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Periop 101 Final Exam|248 Answered Questions Distinction Graded
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Periop 101 Final Exam|248 AnsweredQuestions Distinction Graded
Major components of medical video imaging include: - -Fiber optic light
cable, Camera Control Unit (CCU)
-Special considerations when using a endoscopic light source are: - -Place in
"standby" mode, do not turn on until light cable is connected to the
telescope, set according to manufacturer's parameters
-Special considerations when using insufflation (establishing a
pneumoperitoneum) - -Always have a backup tank available, position at the
level of the patients heart or higher to prevent gases from contaminating the
device, make sure alarm is on and audible, maintain pressure under 12
mm/Hg
-Advantage of endoscopic surgery versus open surgery - -Smaller incisions
-Special considerations when using laparoscopic instruments - -Scrub
should inspect more closely because of unapparent defects that may not be
apparent with casual observation, focus on insulation because of risk for
thermal burns if not intact
-Special considerations for patient undergoing MIS/Endoscopic Surgery - -
Previous incisions (Hasson minilap) that may require additional sterile
supplies, hx of DVT, consent for possibility of open procedure, voiding to
empty bladder and prevent puncture during trocar placement/unnecessary
catheterization
-Correct fluid management procedures in MIS - -Monitor overload of
IV/irrigation fluids dispensed and returned during procedure (prevent
hypervolemia/fluid overload)
-Mechanical Methods of Hemostasis - -Manual pressure (sponges),
hemostatic clamps, sutures, staples, clips, ligatures, and/or pledgets
-What is a ligature? - -Also known as a tie, strand tied around a blood vessel
to occlude bleeding; large vessels may require transfixion suture (crosscriss
stitch)
-What is a pledget? - -Non-absorbable suture support used when possibility
of sutures tearing through tissue
, -Where is a pledget most commonly used? - -Vascular closure, septal repair,
heart repair and hepatic repair
-What is bone wax? - -A mixture of beeswax, isopropyl, and a softening
agent
-Where is bone wax used? - -Ortho, neuro, and the sternum during heart
procedures
-Chemical Methods of Hemostasis - -Pharmocological methods (meds such
as epi, vit K, protamine, lysine, tranexamic acid)
Topical methods (thrombins, collagen gelatins, phenol sealants)
-Thermal Methods of Hemostasis - -ECU via coagulation, bipolar sealing
devices, lasers, ultrasonic energy, Argon gas
-Types of Surgical Sponges - -Laps, tonsils, neuro-patties, dissector
sponges, raytecs (4x4)
-Counting of Sponges - -Before, during and after surgical procedures
Separate as you count
Two people, one of whom is RN should count
-Participation in Sponge Counts - -All personnel in case are responsible for
counts including remaining aware of location of sponges
-RN responsibilities in Sponge Counts - -Initiate count (any team member
can initiate count??), perform count, document count activities, reporting
count deficiency
-Drainage is achieved by ________ or ___________ means - -passive (gravity)
or active (suction)
-Types of Drains - -Penrose, nasogastric, T-tube, suction drains, chest tubes
-What are Suction Drains and their purpose? - -Remove blood, pus, necrotic
material from wounds via suctions (Jackson-Pratt for abdominal/breast,
Hemovac for ortho)
-What is a Neutral Zone? - -Designated area on surgical field where scrub
and surgeon place all sharp instruments
-What is a Crile? - -A hemostat used to control bleeders in SQ tissue
-What is a Mosquito? - -A hemostat used to control superficial bleeders in
delicate surgery (hand/plastic)
, -What is a Kelly? - -A hemostat used to control bleeders in muscle tissues
-What are the Surgical Powered Cutting Instruments? - -Bone reamers,
variable speed saws, tissue shavers
-Care and handling of powered cutting instruments? - -Always hand to
surgeon with safety on, always use with drill guard in place, always have
irrigation ready because of heat generation
-What are the Critical Concepts to the Periop Environment - -Geographic
isolation
Bacteriologic isolation through specific practices (attire, delivery/disposal
systems)
Centralize equipment and supplies
-What is Individualized Care? - -Reflects art of nursing, meets individual
needs of pt, provide comfort measures
-What is Standardized Care? - -Derived from body of scientific knowledge
developed through research and clinical practice such as counting sponges
-What is the Restricted Zone? - -Located in the semi-restricted area and
only accessible via semi-restricted area; includes actual OR
-How should air be cleaned in OR rooms? - -Via HEPA filter, under POSITIVE
pressure and by 20 air exchanges per hour (minimum of 4 exchanges from
outdoor air)
-What is the Semi-Restricted Zone? - -Equipment and sterile supply storage,
SPD
-What is the Unrestricted Zone? - -Pre-Op Holding Area, Waiting Rooms,
Blood/Specimen processing
-Important points about the 2 Piece Scrub Suit - -Lint free, minimize
bacterial shedding; secure at waist, tuck into pants and fit closely to the
body to prevent skin cells from shedding
-Important points about Sterile Gowns - -Can be re-usable or disposable,
required by sterile team and resistant to strike-through by fluids
-Important points about perioperative personnel's hair - -Cover BEFORE
surgical attire is donned, no skull caps unless covered by bouffant, wear in
areas where equipment is processed and stored
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