Major components of medical video imaging include: - ANSWER-Fiber optic light cable, Camera Control Unit (CCU)
Special considerations when using a
... [Show More] 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
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
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
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
Important points about perioperative personnel's hair - ANSWER-Cover BEFORE surgical attire is donned, no skull caps unless covered by bouffant, wear in areas where equipment is processed and stored
Circulating RN responsibilities include? - ANSWER-Emotional support during induction
Ongoing patient assessment
Accurate and complete prep of supplies, instruments, and equipment preop for each pt
Implementing/enforcing policies and procedures
Preparing specimens
Coordinating nursing care from other health care team members
Communicating info to family and other health care team members
Documenting
Activities that are made possible with periop nursing documentation - ANSWER-Billing for finance and accounting
Supply and equipment inventory
Communication of patient care by caregivers
Planning perioperative care
Evaluation of care rendered
Documentation provides a basis for future reference for things like? - ANSWER-Ensure quality of patient care
Reconstruct a personal experience record
Evidence in a court of law
Commonly accepted nursing tools: - ANSWER-Nursing process
PNDS (Perioperative Nursing Data Set)
WHO (World Health Organization)/Joint Commission/AORN surgical safety checklists
What statements reflect the concept of critical thinking? - ANSWER-Informed practice
Holistic thinking
Unbiased thinking
Reasoned application of a step by step process
Clinical setting culture is affected by? - ANSWER-Beliefs (about the patient and periop setting)
Attitudes (desire to provide effective care, engage in critical thinking)
Values (fairness, equitable care
Skills (demonstrate critical thinking/clinical reasoning by problem-solving, situational awareness, collaboration, conflict resolution, decision-making, leadership)
What is a mentor? - ANSWER-Provides encouragement and acts as a guide and facilitator while modeling professional nursing behaviors (guide through wide range of professional activities)
What is a preceptor? - ANSWER-Teaches, counsels, inspires, serves as a role model, and supports growth and development for FIXED period of time (guide through defined clinical activities)
Questions a competent nurse might ask? - ANSWER-How does the conduction system work?
Question a advanced beginner might ask? - ANSWER-What does this patient need to support his cardiac function?
Question a novice nurse might ask? - ANSWER-Whats the anatomy and physiology of the heart? [Show Less]