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Periop 101 Questions and 100% Verified Correct Answers Guaranteed A+, Complete Document for Exam
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Periop 101 Questions and 100% Verified Correct Answers Guaranteed A+, Complete Document for Exam
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Periop 101. . . the problems they present may not be apparent upon casual observation. Special attention
should be focused on the condition of the insulation. Electrical current will escape through any
break in the insulation, and thermal burns can result from these breaks. - ANS-Laparscopic
instruments should be thoroughly inspected because . . .
"changes within health care organizations will have the most direct impact on making care
delivery processes safer for patients" - ANS-The Institute of Medicine (IOM) Report stated that,
"______________________________________________________________________"
* - ANS-Compare competent nurse with novice nurse . . .
* A combination of liquid monomers from polymers in the presence of water and act as a liquid
topical skin adhesive which can be used as a replacement for sutures. - ANS-Description of skin
adhesives
* A sense of trust among team members.
** Development and support of a proactive approach rather than a reactive, blaming approach.
* Dissemination and verification of receipt of information to all levels of staff and management.
* A sincere commitment to affirming safety as the first priority. - ANS-Culture of safety includes:
* Airway - Always FIRST
* Monitor for BP, SaO2, HR
* LOC
* Pain and PONV - ANS-What should the perioperative nurse know about a patient that is
admitted to Phase 1 Postanesthesia Care?
* alcohol-based skin antiseptic
* pooling or soaking of flammable antiseptics
* drips or excess solution
* saturated materials not removed before draping
* not allowed time to dry
* not made aware of flammable substances
* heating of flammable skin antiseptics - ANS-fire risks (fuel sources)
* All perioperative personnel involved in a surgical case are responsible for the accuracy of the
sponge count.
* Each has a duty to remain aware of the location of the sponges on the sterile field and in the
wound.
* Two people, one of whom is the RN circulator, must perform the sponge count.
,* The scrub person should maintain awareness of the location of all soft goods (e.g, ray-tecs,
towels, textiles).
* The scrub person and the CRN should count sponges simultaneously and audibly as each
sponge is separated from others in the pack before the beginning of the operation, before any
closure begins, and when skin closure is begun.
* All sponges must remain in the same OR room until the count is complete. - ANS-Participation
guidelines for sponge counts
* Also referred to as a spring or split eye.
* The suture strand is pulled through the slit to secure.
* This needle must be used with pliable, braided material such as silk, or with cotton suture in a
medium to fine size.
* French eye needles are not practical to be used with surgical gut, because they may fray the
suture. - ANS-french eye needle
* Always hand powered instrument to surgeon with safety turned on
* Always use instrument with blade or drill guard in place
* Always have irrigation ready to use with drill or saw because they generate enough heat to
injure or burn surrounding tissue - ANS-care & handling of powered instruments
* Always have a back-up tank of CO2 available.
* The insufflator should be positioned on the cart at the level of the patient's heart or higher to
prevent intra-abdominal fluids or gases from contaminating the device.
* Most insufflators have alarms and displays to show actual CO2 pressure and CO2 supply
levels. Make sure the alarm is on, is audible, and working correctly.
* Maintaining intra-abdominal pressure UNDER 12 mmHg IN ADULT PATIENTS reduces the
risk of systemic hemodynamic changes. - ANS-Precautions with CO2 insufflation
* anesthetize on gurney, then log roll to bed
* prevent foot drop
* rotate arms slowly
* protect eyes
* reduce pressure on inferior vena cava and femoral veins
* prevent pressure on carotid artery (can cause HoTN and arrhythmias)
* maintain respiratory effort by reducing compression on diaphragm
* reduce airway pressure and weight against abdominal wall - ANS-key points for prone position
* anxiety about an uncertain outcome
* discomfort or pain
* fear of the unknown
* limited time for assessment and teaching - ANS-Barriers to effective patient and family
education in perioperative settings include
* AORN - has guidelines for autologous tissue mgmt
,* AATB - The American Association of Tissue Banks
* FDA - US Food and Drug Administration - ANS-Organizations that provide guidelines r/t
surgical tissue banking
* AORN: has guidelines for autologous tissue mgmt, or auto-transplantation on or in the same
patient
* AATB (American Association of Tissue Banks)
* FDA (US Food and Drug Administration) - ANS-What organizations provide guidance related
to surgical tissue banking?
* Assists in achieving accuracy during the count procedure.
* Assists in conducting efficient counts
* Human error studies have shown that many errors result from deviation
* Provides continuity among all team members - ANS-The benefits of a standardized count
procedure include the following
* Billing documents for finance and accounting
* Supply and equipment inventory
* Communication of patient care by caregivers - ANS-Important examples of activities that are
made possible with perioperative nursing documentation:
* buttocks are even with lower break in bed to prevent lumbosacral strain
* padded arm boards
* drop in BP if legs lowered too quickly
* compression of abdominal contents on the inferior vena cava and abdominal aorta
* nerve damage to femoral, obturator, and perineal nerves can occur with this position -
ANS-Key points for lithotomy position
* Clean care is safe care - focus on hand hygiene.
* Safe Surgery Saves Lives - the WHO Surgical Safety Checklist came from this initiative
* Surgical Hand Preparation - includes discussion on the length of preoperative hand antisepsis,
encouragement of the use of brushless hand scrubs, and review of hand scrub preparations -
ANS-World Alliance on Patient Safety initiatives include:
* Clean off external debris during the case with a moistened sponge.
* Flush channels with sterile water to remove gross soil during surgery. Sterile water is
recommended because saline water can cause erosion of metal surfaces.
* Test scissors for sharpness prior to sterilization. - ANS-Cleaning endoscopic instruments
* collagen remodeling
* tensile strength gain - ANS-Events that occur during the remodeling phase of wound healing
* Counts are performed before, during, and after surgical procedures.
, * Sponges are to be separated as they are counted.
* Two people, one of whom is the RN circulator, should count the sponges simultaneously and
audibly as each sponge is separated. - ANS-Counting sponges
* Current medications and dosages.
* Medication allergies and idiosyncratic responses.
* Potential interaction with other medications.
* Herbal or dietary supplements.
* Patient's weight, age, and existing disease or condition. - ANS-Relevant patient history
information
* Decrease and slowing of blood flow from coronary arteries > decreased rate of medication
absorption > need for DVT prophylactic devices.
* May need warming devices to maintain normothermia.
* Position may have to be adapted for effective air exchange.
* Decreased sensation to pain and body temperature variations.
* May have problems with depth and color perception, as well as dry eyes. - ANS-Geriatric
concerns
* decreases in barrier quality after 75 - 100 laundry or sterilization cycles - ANS-reusable drapes
* Discard sponges in plastic-lined receptacle. Count bag.
* Bag all soiled linen and used disposable items in the proper bags prior to removal at end of
procedure.
* Clean up spills immediately with effective disinfectant.
* Remove soiled shoe covers before leaving OR.
* Items contaminated with body fluids should be discarded into appropriate impervious
biohazard waste receptacles.
* Unused sponges, nonwoven drapes, and other non-bloody disposable waste are placed in
trash.
* All disposable sharps such as blades, needles, stapling devices, pins, and cautery tips should
be discarded in a sharps disposal container. - ANS-Standard methods and procedures to
CONFINE AND CONTAIN contamination and PHYSICALLY REMOVE microorganisms:
* Disposable stapling sets, or single instruments, come preassembled and sterile.
* These instruments are self-contained, lightweight, and available in a variety of sizes. -
ANS-Characteristics of disposable stapling instrument sets
* distraction
* fatigue and/or sleep loss
* drugs
* juggling multiple activities
* stress
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