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Perioperative Nursing > Wk 4 > Flashcards

Wk 4 Flashcards

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1
Q

What are Grasping and holding forceps used for

A

Secure drapes and diathermy quivers
Hold needles for suturing
Hold sponges/gauze
Hold skin, muscle cartilage

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2
Q

What are cutting and dissecting instruments used for

A 
Dissecting scissors 
Wire cutters
Dissect
Incise
Seperate tissues
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3
Q

What are clamps used for

A

Artery forceps
Haemostatic forceps
Mosquito forceps
Occlude vessels, crush tissues, hold tissues

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4
Q

What are retractors used for

A

Hold back wound layers and anatomical structures to allow visualisation

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5
Q

What is suction used for

A

Aspirate fluids and debris from a surgical site or body orifice

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6
Q

What is haemostasis

A

Arrest or control of bleeding
Usually through blood clotting
Can use electrosurgery and tourniquet

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7
Q

Artificial methods of haemostasis

A 
Internal or external pressure
Tourniquet 
Surgical instruments
Ligatures or ties
Ligating clips 
Bone wax
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8
Q

Mechanical haemostasis - internal or external pressure

A

Direct to site
Indirect is area adjacent
Slows bleeding to allow clotting

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9
Q

Mechanical haemostasis - tourniquet

A 
Construct blood flow
Compresses blood vessel
Used on extremities
Temporary
Bleeding needs to be controlled before tourniquet is released
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10
Q

Mechanical haemostasis - ligating clips

A 
Pinching shut over a blood vessel
Made of metal
Serrated to prevent slippage
Quick and easy to apply
Large vessels
Difficult to access areas
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11
Q

Mechanical haemostasis - bone wax

A

Sterile refined beeswax and softening agent
A mechanical barrier
Control of bone marrow oz zing from cut to bone surfaces
Rolled into small balls

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12
Q

Methods of thermal haemostasis

A

Electrosurgery
Laser
Ultrasonic surgery

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13
Q

thermal haemostasis - electrosurgery

A

Diathermy machine
Generates electrical current
Used to coagulate tissue

When electrical current meets resistance (passes through tissue) it generates heat (bursts tissue cells)
Because electrical current takes path of least resistance the placement of a diathermy plate (dispersive electrode) is important
Sticky gel plate, once only application, close to operative site, well vascularised/muscular area, no scars, prosthesis or hair, applied after positioning

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14
Q

What is a diathermy plate and how is it relevant

A

When electrical current meets resistance (passes through tissue) it generates heat (bursts tissue cells)
Because electrical current takes path of least resistance the placement of a diathermy plate (dispersive electrode) is important
Sticky gel plate, once only application, close to operative site, well vascularised/muscular area, no scars, prosthesis or hair, applied after positioning

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15
Q

Chemical methods of haemostasis

A

Gelatine sponge
Oxidised cellulose
Thrombin
Adrenaline

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16
Q

Chemical methods- gelatine sponge

A

Pliable and absorbable
Up to 45 times it own weight in blood
Foamy consistency

17
Q

Chemical methods - oxidised cellulose

A

Absorbable
Knitted fabric
Swells in size when contact with blood
Forms gelatinous blood clot with mesh

18
Q

Chemical methods - thrombin

A

Reacts with fibrinogen to form clots

19
Q

Chemical methods - adrenaline

A

Causes vasoconstriction
Not recommended for extremities
Only fingers, toes, genitals, nose, ears

20
Q

Instrumentation method of haemostasis

A

Haemostatic clamps: clamped onto end of bleeding vessel
Ties: strand of material tied around a vessel to occlude lumen
Sutures

21
Q

Types of sutures

A

Absorbable and non absorbable

Synthetic and non synthetic

22
Q

Tensile strength of sutures

A

Knot pull strength of suture

As tensile strength of suture increases so does the diameter of strand

23
Q

Suture sizing

A

Diameter of strand
Largest and strongest is 5
Smallest and weakest is 10/0

24
Q

Suture needles and the different types

A

Three basic components: point, body/shaft, eye
Tapered: no cutting edge, tissue with little resistance
Cutting: cutting edge, tough tissues
Spatula: flattened needle shaft, opthalmology
Trocar: highly sharpened point, tough tissue, small hole

25
Q

Needle body /shaft

A

Part of needle grapes when in use

May be curved or flat

26
Q

Needle eye

A

Swagged/eyeless needle: attached to suture material, diameter of needle matches size of suture
Closed eye: round, oblong or square eye similar to household needle
French eye: has slit from inside the eye to the end of the needle with ridges that catch and hold the suture in place, results in double strands going through skin

27
Q

Suture classification

A

Monofilament: single strand that resists fluids soaking into it

Multifilament: multiple strands held together by a process of twisting, braiding or spinning (capacity to absorb body fluids) less sterile

28
Q

Absorbable sutures

A

Digested by body enzymes or hydrolysis
Lose strength and gradually disappear
Prepared from collagen or synthetic polymer
Used on fast healing tissues

29
Q

Natural absorbable sutures

A

Plain or chromic - results in closer absorption rate
Packaged in fluid to maintain pliability
Should only be handled when moist
Handled as little as possible

30
Q

Synthetic absorbable sutures

A 
Packaged and used dry
Hydrolyse in body fluid 
Monofilament, braided, coated or uncoated
Tensile strength is high
Can be used in presence of infection
31
Q

Non absorbable sutures

A

Encapsulated in fibrous tissue during healing process
Remain in body until surgically removed
Useful for slower healing areas

32
Q

Natural non absorbable sutures

A 
Thread from silkworm
Braided or multifilament
Treated to improve tensile strength
Relatively strong
Can't be used if signs of infection
33
Q

Synthetic non absorbable suture

A

Polyester and polymides
Less irritation and higher tensile strength than natural fibres
Mono or multi
Smooth and inert
Used in delayed healing, infection, intended tissue support is required

34
Q

Metallic non absorbable sutures

A 
Mono
Greatest tensile strength of all
Inert, nonmagnetic, electro passive in tissue fluids
In infection or slow healing areas
Cutting requires wire scissors
Avoid kinking
35
Q

Most surgical instruments are made out of what

A

Stainless steel, titanium, vitallium, other

Perioperative Nursing (7 decks)

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