5 Written Questions

1. 5-6 minutes (each arm); hands, wrists, forearms, 2" above elbows; hands held up for rinsing; prevents bringing microorganisms from unwashed area; clean nails with brush after pick; use scrub brush for friction; dry with sterile towels; no lotion; sterile gloves for protection and sterility.
2. A. sterile saline 0.9% comes in 1. multiple dose vial for injections, 2 larger container for rinsing and irrigating wounds. B. sterile water comes in 1. multiple dose vial for use as diluent for mixing meds, 2. large container for rinsing instruments after chemical disinfection.
3. overall: smallest possible for face 7-0 ideally,
   higher for joints and higher tension areas or deep sutures more like 4-0 (handout)
4. Signs inflammation has moved to infection: exudate, systemic heat, nausea, general malaise, function loss
5. may be added to anesthesia, will have red labelling. It is a vasoconstrictor and should not be used on Pts with hypertension or on areas that are extremities. It's benefit is less bleeding during procedure.

5 Matching Questions

1. minor surgical procedures done in office
2. chromic gut vs. plain gut sutures
3. topical anesthesia
4. atraumatic needles
5. Autoclave temperature for sterilization

1. a applied to the skin or sprayed on with short duration to allow piercing, lancing or injecting for patient comfort; ex: ethyl chloride spray, Emla patch
2. b 250-254 F or 121-123 C. Autoclave requires-heat water and pressure: 15psi, 20 minutes minimum
3. c suturing, cyst removal, incision and drainage of an abscess, collection of biopsies, vasectomy, arthroscopy, circumcision, teeth extraction, toenail removal, mole removal, needle biopsy, joint fluid aspiration, spinal tap, bone marrow aspiration
4. d "not traumatic needles", no eye, minimizing trauma to skin, called "swaged" needles because the suture is pre-attached, usually curved
5. e made from sheep historically, both are absorbable sutures. Chromic gut is treated with chromic salts and will last longer (up to 60 days)

5 Multiple Choice Questions

1. requires higher heat 320 F, and longer exposure 3-4 hours; done in an autoclave, for easily corroding instruments like sharp blades or things that should not get wet.
   1. tensile strength
   2. Dry heat sterilization
   3. sterile solution
   4. on the side
2. must be sanitized, disinfected, sterilized for next time or disposed of if they were intended for single use.
   1. lock box instruments
   2. Probing instruments
   3. Sharps instruments
   4. Post-op instruments
3. Dilators:used to enlarge openings like uterine cervix.
   Retractors: pull wound edges back.
   Speculums open things wider: nasal and vaginal.
   1. Probing instruments
   2. Sharps instruments
   3. Grasping instruments
   4. Dilating instruments
4. to approximate edges (bring edges together) speed healing, reduce scarring
   1. Size of sutures
   2. Purpose of suturing
   3. absorbable sutures
   4. dressing
5. 2-3 minutes; hands and wrists; hands held down for rinsing; pathogens loosened and carried away from hands and wrists; clean nails with pick; hands together for friction; dry with paper towels; lotion use ok; apply gloves for protection; (removes transient flora)
   1. medical asepsis
   2. medically aseptic hand wash
   3. topical anesthesia
   4. surgical asepsis

5 True/False Questions

1. on the side → an area separate from the sterile field, but should be nearby; can turn your back on it, may have unopened sterile items and all items will at least be clean.

   True        False

2. absorbable sutures → silk, nylon, Dacron, cotton, stainless steel staples; used on body surface, must be removed

   True        False

3. incisional procedures → invasive, cutting into patient's body; surgical asepsis required

   True        False

4. Size of sutures → From largest to smallest 4, 3, 2, 1, 0 "aught", 1-0 or 0 or one-aught, 2-0 or 00 or two-aught, 3-0 or 000 or three-aught, 4-0 or 0000 or four-aught, 5-0 or 00000 or five-aught, 6-0 or 000000 or six-aught, 7-0 or 0000000 or seven-aught. The more zeros, the smaller the gauge.

   True        False

5. bandage → to cut into

   True        False