

A

Total loss of all sensation & consciousness and protective reflexes

85
Q

Disadvantages of general anesthesia

A

Vital function depression
Fears & anxiety
Long term effects
Risk of death

86
Q

Advantages of general anesthesia

A

Vital functions regulated
Adjustable to surgery
Age
Physical status

87
Q

What stage is operative anesthesia done at

A

3

88
Q

Regional anesthesia

A

Not unconscious

Interruption of nerve impulses to a specific area of body

89
Q

Minimal depression of consciousness, airway maintained, quick emergence

A

Conscious sedation

90
Q

Name the three phased of anesthesia

A

Induction
Maintenance
Emergence

91
Q

Complications of general anesthesia

A

OD, hypoventilation, aspiration,hypotension

92
Q

Complications with regional anesthesia

A

Nerve damage, hematoma at injection site, spinal HA

93
Q

Complications of local anesthesia

A

Safe with rare complications

94
Q

Genetic reaction to general anesthesia. Increase temperature, heart rate, muscle rigidity
Genetic

A

Malignant hyperthermia

95
Q

What affects can surgery have on the elderly

A 
Blood loss
Fluid loss
Hypothermia
Pain
Issues with anesthesia
96
Q

What kind of teaching can be done

A

About anesthesia
Treatment of symptoms
Explore pts fears & feelings
Advantages & disadvantages

97
Q

Goal of PACU

A

Promote I eventful recovery from anesthesia & the immediate effects of surgery

98
Q

Special clothing & footware

Separate water supply, Airflow system, Laundry & disposal systems

A

Bacterial isolation

► Med Misc 49 (29 decks)

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