Periop 101 Final Exam Questions And Answers

Periop 101 Final Exam Questions And Answers Major components of medical video imaging include: - ANS Fiber optic light cable, Camera Control Unit (CCU) Special considerations when using a endoscopic light source are: - ANS 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) - ANS Always have a backup tank available, position at the level of the patient's heart or higher to prevent gasses from contaminating the device, make sure alarm is on and audible, maintain pressure under 12 mm/Hg Advantage of endoscopic surgery versus open surgery - ANS Smaller incisions Special considerations when using laparoscopic instruments - ANS 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 - ANS 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 - ANS Monitor overload of IV/irrigation fluids dispensed and returned during procedure (prevent hypervolemia/fluid overload) Mechanical Methods of Hemostasis - ANS Manual pressure (sponges), hemostatic clamps, sutures, staples, clips, ligatures, and/or pledgets What is a ligature? - ANS 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? - ANS Non-absorbable suture support used when possibility of sutures tearing through tissue Where is a pledget most commonly used? - ANS Vascular closure, septal repair, heart repair and hepatic repair What is bone wax? - ANS A mixture of beeswax, isopropyl, and a softening agent Where is bone wax used? - ANS Ortho, neuro, and the sternum during heart procedures Chemical Methods of Hemostasis - ANS Pharmocological methods (meds such as epi, vit K, protamine, lysine, tranexamic acid) Topical methods (thrombins, collagen gelatins, phenol sealants) Thermal Methods of Hemostasis - ANS ECU via coagulation, bipolar sealing devices, lasers, ultrasonic energy, Argon gas Types of Surgical Sponges - ANS Laps, tonsils, neuro-patties, dissector sponges, raytecs (4x4) Counting of Sponges - ANS Before, during and after surgical procedures Separate as you count Two people, one of whom is RN should count Participation in Sponge Counts - ANS All personnel in case are responsible for counts including remaining aware of location of sponges RN responsibilities in Sponge Counts - ANS Initiate count (any team member can initiate count??), perform count, document count activities, reporting count deficiency Drainage is achieved by ________ or ___________ means - ANS passive (gravity) or active (suction) Types of Drains - ANS Penrose, nasogastric, T-tube, suction drains, chest tubes What are Suction Drains and their purpose? - ANS Remove blood, pus, necrotic material from wounds via suctions (Jackson-Pratt for abdominal/breast, Hemovac for ortho) What is a Neutral Zone? - ANS Designated area on surgical field where scrub and surgeon place all sharp instruments What is a Crile? - ANS A hemostat used to control bleeders in SQ tissue What is a Mosquito? - ANS A hemostat used to control superficial bleeders in delicate surgery (hand/plastic) What is a Kelly? - ANS A hemostat used to control bleeders in muscle tissues