Surgical Asepsis and Asissting with Surgical Procedure Notes
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| Permeable means? | allowing a substance to pass or soak through
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| Dehiscence means? | separation of wound edges or rupture of a would closure
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| an infection is | an invasion of body tissue by microorganism which then proliferate and damage tissues
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| Surgical Asepsis | Complete destruction of organisms on instruments or equipment that will enter the patients body
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| antiseptic | substance that kills microorganisms
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| microorganisms | living organisms that can be seen only with a light microscope
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| cicatrix | early scar tissue that appears pale, contracted, and firm
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| pathogens | disease causing microorganisms
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| spores | a thick walled dormant form of bacteria very resistant to disinfection measures
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| sanitization | reducing the number of microorganism to a relatively safe level
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| Disinfection | destruction of pathogens by physical or chemical means
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| asepsis | freedom from infection or infectious material
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| contamination | becoming non-sterile by contact with any non-sterile material
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| Disease | a pathologic process; having a descriptive set of signs and symptoms
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| sterilization | complete destruction of all forms of microbial life
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| medical asepsis | destruction of organisms after they leave the body
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| edema | swelling between layers of tissue
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| Before instruments can be used in surgery.. | it must be sanitized, disinfected, and sterilized in that order.
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| Sterilization process is to ensure that all.. | debris has been removed so cleansing properties can penetrate every surface
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| cleaning of an instrument should be done? | immediately after using, if impossible, items should be rinsed under cold water and placed in detergent solution
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| Bodily fluids or contaminants should never be allowed | to dry on surgical equipment
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| gloves must be warn while | sanitizing
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| sharps instruments should be | separated while cleaning
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| sanitization reduces | the number of organisms to a safe level and disinfection kills pathogens or renders them inactive
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| The cleansing area should be divided into 2 area | dirty/ and clean to prevent errors
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| the sterilization room should include | a sink, receiving basins, cleaning agents, brushes, utility gloves, autoclave wrapping paper, autoclave envelopes/tape, sterilizer indicators, disposable gloves, and biohazard waste container
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| PPE for autoclave include | heat-resistant gloves, fluid resistant gloves, lab. coat/impervious gown, face shield and or goggles
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| sterilization can be achieved by | moist heat in an autoclave, by gas, or with chemicals,
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| written sterilization procedures | must be in place
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| What is the best sterile method> | autoclave; higher then boiling point heat, combined with moisture, once steam hits all surfaces every microorganism is killed, once the camber cools, the steam condenses and explodes the cells of microorganisms
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| recommended temperature for an autoclave is | 121-123 C or 250-255 F
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| unwrapped items should be sterilized in an autoclave for? | 20 minutes
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| small wrapped items should be sterilized in an autoclave for? | 30 minutes
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| large/tightly wrapped items should be sterilized in an autoclave for? | 40 minutes
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| what are the three auto clave cycles | gravity (fast exhaust) cycle, liquid (slow exhaust cycle), prevacuum cycle
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| Gravity cycle in an auto clave | sterilizes stainless steel, and glassware. autoclave fills with steam and held at required temp. for a period of time. a valve is opened returns the chamber to atmosphere pressure. dry times added (sum) used in physicians office
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| liquid cycle in an autoclave | prevents sterilized equipment from boiling. steam exhaust slowly at the end of the cycle to allow liquids to cool
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| prevacuum cycle in an autoclave | porous materials (soaks through) chamber is partially evacuated before steam enters for more penetration; not available on all machines
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| if steam temps. are to high | it is dried out and advantages are minimized
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| to wet steam could cause | incomplete sterilization
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| Wrapping materials must be | permeable to steam and resistant to contaminants, shouldn't be used if it has a hole
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| Wrapping must allow the pack to be opened without | contaminating it
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| when wrapping wrap hinged instruments | in the open position
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| when wrapping sharp instruments place | gauze sponge around sharp tips
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| when using bags to wrap instruments | insert jaws 1st for easy handling
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| labeling a wrapped instrument | sterilization date, your initials, permanent marker
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| polypropylene is? | plastic material and resistant to heat transfer and requires more time to sterilize
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| 2 basic types of sterilization indicators | chemical indicators (autoclave tape), biologic indicators (bacterial spore strips)
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| chemical sterilization indicators contain | a chemical dye changes color when exposed to steam, not absolute indication of proper time/technique, indicates high temp. must completely chance color or reveal autoclaved
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| Biologic sterilization indicators | facilities of policy's about frequency, spore strip indicator contains a temp. sensitive dye, placed in the largest pack in center, some use Bacillus stearothermophilus, destroyed at 250F and 121 C, ampule sent to lab to analyze for microbial growth
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| evaluations and record keeping must be done | at intervals specific to autoclave use
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| once the pressure gauge of an autoclave reads 0 | open the door 1.4 inch
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| do not place sterile packs on cold surfaces to avoid | cross contamination due to condensation
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| if the integrity of the sterilization is in question | consider it to be non-sterile
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| muslin/autoclave paper packs are considered sterile for | 28 days
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| polypropylene bags are considered sterile for up to | 6 months
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| gas sterilizations are unrealistic to use in a physicans office due to | long processing times, ventilation requirements, and health hazards
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| common surgeries for primary care office | suturing, cyst removal, incision and drainage I&D of abscesses, collection of biopsy specimens
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| an electrosurgical unit uses | high frequency currents to cut through tissue and coagulate blood vessels
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| Grounding pad; carefully inspect | the pad, cable, and skin before the procedure
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| grounding pad; place the pad close | to the operative site
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| grounding pad; the pad must be | tight against the patients skin
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| ground pad; apply to | a fleshy area, not a boney area, not over body hair, or not over metal implants/ pacemaker
inspect after procedure
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| laser surgery may now be used for | excisions of lesions, removal of warts/moles, cauterization of blood vessels, cosmetic procedure
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| microsurgery uses | a microscope to perform delicate surgeries
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| endoscope | medical device with miniature camera mounted on a flexible tube with a light source that is used to examine the inside of a cavity
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| cryosurgery uses a | low temp. probe to kill tissue by freezing it on contact
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| cryosurgery is used to treat | cancers of the skin, prostate, liver, pancreas and kidneys
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| patient prep; to alleviate patient fears | be sure to explain the surgery thoroughly and give the patient time to discuss any concerns
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| patient prep; direct questions outside of your knowledge | to the physician and be sure to relay them
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| preoperative preparation; | blood/urine tests, consent form, recent illnesses, medications, allergies noted
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| preoperative preparation may also include | a shave prep, cleansing enema, food/drink restriction, special bathing, and sedatives
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| patient prep; the patient will be asked to | empty their bladder on the day of surgery and put on the gown requested, vital signs will be recorded
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| preoperative instructions; have consent forms | signed
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| preoperative instructions; give the patient | preoperative instruction
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| preoperative instruction; telling the patient to bring someone | who can drive them home after surgery
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| preoperative instructions; telling the patient to leave | valuables at home
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| preoperative instructions; call the patient a day ahead | to confirm the special instructions
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| before signing the consent form, the patient must have a discussion with the physician that indicates | what procedure will be done, why it will be done, potential risks/ benefits, alternative treatments, risks and benefits for that,
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| discussion of the informed consent will be fully | documented
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| copy of consent form must be | included in the patients recorded
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| treatment must not exceed | the scope of the consent form
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| the patient cannot sign while | under the influence of and sedatives
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| if sterile packets are open for more than 1 hour | it is not longer sterile
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| even wrapped sterile items cannot be used | if dropped
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| if a sterile object comes into contact with non sterile surface | it is considered non-sterile
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| talking must be limited | to avoid bacteria spreading through air currents
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| sterile team members must | face eachother
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| the sterile field must remain | in your view in order to be considered sterile
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