PERIOP 101 PAPER EXAMS SET QUESTIONS AND
ANSWERS SURE A+
✔✔Gases used for insufflation include: - ✔✔• Carbon dioxide (CO2)
o The most used gas for insufflation
- Dissolves easily into the bloodstream
- Is colorless, odorless, nonflammable, and inexpensive
• Air
• Nitrogen
• Nitrous oxide
• Argon
• Helium
✔✔Gas is insufflated into the peritoneal cavity to create a __________________,
allowing for visualization of the abdominal organs and providing room in which to work. -
✔✔pneumoperitoneum
✔✔Potential complications associated with gas insufflation include: - ✔✔• Elevation in
blood pressure
• Increase in CO2 blood levels
• Acidosis
• Decreased cardiac output
• Cardiac arrythmias
• Gas embolism
• Peritoneal irritation
• Decreased renal blood flow
• Decreased urine output
✔✔An inspection tool that is placed through the instrument's lumen and is used to
inspect the internal element of the instrument - ✔✔Boreoscope
✔✔Infiltration or effusion into surrounding tissues - ✔✔Extravasation
✔✔Gas that is blown into a body cavity for visualization - ✔✔Insufflation
✔✔No-fly zone - ✔✔• Restricted area reserved for imaging equipment
• Other necessary equipment is positioned outside of this area or moved to allow for
imaging equipment use
✔✔Practices to reduce the risk for patient injures and complications associated with gas
insufflation are: - ✔✔• Placing the insufflator above the level of the surgical cavity
• Checking that the alarms are on and audible
• Ensuring that a hydrophobic filter is between the insufflator and the insufflation tubing
• Flushing the insufflator tubing with the gas that will be used for the surgery before the
tubing is connected to the cannula
,• Setting the flow rate according to the manufacturer's instructions for use and surgeon's
preference
o Maintain the pneumoperitoneum at a pressure less than 15 mm/Hg
• Maintaining insufflation pressure at the lowest level necessary for the
pneumoperitoneum and surgical site visualization
✔✔Clinical signs of a gas embolism include: - ✔✔• Dyspnea
• Systemic hypotension
• Cardiac anomalies
• Hypoxemia
• End-tidal CO2 changes
✔✔Intra-abdominal gas embolism is a rare but potentially serious complication of
insufflation because it: - ✔✔• Gas increases abdominal pressures.
• Open blood vessels allow the gas to enter the circulatory system.
• The gas embolism enters the vascular system.
• The embolism travels to the right ventricle or pulmonary artery.
✔✔Gas cylinder safety include: - ✔✔• Verify that the correct gas is being used by
checking the cylinder's label, connector, and color coding.
• Make sure there is enough gas in the cylinder.
• Check that the key can open the cylinder.
• Ensure that the cylinder is opened before use.
• Have a second, full cylinder of the same gas being used immediately available.
✔✔Fluids can be used to create a surgical working space either by gravity or pump
infusion. The fluid selected is based on the: - ✔✔• Surgical procedure
• Patient assessment
• Instruments used during the surgical procedure
✔✔Low viscosity non-electrolyte fluid is used for: - ✔✔• Gynecological and urological
procedures
• Used with monopolar instruments
• Hypotonic
• Can cause transurethral resection syndrome if large quantities are absorbed
✔✔Examples of Low viscosity non-electrolyte fluids include: - ✔✔o 1.5%glycine
o 5% mannitol
o 3% sorbitol
✔✔Normal saline is used: - ✔✔• bipolar instruments
• Isotonic
• Contains electrolytes
• Safer than non-electrolyte fluids if large amounts are absorbed
, ✔✔High-viscosity fluid used as: - ✔✔• Plasma volume expander
• Can draw six times its own volume into the bloodstream
• Has a high glucose content
✔✔High-viscosity fluid can cause significant complications such as: - ✔✔o Fluid
overload
o Heart failure
o Pulmonary edema
✔✔Type(s) of High-viscosity fluid include: - ✔✔Dextran
✔✔Benefits of robotic surgery include: - ✔✔• Precision o Surgeon hand, wrist, and
finger movements control the movements of the scope and the thin, lightweight robotic
instruments within the patient's body.
• Flexibility
o Robotic instrumentation may have more flexibility and range of motion than the human
wrist.
o Each instrument performs a specific task (eg, coagulation, cutting, retraction).
• Efficiency o The instrument's quick release from the robotic arm allows for faster
instrument changes during surgery.
• Safety
o Safety features built into the robotic system prevent inadvertent or independent
instrument or arm movements that may harm the patient.
✔✔Energy-generating device safety practices include: - ✔✔• Use the lowest power
setting possible.
• The person controlling the hand piece is the only person who should operate the foot
pedal.
• Only use trocar systems that protect the patient from errant electrical current.
• Inspect instrument insulation before, during, and after use.
• Use a scanning device during the sterilization process to ensure the instrument's
insulation is not compromised.
✔✔Chain of Infection - Reservoir: - ✔✔- Dirty surfaces & equipment
- people
- water
- animals
- insects
✔✔Chain of Infection - Mode of Transmission: - ✔✔- Contact
- droplet
- airborne (inhalation)
- ingestion
- water
- Blood
ANSWERS SURE A+
✔✔Gases used for insufflation include: - ✔✔• Carbon dioxide (CO2)
o The most used gas for insufflation
- Dissolves easily into the bloodstream
- Is colorless, odorless, nonflammable, and inexpensive
• Air
• Nitrogen
• Nitrous oxide
• Argon
• Helium
✔✔Gas is insufflated into the peritoneal cavity to create a __________________,
allowing for visualization of the abdominal organs and providing room in which to work. -
✔✔pneumoperitoneum
✔✔Potential complications associated with gas insufflation include: - ✔✔• Elevation in
blood pressure
• Increase in CO2 blood levels
• Acidosis
• Decreased cardiac output
• Cardiac arrythmias
• Gas embolism
• Peritoneal irritation
• Decreased renal blood flow
• Decreased urine output
✔✔An inspection tool that is placed through the instrument's lumen and is used to
inspect the internal element of the instrument - ✔✔Boreoscope
✔✔Infiltration or effusion into surrounding tissues - ✔✔Extravasation
✔✔Gas that is blown into a body cavity for visualization - ✔✔Insufflation
✔✔No-fly zone - ✔✔• Restricted area reserved for imaging equipment
• Other necessary equipment is positioned outside of this area or moved to allow for
imaging equipment use
✔✔Practices to reduce the risk for patient injures and complications associated with gas
insufflation are: - ✔✔• Placing the insufflator above the level of the surgical cavity
• Checking that the alarms are on and audible
• Ensuring that a hydrophobic filter is between the insufflator and the insufflation tubing
• Flushing the insufflator tubing with the gas that will be used for the surgery before the
tubing is connected to the cannula
,• Setting the flow rate according to the manufacturer's instructions for use and surgeon's
preference
o Maintain the pneumoperitoneum at a pressure less than 15 mm/Hg
• Maintaining insufflation pressure at the lowest level necessary for the
pneumoperitoneum and surgical site visualization
✔✔Clinical signs of a gas embolism include: - ✔✔• Dyspnea
• Systemic hypotension
• Cardiac anomalies
• Hypoxemia
• End-tidal CO2 changes
✔✔Intra-abdominal gas embolism is a rare but potentially serious complication of
insufflation because it: - ✔✔• Gas increases abdominal pressures.
• Open blood vessels allow the gas to enter the circulatory system.
• The gas embolism enters the vascular system.
• The embolism travels to the right ventricle or pulmonary artery.
✔✔Gas cylinder safety include: - ✔✔• Verify that the correct gas is being used by
checking the cylinder's label, connector, and color coding.
• Make sure there is enough gas in the cylinder.
• Check that the key can open the cylinder.
• Ensure that the cylinder is opened before use.
• Have a second, full cylinder of the same gas being used immediately available.
✔✔Fluids can be used to create a surgical working space either by gravity or pump
infusion. The fluid selected is based on the: - ✔✔• Surgical procedure
• Patient assessment
• Instruments used during the surgical procedure
✔✔Low viscosity non-electrolyte fluid is used for: - ✔✔• Gynecological and urological
procedures
• Used with monopolar instruments
• Hypotonic
• Can cause transurethral resection syndrome if large quantities are absorbed
✔✔Examples of Low viscosity non-electrolyte fluids include: - ✔✔o 1.5%glycine
o 5% mannitol
o 3% sorbitol
✔✔Normal saline is used: - ✔✔• bipolar instruments
• Isotonic
• Contains electrolytes
• Safer than non-electrolyte fluids if large amounts are absorbed
, ✔✔High-viscosity fluid used as: - ✔✔• Plasma volume expander
• Can draw six times its own volume into the bloodstream
• Has a high glucose content
✔✔High-viscosity fluid can cause significant complications such as: - ✔✔o Fluid
overload
o Heart failure
o Pulmonary edema
✔✔Type(s) of High-viscosity fluid include: - ✔✔Dextran
✔✔Benefits of robotic surgery include: - ✔✔• Precision o Surgeon hand, wrist, and
finger movements control the movements of the scope and the thin, lightweight robotic
instruments within the patient's body.
• Flexibility
o Robotic instrumentation may have more flexibility and range of motion than the human
wrist.
o Each instrument performs a specific task (eg, coagulation, cutting, retraction).
• Efficiency o The instrument's quick release from the robotic arm allows for faster
instrument changes during surgery.
• Safety
o Safety features built into the robotic system prevent inadvertent or independent
instrument or arm movements that may harm the patient.
✔✔Energy-generating device safety practices include: - ✔✔• Use the lowest power
setting possible.
• The person controlling the hand piece is the only person who should operate the foot
pedal.
• Only use trocar systems that protect the patient from errant electrical current.
• Inspect instrument insulation before, during, and after use.
• Use a scanning device during the sterilization process to ensure the instrument's
insulation is not compromised.
✔✔Chain of Infection - Reservoir: - ✔✔- Dirty surfaces & equipment
- people
- water
- animals
- insects
✔✔Chain of Infection - Mode of Transmission: - ✔✔- Contact
- droplet
- airborne (inhalation)
- ingestion
- water
- Blood
