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Periop 101 Final Exam Study Guide Solutions

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Periop 101 Final Exam Study Guide Solutions Major components of medical video imaging include: - ANSWER-Fiber optic light cable, Camera Control Unit (CCU) Special considerations when using a endoscopic light source are: - ANSWER-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) - ANSWER-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 - ANSWER-Smaller incisions Special considerations when using laparoscopic instruments - ANSWER-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 - ANSWER-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 Copyright © OLIVIAWEST2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 2/45 Correct fluid management procedures in MIS - ANSWER-Monitor overload of IV/irrigation fluids dispensed and returned during procedure (prevent hypervolemia/fluid overload) Mechanical Methods of Hemostasis - ANSWER-Manual pressure (sponges), hemostatic clamps, sutures, staples, clips, ligatures, and/or pledgets What is a ligature? - ANSWER-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? - ANSWER-Non-absorbable suture support used when possibility of sutures tearing through tissue Where is a pledget most commonly used? - ANSWER-Vascular closure, septal repair, heart repair and hepatic repair What is bone wax? - ANSWER-A mixture of beeswax, isopropyl, and a softening agent Where is bone wax used? - ANSWER-Ortho, neuro, and the sternum during heart procedures Chemical Methods of Hemostasis - ANSWER-Pharmocological methods (meds such as epi, vit K, protamine, lysine, tranexamic acid) Topical methods (thrombins, collagen gelatins, phenol sealants) Thermal Methods of Hemostasis - ANSWER-ECU via coagulation, bipolar sealing devices, lasers, ultrasonic energy, Argon gas Types of Surgical Sponges - ANSWER-Laps, tonsils, neuro-patties, dissector sponges, raytecs (4x4) Counting of Sponges - ANSWER-Before, during and after surgical procedures Copyright © OLIVIAWEST2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 3/45 Separate as you count Two people, one of whom is RN should count Participation in Sponge Counts - ANSWER-All personnel in case are responsible for counts including remaining aware of location of sponges RN responsibilities in Sponge Counts - ANSWER-Initiate count (any team member can initiate count??), perform count, document count activities, reporting count deficiency Drainage is achieved by ________ or ___________ means - ANSWER-passive (gravity) or active (suction) Types of Drains - ANSWER-Penrose, nasogastric, T-tube, suction drains, ches

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Periop 101 Final Exam Study Guide

Solutions


Major components of medical video imaging include: - ANSWER✔✔-Fiber optic light cable, Camera

Control Unit (CCU)


Special considerations when using a endoscopic light source are: - ANSWER✔✔-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) - ANSWER✔✔-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 - ANSWER✔✔-Smaller incisions


Special considerations when using laparoscopic instruments - ANSWER✔✔-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 - ANSWER✔✔-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




Copyright ©Stuvia International BV 2010-2024 Page 1/45

, Copyright © OLIVIAWEST2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED


Correct fluid management procedures in MIS - ANSWER✔✔-Monitor overload of IV/irrigation fluids

dispensed and returned during procedure (prevent hypervolemia/fluid overload)


Mechanical Methods of Hemostasis - ANSWER✔✔-Manual pressure (sponges), hemostatic clamps,

sutures, staples, clips, ligatures, and/or pledgets


What is a ligature? - ANSWER✔✔-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? - ANSWER✔✔-Non-absorbable suture support used when possibility of sutures

tearing through tissue


Where is a pledget most commonly used? - ANSWER✔✔-Vascular closure, septal repair, heart repair and

hepatic repair


What is bone wax? - ANSWER✔✔-A mixture of beeswax, isopropyl, and a softening agent


Where is bone wax used? - ANSWER✔✔-Ortho, neuro, and the sternum during heart procedures


Chemical Methods of Hemostasis - ANSWER✔✔-Pharmocological methods (meds such as epi, vit K,

protamine, lysine, tranexamic acid)


Topical methods (thrombins, collagen gelatins, phenol sealants)


Thermal Methods of Hemostasis - ANSWER✔✔-ECU via coagulation, bipolar sealing devices, lasers,

ultrasonic energy, Argon gas


Types of Surgical Sponges - ANSWER✔✔-Laps, tonsils, neuro-patties, dissector sponges, raytecs (4x4)


Counting of Sponges - ANSWER✔✔-Before, during and after surgical procedures




Copyright ©Stuvia International BV 2010-2024 Page 2/45

, Copyright © OLIVIAWEST2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED


Separate as you count


Two people, one of whom is RN should count


Participation in Sponge Counts - ANSWER✔✔-All personnel in case are responsible for counts including

remaining aware of location of sponges


RN responsibilities in Sponge Counts - ANSWER✔✔-Initiate count (any team member can initiate

count??), perform count, document count activities, reporting count deficiency


Drainage is achieved by ________ or ___________ means - ANSWER✔✔-passive (gravity) or active

(suction)


Types of Drains - ANSWER✔✔-Penrose, nasogastric, T-tube, suction drains, chest tubes


What are Suction Drains and their purpose? - ANSWER✔✔-Remove blood, pus, necrotic material from

wounds via suctions (Jackson-Pratt for abdominal/breast, Hemovac for ortho)


What is a Neutral Zone? - ANSWER✔✔-Designated area on surgical field where scrub and surgeon place

all sharp instruments


What is a Crile? - ANSWER✔✔-A hemostat used to control bleeders in SQ tissue


What is a Mosquito? - ANSWER✔✔-A hemostat used to control superficial bleeders in delicate surgery

(hand/plastic)


What is a Kelly? - ANSWER✔✔-A hemostat used to control bleeders in muscle tissues


What are the Surgical Powered Cutting Instruments? - ANSWER✔✔-Bone reamers, variable speed saws,

tissue shavers




Copyright ©Stuvia International BV 2010-2024 Page 3/45

, Copyright © OLIVIAWEST2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED


Care and handling of powered cutting instruments? - ANSWER✔✔-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 - ANSWER✔✔-Geographic isolation


Bacteriologic isolation through specific practices (attire, delivery/disposal systems)


Centralize equipment and supplies


What is Individualized Care? - ANSWER✔✔-Reflects art of nursing, meets individual needs of pt, provide

comfort measures


What is Standardized Care? - ANSWER✔✔-Derived from body of scientific knowledge developed through

research and clinical practice such as counting sponges


What is the Restricted Zone? - ANSWER✔✔-Located in the semi-restricted area and only accessible via

semi-restricted area; includes actual OR


How should air be cleaned in OR rooms? - ANSWER✔✔-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? - ANSWER✔✔-Equipment and sterile supply storage, SPD


What is the Unrestricted Zone? - ANSWER✔✔-Pre-Op Holding Area, Waiting Rooms, Blood/Specimen

processing


Important points about the 2 Piece Scrub Suit - ANSWER✔✔-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 - ANSWER✔✔-Can be re-usable or disposable, required by sterile

team and resistant to strike-through by fluids

Copyright ©Stuvia International BV 2010-2024 Page 4/45

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