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Surgery I - Skills
& Venapuncture
| Question | Answer |
|---|---|
| What should you never do when draping a patient? | Reach over the patient |
| What should you have a patient do to facilitate placement of an NG tube? | Swallow by drinking water |
| How does one confirm placement of an NG tube? | By injecting air into the stomach and auscultating or by obtaining a chest radiograph |
| When should a jejunal- tube be placed instead of a gastric tube? | When concerns for aspiration are present or in the setting of gastric ileus |
| What is an advantage to placement of a PEG (percutaneous endoscopic gastrostomy) tube? | It avoids the need for general anesthesia and a large incision |
| Name the lays of the abdominal wall encountered when performing an inguinal hernia repair | 1. skin 2. subcutaneous fat (camper's fascia) 3. Scarpa's fascia 4. external oblique 5. spermatic cord 6. cremasteric muscle 7. tranversalis fascia 8. pre-periotneal fat 9. parietal peritoneum |
| Indicate the proper positioning for central line placement | Reverse trendelenburg to prevent air embolism |
| List 3 indications for performing a tracheostomy | 1. prolonged mechanical ventilation 2. upper airway obstruction (tumors) 3. neurologic deficits preventing clearing of secretions and increasing risk of aspiraiton |
| List 4 common indications for performing a lung resection | 1. lung cancer 2. atelectasis 3. emphysema 4. tuberculosis |
| Where should one perform a needle thoracostomy? | midclavicular line at the 2nd intercostal space |
| Where should one place a chest tube? | Anterior axillary line at the 4th or 5th intercostal space, make the incision above the 6th rib and enter above the 5th rib |
| How does a chest tube function under suction? | Creates a negative pressure to prevent collapse of lung |
| Which location is first choice for IV placement? | Cephalic vein, approx 10 cm above wrist (but should START with metacarpal) |
| What 4 areas should absolutely be avoided in IV placement? | 1. Volar aspect of wrist 2. below compromised area 3. sclerosed veins 4. arm on the side of mastectomy, blood clot or infection 4. arm with fistula or shunt |
| What size catheters are idea for: **** 1. Trauma 2. Blood administration 3. Fluid infusion | 1. 16 or 18 gauge 2. 18 gauge 3. 20 gauge |
| Which veins are not appropriate for irritating solutions? | Metacarpals |
| How often should a peripheral IV be changed? | Every 3-4 days (<5), or sooner if patient experiences pain |
| How long should a tourniquet be left on? | No more than 3 minutes |
| Cite indications for a nontunneled central venous catheter | Short term therapy < 7 days |
| Cite indications for a tunneled central venous catheter | Long term therapy Note; must be placed in vascular radiology or surgery |
| What tow maintenances are required for implanted ports? | 1. Flushing every 4 weeks with Heparin 2. Huber needle change every 7 days |
| What is the most common complication of IV therapy? | Infiltration - fluid infusion in the tissues |
| What should one do if an extravasation (leakage of vesicant solutions out of vein) occurs? | Stop the infusion immediately |
| What three pieces of Info should be documented on the IV site? | 1. Date and time 2. Catheter size 3. initials of person who placed it |
Created by:
eedavila
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