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SURGICAL NURSING - Surgery

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What are the 3 primary duty areas involved with surgery?
Primary duty areas for surgery include: anesthetist, prep, and assistant.
How often are vitals charted during anesthesia?
Vitals are charted every 15 minutes during anesthesia.
Which veterinary team member most often performs the prophy?
The anesthetist most often performs the prophy.
What is the first task of the anesthetist?
The anesthetist will first calculate and administer induction agent.
Which veterinary team member is responsible for monitoring and charting vitals and EKG during surgery?
The anesthetist is responsible for monitoring and charting vitals and EKG during surgery.
What is the role of the anesthetist?
The anesthetist will calculate and administer induction agent, place catheter, intubate patient, induce anesthesia, and monitor.
What are some of the responsibilities of the prep team?
The prep team will restrain for administration of anesthetic, express bladder, prep catheter site, prep surgery site, transport to surgery suite, monitor, and clean.
How is a surgery site prepared?
The surgery site is prepared by clipping with #40 blade and surgically scrubbing area.
What is the purpose of the unsterile assistant?
The unsterile assistant acts as a gopher to fetch required supplies and equipment, and will help anesthetist to set up.
What are some specific dental preparation duties?
Specific dental preparation duties include: assisting doctor or anesthetist with physical exam, setting up for catheter placement, and setting up dental trays.
What supplies should be on hand for catheter placement for a dental procedure?
Supplies needed for catheter placement include: 2 catheters, 1 adaptor plug, 3cc syringe with heplock, tape, clippers, and surgical scrub materials.
Which solution is most commonly used as a rinse in dental procedures?
Chlorahexadine is most commonly used as a rinse during dental procedures.
What time of day are dental procedures usually performed?
Dental procedures are usually performed late morning.
Which safety equipment should be laid out before performing dental procedures?
For safety purposes, the following equipment should be available: 2 caps, 2 masks, 2 goggles, and 3 to 4 sets of gloves.
Why is it necessary to express bladder?
If bladder is enlarged, it is more likely to get nicked during surgical procedures.
What should be sprayed on surgical site while prepping an animal for a procedure?
Betadine should be sprayed on site to keep it clean before procedure is begun.
What should be the minimum reading on the oxygen tank before performing anesthesia?
The oxygen tank should be checked to ensure that reading is above 50 PSI.
What should be the minimum gas level in vaporizer before performing anesthesia?
The gas levl in vaporizer should be at half or above.
What is the main purpose of checking the anesthesia prior to use?
The anesthesia machine should be checked for damage, leaks, and capability of maintaining air.
What is the purpose to using surgical hand scrub?
Surgical hand scrub is used to reduce microorganisms on hands and arms.
What is the recommended scrub procedure?
Wash hands with antibacterial soap and water, clean underneath fingernails, use scrub brush from fingertips to 1 inch above elbows keeping arms elevated, and rinse.
How long should the process of scrub procedure take?
Scrub process should take 2.5 minutes for each side, or 5 minutes total for a one-time scrub.
What is the purpose of sterile gowning and gloving?
Sterile gowning and gloving is used to eliminate microorganisms that could come into contact with surgical instruments or patient.
What part of the gown is considered sterile?
The part of the gown considered sterile is the front area above the waist.
What is the sterile gowning procedure?
Grasp gown my shoulder seams, advance arms into sleeves one at a time while keeping fingers inside sleeve, spread arms apart to get gown on shoulders, and wait for prep team member to tie in.
What are the 2 types of gloving?
The 2 types of gloving are open and closed.
What is the purpose of scalpels?
Scalpels are used to separate tissues with the least amount of trauma.
How are different sizes of scalpels identified?
Different sizes of scalpels are identified with a stamp at end of handle.
Which size scalpel handle is used for small animal surgery?
Small animal surgery uses a #3 scalpel handle.
What size scalpel handle is used for large animal surgery?
Large animal surgery uses a #4 scalpel handle.
What size blades are used with a #3 scalpel handle?
Blades used with a #3 scalpel handle are 10, 11, 12, and 15.
Which blades are most commonly used with a #3 scalpel handle?
The most commonly used blades with a #3 scalpel handle are 10 and 15.
What is the difference in use between the 10 and 15 blade?
The 10 blade is used for thick fibrous tissue while the 15 blade is used for delicate tissue and ocular work.
How are the different types of scissors classified?
Scissors are classified according to use, point type, blade type, and cutting edge.
How are points described on scissors?
Scissor points can be blunt-blunt, sharp-sharp, or sharp-blunt.
What are the 2 types of cutting edges on scissors?
The 2 types of cutting edges on scissors are plain or serrated.
What are the 2 types of blades on scissors?
Scissors may have either curved for straight blades.
What are the 3 main uses for scissors used for classification?
The 3 main uses for scissors are operating, bandage, and cast.
What are 5 types of operating scissors?
Operating scissors include: mayo, metzenbaum, iris, suture, and suture removal.
What is the difference between mayo and metzenbaum operating scissors?
Mayo scissors are thicker and are utilized to cut tougher tissues, and metzenbaum scissors are thinner and used to cut delicate tissues.
What are the characteristics of iris scissors?
Iris scissors are very sharp and small, and are used to cut delicate tissues in small areas.
Which operating scissors are comparable to standard surgical scissors?
Suture scissors are comparable to surgical scissors.
What are the characteristics of suture scissors?
Suture scissors are used to cut suture material, are short and heavy, and usually have at least 1 serrated blade.
What are the characteristics of suture removal scissors?
Suture removal scissors are lightweight with a hollowed out area on one of the blades to avoid putting pressure on the site.
Hiow are forceps classified?
Forceps are classified by use.
What are 3 types of thumb forceps?
Thumb forcep types incloude: dressing, tissue, and adson.
What are the characteristics of dressing forceps?
Dressing forceps have no teeth and are used to handle viscera and blood vessels.
What are the characteristics of tissue forceps?
Tissue forceps are classified by their teeth, and are used to handle skin and dense tissues.
What are the 2 classifications of tissue thumb forceps?
The 2 classifications of tissue forceps are mouse tooth and rat tooth.
What is the difference between mouse tooth forceps and rat tooth forceps?
Mouse tooth forceps have 3 teeth, while rat tooth forceps have more than 3 teeth.
What are the characteristics of adson thumb forceps?
Adson thumb forceps have teeth along the side, and are used to apply a minimal amount of trauma to tissues.
What is the purpose of hemostats?
Hemostates are used to hold and clamp vessels to control bleeding.
What are 6 examples of hemostats?
Examples of hemostats are: rochester-pean, rochester-ochsner, rochester-carmalt, kelly, crile, and halsted mosquito.
What is the difference between rochester-pean and rochester-ochsner hemostats?
Rochester-pean hemostats have transverse grooves across jaws, and rochester-ochsner has small teeth at end of jaws in addition to grooves.
What is the purpose for using Rochester-Pean hemostats?
Rochester-Pean hemostats are most commonly used to control large bundles of tissues or larger vessels.
What are the characteristics of Rochester-Carmal hemostats?
Rochester-Carmalt hemostats have longitudinal grooves in jaws and crossgrooves at tip.
What is the difference between Kelly and Crile hemostats?
Kelly hemostats have grooves halfway down jaws while Crile hemostats have grooves all the way down the jaw.
What is the purpose of the Halsted Mosquito hemostat?
The Halsted Mosquito hemostate is used to clamp very small vessels.
What are 4 types of misvcellaneous forceps?
Miscellaneous forceps include: Allis tissue, alligator, sponge, and towel clamps.
What are 3 types of towel clamps?
Types of towel clamps include: Backhaus, Roeder, and Jones.
What is the purpose of towel clamps?
Towel clamps are used to hold towels in place during surgery.
What are the characteristics of Allis tissue forceps?
Allis tissue forceps have strong holding power and yet apply minimal pressue.
Which forceps is used for retrieving small objects?
Alligator forceps are used for retrieving small objects such as grass awns from ears.
Which towel clamp has balls to prevent deep tissue puncture?
Roeder towel clamps have balls on jaws which help prevent deep tissue punture.
What are the 2 most used needle holders?
The 2 most used needle holders are Mayo-Hegar and Olsen-Hegar.
What is the purpose of retractors?
Retractors are used to hold two opposing sides apart.
What is the most commonly used retractor?
The most commonly used retractor is the Weitlaner retractor.
What is the pre-check process for the anesthesia machine?
Check that oxygen tank is above 50 PSI, check that gas level is above half full in vaporizer, check hoses and inspiration prots for good seal, check baralyme granules, check rebreathing bag, and flush system using o2 valve to check for leaks.
What is the post-check process for the anesthesia machine?
Disconnect endotracheal tube and disinfect end of y piece hanging to drain, disconnect rebreathing bag and rinse and hang to dry, check to ensure o2 levels are above 50PSI and turn off oxygen, check gas levels, clean out valves and connections weekly.
What is autoclaving?
Autoclaving is the process by which microorganisms are killed with use of steam.
What should the water level be in the autoclave reservoir?
The water level in reservoir should be 1/2 to 3/4 full.
What is the bare minimum time period for using the autoclave?
The minimum time period for autoclave is 13 to 14 minutes.
What is the recommended autoclave time period for most instrument packs?
The best time period for most instrument packs to be sterilized in autoclave is 30 to 45 minutes.
What is the optimal autoclaving temperature?
The optimal autoclaving temperature is 250 degrees F.
How is the autoclave chamber filled with water?
Chamber is filled with water by turning control knob to "fill" position until indicator tab is covered by water.
What is done after the autoclave chamber is filled with water?
After chamber is filled with water, control knob needs to be set to "sterilize" position.
What should be done after the autoclave time has been completed?
After autoclave time has been completed, turn indicator knob to "dry sterilization".
At what temperature should autoclave control knob to "vent" position?
When temperature has been reduced to 175 degrees F, control knob should be sent to "vent".
How long should autoclave be vented?
Autoclave should be vented for 15 minutes.
At what temperature should autoclave be opened?
Autoclave should be opened once temperature reaches 100 degrees F.
How long should packs remain in autoclave after machine is turned off?
Packs should remain in opened autoclave for 10 minutes to dry and cool.
What is the basic autoclaving procedure?
Check water level, fill chamber and set to "sterilize", load packs, close and lock door, set on "steam sterilization", set timer for 30 to 45 minutes, after that time set on "dry sterilization" until temperature reaches 175 degrees F, turn setting to "vent" for 15 minutes, turn autoclave off, let packs sit for 10 minutes.
What is cold sterilization?
Cold sterilization is a process using chemical disinfectant to soak instruments that are not used in major procedures.
What are examples of instruments that are commonly cold sterilized?
Instruments that are commonly cold sterilized are: hemostats, thumb forcepts, needle drivers, needles.
What is the difference between antiseptics and disinfectants?
Antiseptics go on living tissue, while disinfectant goes on inanimate objects.
How often should disinfectant used for cold sterilization be changed?
Cold sterilization disinfectant should be changed weekly.
What is the process for instrument care following surgery?
Remove all sharps, place needles in needle rack, put instruments in sink and soak in cold water, scrub with brush and rinse, place in ultrasonic cleaner, dip in instrument milk, place on towel to dry.
What should be written on the autoclave tape?
The autoclave tape should have initials of pack preparer, date autoclaved, and type of pack.
When should a pack be repacked and re-autoclaved?
A pack should be repacked and re-autoclaved if not used within a month, if it becomes wet or dirty, or if a break in wrap material occurs.
How should packs be stored?
Packs should be stored in an area with low humidity as airtight as possible, and rotated according to date.
Why should instruments not be ratcheted before autoclaving?
Autoclaving can cause ratchets to weld together.
Why should warm water not be used to soak bloody instruments?
Bloody instruments should not be soaked in warm water because warm water sets blood causing corrosion.
What is the maximum time that instruments should be in an ultrasonic cleaner?
Instruments should not be in an ultrasonic cleaner longer than 15 minutes.
What are single packs or pouches used for?
Single packs or pouches are used for autoclaving gauze, suture material, or single instruments.
Where should the sterilization indicator strip be placed?
The sterilization indicator strip should be placed as close to the middle of the pack as possible.
Why should the autoclave be not vented longer than 15 minutes?
Venting the autoclave longer than 15 minutes causes a vacuum to form, making it difficult to open door.
What is the difference between a four corner drape and a fenestrated drape?
The fenestrated drape has a perforation, and four corner drapes are set around the surgical area.

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