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Stack #26033

CHAP 2 PREOPERATIVE PREPARATION

PART 2 PREOP PREPANSWER
Room temp for infants and children shoud be maintained as warm as 85oF
Areas needing special cleaning attention on a weekly or monthly routine would include ceiling and wall mounted fixtures and tracks
A glass suction bottle should ideally be cleaned with a disinfectant solution and autoclaved before reuse
Storage shelves must be cleaned with a germicide each week
While a surgical case is in progress doors should remain closed
When cleaning the floor between cases a clean mop head must be used each time, a two-bucket system, one detergent and one clear water, is used, buckets must be empited and cleaned between ea case, ALL OF THE ABOVE
A dropped sterile item may only be used if the wrapper is imprevious and contact area is dry
In the event that a child needs emergency surgery, and the parents cannot be located to sign the permission a written consultation by two physicians other than the surgeon will suffice
The surgical concent form can be witnessed by ea of the following EXCEPT the surgeon, the nurse, an authorized hospital employee, THE PATIENT'S SPOUSE
A general concent form is a form authorizing all treatments or porcedures
The ultimate responsibility for obtaining consent lies with the surgeon
The surgical consent is signed before administration of preoperative medications
an informed consent protects patient from unratified or unwanted procedures and preotects the surgeon and the hospital from claims of an unauthorized operation
Implied consent is allowed by law in emergencies when no other authorized person may be contacted
Which position would be the most desirable for a pilonidal cystectomy or an hemorrhoidectomy Kraske
a postition often used in cranial procedures is called Fowler's
in positioning for laminectomy, rolls or bolsters are placed longitudinally to support the chest from axilla to hip
the position used for a patient in hypovolemic shock is modified Trendelenbrug
A Mayfield table would be used for which type of surgery neurologic
Good exposure for thyroid surgery is ensured by all of the following EXCEPT modified dorsal recumbent with shoulder roll, hyperextension of the neck, utilization of skin-stay
A procedure requiring the patient to be positioned supine in modified lithotomy is Abdominoperineal resection (APR)
In which procedure may the patient be placed in a supine position with the right side slightly elevated by a wedge to tilt the patient to the left Cesarean section
The position for most open bladder surgery would be supine, bolster under pelvis
In which circumstance could the patient sustain injury to the pudendal nerves positioned on the fracture table
Which factor is important to consider when positioning the aging patient skeletal changes, limited range of motion of joints, tissue fragility, ALL OF THE ABOVE
When positioning the patient for a procedure, which of the following provides maximum patient safety and maximum surgical site exposure patient;s body doesn't touch metal on table, equipment, Mayo stand, and personnel are not resting on pt, bony prominences are padded, ALL OF THE ABOVE
When preparing a patient for a breast biopsy, a breast scrub is either eliminated or done very gently because of dispersal of cancer cells
The ideal place to do the shave prep is in the holding area of the OR
Any area that is considered contaminated should be scrubbed last or separately
In preparation for surgery, skin should be washed and painted from the incision site to the periphery in a cirucular motion
Preliminary preparation of the patient's skin begins with a preoparative shower
Suction tubing is attached to the drapes with a nonperforating clamp
When draping a table, the scrub nurse shoud drape front to back
A seamless, stretchable material often used to cover extremities during draping stockinette
Drapes are placed on a dry area
which statement demostrates a break in technique during the draping process gloved hands may touch the skin of the patient
A head drape consists of medium sheet, towel, towel clip
Gowns are considered sterile only from chest to sterile field level, and sleeves from elbow to cuffs
An acceptable action when drying the hands and arms after the surgical scrub is to dry thoroughly, cleanest area first
Which statement regarding the scrub procedure is not true renders the skin aseptic
If the scrub nurse needs to change a glove during an operation the circulator pulls the glove off
Which statement regarding the removal of gown and gloves doesn't meet safe criteria The gloves are removed before the gown
An effective surgical scrub procedure is time method and brush-stroke method
Regarding the surgical scrub, which statement would violate acceptable practice nail polish may be worn if freshly applied
Eyewear, goggles and/or facesshields should be worn on every case
the surgical scrub is mechanical washing and chemical antisepsis of the skin
Scrub technique endos 2 inches above the elbow
Which statement reagarding the surgical scrub indicates INAPPROPRIATE preparation by the scrub nail polish may be worn, if not chipped
Which statement best decribes an effective surgical hand scrub time or number of strokes, ahnd to elbow sequence
The brush-stroke method of scrubbing prescribes the number of strokes required. Indicate the number for ea: nails, fingers, hand and arms 30,20,20,20
A surgical treatment for scoliosis (is a lateral deviation of the spine) could employ the use of Harington rods (are internal splints that help maintain the supine as straight as possible)
What is a lebsche used for A Lebsche sternum knife is used in chest surgery to open the sternum
A rongeur used extensively in surgery of the spine and in neurosurgery is the Kerrison rongeur (available in several angles)
Bakes are common duct dilators and have maleable shafts in sizes 3-11mm. they are used to explore the common bile duct
A rib retractor is a Finochietto
A Doyen is a rib raspatory
The instrument used to enlarge the burr hole made during a craniotomy is Rongeur. (an electric drill or a hand perforator is used to make the burr holes. a rongeur is used to enlarge the burr hole)
Wescott scissors are used in ophtalmic surgery
The instrument used in a splenectomy is a pedicle clamp (For splenectomy prepare a basic laparotomy set plus two large right angled pedicle clamps and long instruments and hemostatic material)
Bowman probes are used in to probe the lacrimal duct in a dacrocystorhinostomy and in lacrimal probing to open a closed lacrimal drainage system
A Hurd dissector and pillar retractor is used in tonsillectomy to free the tonsil lobe from its attachments to the pillars
The lempert elevator is used in surgery of the delicate ear surgery
A Scoville retractor is used in a laminectomy
A Bailey is a rib approximator and is used to approximate the ribs for closure of the thoracic incision before closure of the chest
A Sauerbruch is a rib rongeur used to resect a rib and is found in a thoracotomy rib instrument bone set
An Auvard is a speculum that is weighted fro use in the bagina
A babcock is used to grasp delicate structures
Nasal cartilage is incised with Ballenger swivel knife
A self-retracting retractor is a Weitlaner
A rectal speculum is a Hill
A small fine needle holder used in plastic surgery is a Webster
A kidney pedicle clamp is a Herrick
Uterine dilators are Hanks
On which set would a Jenning's mouth retractor be found tonsillectomy set
An instrument used to retrieve a needle biopsy from either thyroid, liver, kidney or prostate is Silverman biopsy needle
The instrument used for a corrective rhinoplasty is a freer elevator to undermine the skin of the nose and free the periosteum and perichondrium
The instruments found on an intestinal set up are The Doyen clamps that come straight or curved
The retractor in a thorocotomy set to separate the ribs is the Bailey rib retractor
What is the Green retractor It is a goiter retractor also known as a loop retractor. It is used to retract the sternocleidomastoid muscle during thyroidectomy
An instrument found in a major bone set is a Stille-Luer Duckbill rongeur. It is used to bite off sharp, irregular bone edges
What is a Davidson A Davidson is a scapula retractor. It is found in a thoracotomy set
The instrument used to grasp lung tissue is the Duval forceps is alung-grasping forcep and is included in the instrumentation for lobectomy and pheumonectomy
The instruments found on a vascular set up are The stinsky and DeBakey are vascular clamps, and the Pott Smith is an angled or straight vascular scissors. The DeBakey cross action bulldog is a clamping instrument
The instrument known as bulldog is A DeBakey bulldog is a cross action clamp, straight or curved. It is used for occlusion of major perpheral arteries.
What is a Heaney A Heaney is a hysterectomy forceps. It has double serrated jaws with cross grooves
What is a Potts-Smith instrument is a vascular scissors that is angled to the side
The instrument used to clamp the aorta in an AAA surgery is The satinsky aortic clamp
The Castroviejo needle holder is used in both eye and plastic surgery as well as other surgeries requiring fine, delicate suture
What is a kidney instrument Randall stone forceps
What is a Harrington it is a retracting instrument frequently used for gallbladder surgery. Its tip is heart-shaped, thus it is sometimes called the sweetheart
A techinique utilizing the insertion of a needle or wire thorugh a needle in order to identify suspicious breast tissue is a wire localization
a forceps used to remove stones in billiary surgery is a Randall stone forcpes
Which procedure may require the preparation of a skin graft setup In a total radical mastectomy, the surgeon may prapare the anterior surface of the thight in the venet a skin graft is needed
Right angled pedicle clamps would be found on a setup for splenectomy
Blunt nerve hooks are selected for a vagotomy setup
In which procedural setup would a T-tube be found exploration of the common bile duct
Stapedectomy requires all of the followning EXCEPT small microsuction, speculum, prothesis, AUTOGRAFT
Cochlear implants utilize an electode device to restore hearing
all of the following are required for repair of a nasal fracture bayonet forceps, splint and Asch forceps
A forceps used in nasal surgery is a Bayonet
All of the following instruments can be forund on a nasal setup EXCEPT Freer elevator, bayonet forceps, POTTS FORCEPS Frazier suction tube
On which setup would bougies be found esophagoscopy (they're esophageal dilators)
All of the following can be found on a tonsillectomy setup yankauer suction, Hurd dissector and pillar retractor and tongue depressor
Tissue expanders are used in breast reconstruction
The fracture trated with arch bars is mandibular and maxillary fractures reductions
Rib removal for surgical exposure of the kidney requires all of the following alexander periosteotome, Doyen raspatory and Sille shears
Stone forceps on a kidney set are Randall
A Sarot is a bronchus clamp
Which item would not be included on a setup for a transvenous (endocardial) pacemaker intra-aortic balloon pump
The most frequent conditions requiring the use of a permanent pacemaker are heart block and bradyarrhythmia
Which setup would include distraction and copression components Harrington rods are internal splints -- the distraction rods placed concave to the curve and the compression rods on the convex side
Traction applied directly on bone via pins, wires, or tongs is Skeletal
skeletal traction of a lower leg is accomplished with the use of a Kirschner wire
In orthopedic surgery, the viewing of the progression of the procedure on a television screen is known as image intensification (flouroscopy)
A neurologic study in chich a radiopaque substance is injected into the subarachnoid space through a lumbar puncture is called Myelogram
A neuro headrest skull clamp is called a Mayfield
Maintenance of acceptable blood pressure and prevention of the development of air emboli in the neurosurgical patient can be effected by preoprative utilization of an antigravity suit
A _________ is a mouth gag Dingman
Specialized instruments for a cleft lip rapair would include Logan's bow (it is applied to the cheeks with tape strips to relieve tension on the incision and to splint the lip. it is a curved metal frame)
Cloward instrumentation would be included for suregery of the cervical spine
On which setup would a Bever knife handle be found eye surgery
Which procedure requiers a sterile setup skeletal traction (traction bow, pins and drills)
A craniotomy may employ the use of a ______ for exposure Leyla-Yasargil self-retracting retractor
On which setup would either a Pereyra or a Stamey needle be found urologic surgery (it is used for bladder neck suspension. it is a ligature carrier
Disintegration of kidney stones thorugh a liquid medium is accomplished with an extracorporeal shock wave lithotriptor
A urology perineal retractor system is called Omni-Tract
Which procedure would utilize a Mason-Judd retractor bladder surgery
A Furlow inserter is used in Penile implantation
On which case would a boomerang be found Prostate surgery
A millin is a(n) retropubic bladder retractor
which setup would include a Gomco clamp circumcision (infants)
In which surgical specialty would a HUMI cannula be used gynecologic
an instrument used in laparoscopy to manipulate the uterus for increased structure visibility is the Hulka Forceps
A central venous pressure (CVP) catheter insertion requires a sterile set up
The purpose of a set of Bakes would be common duct dilation
A Steffee plate is a spinal implant for tx of fractures, spondylolishtesis and idiopathic scoliosis of the thoracolumbar column
Skeletal traction is accomplished with Cruthcfield tongs
The Bookwalter is a _______ instrument retracting
Which instrument is a retractor harrington
A long thoracic forceps is a Schnidt
A bougie is a esophageal dilator
Which graft must be obtained with a dermatome split-thickness mesh graft
A Cavitron unit is used for phacoemulsification
The power source for Hall pover equipment is nitrogen
A neurosurgical drill used for precision cutting, shaping, and repari of bone is the Air Drill 100
In what surgery would a small fragment compression set be used olecranon fracture
A permanent pacemaker operates on a pulse generator powered by lithium
Which item is an air drill Hall power equipment
Hypothermia is employed in cardiac surgery to reduce oxygen consumption
which item is not a comp9onent of a cardiopulmonary bypass system oxygenator, hear exchanger, VENTRICULAR FIBRILLATOR, pump
which movement iin a power instrument drills holes or inserts screws, wires or pins rotary movement
The power instrument that is small, lighweight, free of vibration, and easy to handle for pinpoint accuracy at high speed is air-powered
The power source for the Air Drill 100 is compressed nitrogen
the power source for air-powered dermatomes is compressed nitrogen and air
Suction tubing should be processed in the following way residual of distilled water in lumen, steam sterilize, tubing coiled
The suction tip that is right angled and is used for small amounts of fluid such as in brain surgery is Ferguson-Frazier suction tip
Which suction tip has an angle and is used in the mouth or throat yankauer
When using a cellsaver for autologous blood transfusion, the blood is suctioned through a double lumen tubing and is heparinized (heparinized saline or citrated dextrose mixes with blood at the tip of the tubing. it is filtered and separated and RBC are washed, infused with saline, and go into a reinfusion bag
During orthopedic surgery, the suction tubing shoud be cleared frequently
which type of surgery would require several patent suction cannulas and sucction often controlled by a foot-pedal ear, nose and throat (ENT)
when suctioning in neruosurgery a precaution taken is to avoid applying vacuum directly on brain or neural tissue
A tourniquet is utilized only when hemorrhage is not contrelled by other methods
The proper setting for a tourniquet applied to an arm is 250-300 mmHg
Exsanguination of a limb before tourniquet inflation is accomplished with wrapping the elevated extremity with Esmarch
The amount of pressure used to inflate a tourniquet depends on all of the following EXCEPT patient's age, size of extremity, DEPTH OF SURGICAL INCISION, systolic blood pressure
A regional block that uses the tourniquet is a Bier block
The tourniquet is contraindicated if a patient's circulation to distal part of extremity is poor
Which action drains venous blood during tourniquet application elevate extremity before thightening tourniquet
At what point should the surgeon be informed of the time of tourniquet application after 1 hour, then every 15 minutes
When would the use of Esmarch be contraindicated when patient has had recent injury and has had recent cast
Which agent is NOT used to inflate a pneumatic tourniquet nitrous oxide
A precaution necessary when using a pneumatic tourniquet is solutions must be prevented from pooling under tourniquet
In which procedure would a tourniquet be contraindicated gangrenous toe amputation
A grounding pad is not required for the electrocautery in a bipolar unit
The inactive electrode of the cautery is the ground pad
The electrical circuit of the electrocautery when current flows to generator to active electrode, through tissue, and back to generator via the inactive electrode
why must the electrocautery tip be kept clean to ensure electrical contract effectiveness
in electrocautery "buzzing" refers to coagulation of vessel via a metal instrument touching the active electrode
which electrosurgical unit provides precise control of the coagulated area bipolar
which condition is MOST acceptable when using electrocautery ground pad placed close to operative site
the active electrode on the electrocautery is the tip
A cautery would not be used in neck or nasopharynx surgery if nitrous oxide is used
why are only moist sponges utilized during electrocautery use to prevent fire
if the electrocautery is used through the colonoscope, CO2 should be available to flush out the colon because gases normally in colon could cause explosion
Fulguration is utilized primarily in _________surgery transurethral resection and prostate operations (TURP)
When working in the bladder why is more or higher electrical current necessary during cautery use more current is needed when working in solution
Fulguration via the resectoscope is accpomplished by the use of an ____tip electrode
a direct visualization of the common bile duct is done by means of a choledochoscope
Fiberoptic lighting is an intense cool light that illuminates body cavities via a bundle of thousands of coated glass fibers.
Complications can occur during endoscopy such as bleeding and perforation
an endoscopy procedure that does not requiere a steril set up is a bronchoscopy
Fiberoptic cable integrity is questionable when dark spots are evident
when using a fiberoptic, burns and fires are prevented by cable is kept away from drapes when disconnected from endoscope; personnel should not lean on cable endo that is disconnected but is still on ; cable end is kept on a moist
An economical, practical, and effective way to clean reusable channeled endocsopic instruments initially is with the endoflush
a sterilant that is used on endoscopes that is bactricidal, fungicidal, and sporricidal in 20-30 minutes processing time is peracetic acid
which statement is true regarding a STERIS system for endoscope sterilization only one scope or a few instruments can be processed in a cycle
The endoscope that provides aview of the middle of the thorax, between the two pleural sacs is mediastinoscope
Loupes are used for magnification
Resolving power of an operating microscope means the ability to discern detail
Which item in the optical lens system is responsible for magnification oculars and objective lens
The range of focal lenghts of the objective lenses in the operating microscope is 100-400mm
A continuously variable magnification system is afforded to the eye surgeon by the zoom lens with foot control
The purpose of the "slit" lamp in eye surgery is defining depth perception
The operating microscope that visually employs fiberoptics for its light source is coaxial illuminators provides intense, cool light
Care of the microscope would include damp dust external surfaces with detergent-disinfectant before use; enclose in an antistatic plastic cover when not in use and clean casters before each use
The purpose of the beam splitter in an operating microscope is to coincide the assistant's field of view with the suregon's
The colpomicroscope affords a view of the cervix
The procedure employing the use of a self retaining laryngoscope and microscope is called a suspension microlaryngoscopy
The binocular microscope provides stereoscopic vision. This refers to the view afforded by double eyepieces
Which magnifying powers are available for the microscope eye piece 10X, 12.5X, 16X and 20X
Which procedure is inappropriate when caring for optic lenses oil or fingerprints are removed by soaking in solvent for 10 minutes and drying with a cotton ball, (correct: they should be removed with a solvent or lens-cleaning solution or 50% denatured alcohol not immersed)
The OR bed may have a metal crossbar between the two upper sections which may be raised to elevate the kidney and gallbladder
Which item is also known as an "airplane support" double arm board
Operative accessibility in thyroid surgery may be aided by the use of a shoulder bridge
In which position would shoulder braces be indicated extreme Trendelenburg
A precaution necessary when using the kidney rests is to press firmly but not too tightly against body, to pad well and to place the longer rest beneath iliac crest
Chest rolls (bolsters) facilitate respiration
Bakelite orthopedic table attachments are sometimes used because the do not interfere with radiographic studies
Sponges and towels used near the laser tissue impact site are kept wet in order to prevent ignition of these materials by reflected beam
A laser plume is composed of carbonized particles, water and odor
When using lasers, nonreflective instrumentation decreases accidental direct reflection of the laser beam to another area
Which laser emission is primarily absorbed in tissue by hemoglobin or melanin Argon (operates in the visible light region in the blue-green spectrum)
The fire extinguisher of choice for a laser fire is a Halon (consists of hudrogenated halocarbons and doesnt produce a residue and has low toxicity)
In surgical precodure employing the use of the laser, prep solution on the patient's skin should be pat-dried because pooled fluids can retain laser heat and subsequently burn tissue
Laser surgery performed in the rectal area shoud be preceded by suctioning of lower bowel to remove methane gas, and packing in the rectum with wet, counted sponges
Ebonization refers to coating of instruments to decrease reflectivity
The use of each of the following items are measures employed to readuce laser induce injuries ebonized instruments, anodized instruments and reflective drapes
When utilizing the laser, occupational exposure to suergical smoke via the skin, eye and mucous memebranes is best minimized by the use of universal precautions
Which specialty would employ the use of slit lamp and laser ophthalmic
The laser used primarily for port-wine stain lessons of the skin is the Ruby
People who are near the CO2 laser impact area cna guard against corneal injuries by wearing amber-tinted lenses
Each of the following are measures used to control the effects of the laser plume smoke evacuators, suctions and high filtration masks
wich endotrachal tube is contraindicated during laser suergery PVC tube
what item should be on the scrub person's instrumentation table while the laser is in use a basin with sterile water or saline (in case of fire)
The laser used most commonly for retinal detachment, tear or hole is argon
The tunable dye laser used to disintegrate kidney stones is the Candela
A device used to correct and counteract internal bleeding conditions and hypovolemia is MAST (medical antishock trouser)
Placement of a Levin tube would be in the stomach
a sponge used in brain surgery is a cottonoid patty
The dressing used after nasal surgery is moustache dressing
Seemless tubular cotton that stretches to fit a contour and is used for padding is called a stockinette
Which case would require the use of cottonoid strips laminectomy
An item used for padding that has smooth and clingy layers is called Webril is a soft, lint-free, cotton bandage
Rectal packing is made of petroleum-treated gauze
Created by: draanabell on 2005-10-24



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