Untitled Deck Flashcards
What are standard precautions?
A set of precautions to prevent transmission of HIV, HBV, and other blood-borne pathogens; treat everyone like they have an infectious disease.
What is antisepsis?
The destruction of disease-causing microorganisms to prevent infection in the patient’s body surface; can be bacteriocidal or bacteriostatic.
What is disinfection?
The killing of pathogenic organisms from inanimate objects.
What is sterilization?
The destruction or removal of all microorganisms, including spores.
What is the most common cause of wound infection?
Staphylococcus aureus; nasal carriage is high among healthcare workers, especially in orthopedic, surgical, and gynecological settings.
How can iatrogenic infections be prevented?
By washing hands (wet, lather, scrub for 20 seconds, rinse, dry), disinfecting equipment, and wearing clean clothing.
What are exceptions to aseptic technique?
Extreme clinical circumstances where time doesn’t allow for aseptic technique and allergies.
What is the effect of iodine on microorganisms?
Rapidly decreases gram-positive and gram-negative bacteria, viruses, fungi, protozoa, and yeasts for up to 3 hours.
What is chlorohexidine used for?
It is used routinely or if there is an iodine allergy; it has antimicrobial activity against gram-positive and gram-negative bacteria for up to 48 hours.
What is a time out in medical procedures?
A verification step to confirm the correct patient, site, and procedure to be performed.
What is informed consent?
A discussion of indications, risks, benefits, and alternatives to ensure that consent can be obtained.
What should be verified before opening a sterile package?
The package should be intact and the expiration date should be confirmed.
How should disinfectant solution be applied?
It should be repeated 3-4 times with new applicators.
What is a subcutaneous injection?
An injection into the adipose tissue just under the dermis at a 45-degree angle; it has a slow rate of absorption due to few vessels.
What is an intradermal injection?
An injection into the dermis just under the epidermis at a 10-15 degree angle; do not aspirate (this is debatable).
What is an intramuscular injection?
An injection into the body of the muscle at a 90-degree angle.
When should intramuscular injections not be given?
When serum enzymes are required to diagnose or treat conditions (e.g., myocardial infarction), if there is inadequate muscle mass, or if absorption is impaired (e.g., paralysis or clots).
What is an intravenous injection?
An injection into a vein through an IV line or short venous access device (saline lock) at a 25-degree angle; replace every 72-96 hours.
What are contraindications for local anesthesia?
Allergic reactions (esters are most common) and epinephrine should not be given to areas with a single dependent blood supply (e.g., finger, toe, penis, nose, pinna).
What are tension/langer lines?
If a wound is parallel to the long axis of fibers, re-approximation will occur; if perpendicular, the wound will gape.
What characterizes a clean wound classification?
Incisions made during surgery with aseptic technique, no inflammation, and potential infection rate <2%.
What characterizes a clean-contaminated wound classification?
No inflammation or infection, minor break in sterile procedure; GI, respiratory, or GU tracts can be involved without spillage; potential infection rate 8-10%.
What characterizes a contaminated wound classification?
Traumatic wounds with gross spillage (blood, bile, stool), major break in sterile technique, acute inflammation; potential infection rate 15-20%.
What characterizes a dirty/infected wound classification?
Infection present at the surgical site prior to the procedure, pus, gross spillage of stool (perforation), abscess I&D; potential infection rate 27-40%.
How is wound drainage classified by size?
1/4 or less of the bandage covered is small, 1/4-1/2 is medium, and 1/2 or more is large.
What is hemosiderin staining?
A brownish discoloration of the lower legs due to chronic venous stasis
What does induration indicate?
It indicates that the edges of the wound have extra fluid around them.
What does scar tissue look like?
It appears slightly lighter or light pink, indicating past wounds.
What is the purpose of irrigation of wounds?
To decrease bacterial load and remove loose material; it is part of routine wound management.
What is the effectiveness of silver-containing foam dressings?
They do not significantly improve ulcer healing at 4 weeks compared to non-silver-containing dressings.
How are dressings classified?
By their water-retaining ability, as the primary goal is to maintain moisture in the wound environment.
What should be done for tetanus-prone wounds?
For clean minor wounds, give a dose of tetanus vaccine if the last dose was 10+ years ago; for severe wounds, give if the last dose was 5+ years ago. If unsure about the primary series, give 3 doses (4 weeks between 1st & 2nd, then 3rd 6-12 months later).
What is the Braden scale used for?
It is the best way to assess pressure ulcers.
What are the stages of pressure ulcers according to the Braden scale?
- Non-blanchable redness, skin intact.
- Partial thickness skin loss with exposed dermis, pink/red, moist, blister.
- Full thickness skin loss, adipose & granulation visible, rolled wound edges, possible slough & eschar.
- Full thickness skin & tissue loss, exposed fascia, muscle, tendon, ligaments, cartilage, bone; possible slough & eschar, possible rolled edges, undermining, tunneling.
What is an abscess?
A focal circumscribed accumulation of purulent materials.
What is the relationship between suture size and needle size?
The bigger the suture material, the bigger the needle; the bigger the number, the smaller the size of the suture (e.g., 00 is very large, 10-0 is very tiny).
Where should sutures be placed?
In most areas (except the face), sutures should be placed in the skin 3-4mm from the wound edge and 5-10mm apart.
