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AORN Periop 101 Final Exam Study Guide x
Terms in this set (112)
This type of needle point is what you would expect to be needed for suturing friable tissue such as the liver.
What is a Blunt needle point?
These particular wound closing items are available in a wide variety of instrument sizes.
What are disposable stapler sets?
Give one example from TJC list of Do-Not-Use Abbreviations, Acronyms, and Symbols.
What is cc?
.The surgical wound classification for a total abdominal hysterectomy.
What is Clean contaminated?
Following an excisional breast biopsy, the circulating nurse would anticipate the need to have available this type of drain
What is a Jackson-Pratt?
This position can cause physiological effects of circulatory and respiratory compromise due to pressure on the abdomen.
What is Lithotomy Position?
To protect sensitive areas of the skin with appropriate padding is a recommended practice for this:
What is to reduce the patient's risk of intraoperative skin injury.
An environmental sanitation practice that is required to limit the transmission of microorganisms to personnel when handling body fluid spills
What is personal protective equipment?
It is recommended to inspect the active electrode for insulation defects to prevent this from occurring during MIS
What is capacitive coupling?
According to AORN RP for positioning the patient, the perioperative nurse should:
use additional precautions as appropriate based on unique patient considerations
The disadvantage of using this type of wound closure is because they often cause more scarring than other skin closure methods.
What is skin clips?
An automatic intraoperative suspension of a do-not-resuscitate decision violates a patient's ethical right to...
What is Self-determination?
This type of human factor error is responsible when a perioperative nurse is trying to attend to several tasks at once
What is situational-based error?
Restricting pathogenic organisms from the patient, environment, equipment, and supplies is the definition of....
What is aseptic technique?
The most important consideration when selecting these materials is to prevent risk of contaminating patients with endogenous and exogenous microorganisms; and risk of exposing healthcare workers to patient's blood and body fluids
What are draping materials?
Patient and caregiver education for continuing post-op care at home is the primary focus of this Phase of post anesthesia care.
What is Phase II?
According to the Institute of medicine recommendations for improving patient safety, this organization has the greatest potential impact to make changes on improving pt safety
What are Healthcare organizations?
This statement about gloving technique is true
The scrub gown should be fastened in the back before donning gloves
Draping material is this source in the fire triangle? (fuel, ignition, oxidizer)
What is fuel source?
The safest way to pass a cutting instrument to a surgeon is:
What is place it in a designated neutral zone with a verbal cue
To place a patient safely in this particular position the knees are over the break in the procedure bed to allow for knee flexion.
What is Trendelenberg?
A packaging system for items undergoing sterilization should possess this characteristic:
to permit aseptic delivery of contents to the sterile field
Silicone catheters should be stocked on this particular cart in the surgical suite.
What is a Latex-safe cart?
Open this package carefully over a small basin to prevent splashing of the packaging solution.
What is handling natural absorbable sutures (plain, chromic)
An example of administrative controls to assure safe use of lasers, is the appointment of a person in this role:
What is a laser safety officer?
This statement about the perioperative nurse's role in bioethical decision making is most justifiable. The perioperative nurse should... WHAT IS...
act according to the terms of agreement establishing the nature of the relationship between the pt and the nurse
A precaution that should be taken when using this hemostatic agent intraoperatively is to avoid using it with an autologous blood salvage unit (cell saver).
What is microfibrillar collagen
A designation of 4-0 on a suture package indicates this about the suture material.
What is the diameter?
A recommended means of promoting the safety of personnel in the surgical suite is:
Providing access to MSDS (material safety data sheets) for hazardous agents in that environment
This type of healing the wound remains open
What is Granulation?
An abstract concept that has been developing since Socrates.
What is Critical thinking?
This item is placed as close to the operative site as possible
What is the dispersive electrode?
This desired patient outcome most closely related to the use of local anesthesia for a procedure: What is....
The patient reports adequate pain control throughout the perioperative process
Antibiotics are most commonly administered during the intraoperative phase through this route
What is Irrigation solution?
Recent research studies on the value of certification found that: WHAT is....
Nurse Managers would prefer to hire a certified nurse over an otherwise equally qualified non-certified nurse.
The recommended practice for flash sterilization is the item should be processed with this:
What is a routine process monitoring device (chemical indicator, integrator).
When documenting the placement of surgical drains, it should include:
What is location of drain?
The action that the perioperative nurse should take if the pt states he/she is allergic to shellfish and breaks out in hives when ingested.
What is Alert surgeon for the need for appropriate selection of skin prep solution?
Principles of care for forceps during a procedure should include this: WHAT IS...
frequently inspect tips and wipe clean of blood or tissue as needed
A critical perioperative nursing diagnosis within the PNDS is:
What is risk for perioperative positioning injury?
There are 3 process monitors in the sterilization process; this particular monitor indicates that the intended physical conditions in the sterilizer were met.
What is biological monitoring?
This is the most reliable early indication of malignant hyperthermia
What is unexplained increase in end-tidal CO2?
This statement concerning the use of AORN Recommended Practices is true:
Work setting and situation variations may determine the extent to which the RPs can be applied
Lock the wheels of the stretcher and the OR bed is a recommendation when:
What is transferring pt from OR bed to gurney?
Begin this task with higher surfaces and finish with the lowest levels
What is recommended for damp dusting in the OR?
Name one step that should be used to follow TJC universal protocol for preventing wrong site, wrong procedure, and wrong person surgery.
What is using a time-out before beginning the procedure?
This can be performed through smaller incisions
What is the Difference between MIS and open surgical procedures?
After this is procured by the surgeon, the scrub person should keep it moist with saline and in a sterile basin until it can be passed to the circulating nurse.
What is a surgical specimen?
Documentation of the serial number in the medical record and on the pathology requisition when an apparent defect or failure occurs.
What is proper handling of explants
Skin prep agent contraindicated for use during reconstruction of the external ear.
What is CHG?
AORN RP states, this should be matched to the type of laser, optical density, and wavelength
What is appropriate eyewear during laser surgery?
Use a sterile transfer device
What is recommended for transferring medication from a multi-use vial to the sterile field?
Family history of problems related to anesthesia; and pts previous experience with anesthesia
What are assessment factors when screening pts for potential risk of malignant hyperthermia?
The space where direct, scattered, or reflected laser radiation exceeds maximal permissible exposure
What is the nominal hazard zone for laser use?
First step in the sterilization process of surgical instruments that have been used in a procedure
What is decontamination?
This is affected by pt and staff beliefs, staff attitudes, and individual and collective values
What is the culture of a clinical setting?
Decreased color and depth perception
What are sensory assessment findings common among elderly patients?
Principle of asepsis that is most directly related to the concept of surgical conscience
What is consider items of doubtful sterility contaminated?
Most important reason for maintaining endoscopic instruments at optimal level of function
What are insulation defects that can cause unseen thermal burns?
What type of thinking is required to deliver safe patient care based on the statement "safe care requires teamwork and care tailored to the individual patient?"
What is critical thinking?
Evaluation of pt outcomes, Nursing plan of care, Occurrence of any unusual events, and Periop nurses legal signature are components that should be included in this
perioperative nursing documentation.
According to Dewey and Glaser this statement about critical thinking is incorrect.
Passive acceptance of an unreflective jump to conclusion required in the OR.
During this phase of wound healing contraction occurs
What is proliferation phase?
Placing the light in standby mode when not in use
What are guidelines for safe use of an endoscopic light source?
What is a kocher?
an example of an occluding clamp
The surgical team member responsible for preparing the surgical specimen to be sent to the lab
Who is the circulating nurse?
Exposure to this sterilization method is potentially carcinogenic and mutagenic to personnel and patients.
What is EO
The AORN RP that most directly pertains to this phase of cleaning in the Periop environment states that a safe, clean environment should be reestablished after each surgical procedure.
What is interim cleaning?
Placing it in a sterile plastic container is the proper handling of this item when removed from a patient for forensic evidence.
What is a bullet?
During which phase of Cleaning includes the entire floor, moving the OR bed to clean 3-4 feet around it
What is the activity performed during post-procedure cleaning of the OR?
Clinical nurse progression from Novice to Expert requires enhancement of this, and the development and refinement of this is affected by Clinical narratives, simulation, questioning; Partnering with proficient nurses; and the nurse's level of knowledge and experience
What is critical thinking skills?
When performing a skin prep on a patient scheduled for a bunionectomy what steps should be included?
- Prop the foot to allow ample access to all surfaces during the prep
- use an impervious drape to protect the tourniquet
-start at the incision site, include toes and move up the leg.
Name the perioperative nurse's role in pt and family education?
- Explain what the patient will experience -
-Provide emotional support to enhance coping -
-Teaching specific skills that the pt will need to perform post-op -
Why should the perioperative nurse ask about a patient's use of herbal preparations, alcohol, tobacco products, and recreational drugs during the perioperative interview.
-Herbal supplements may affect the metabolism of drugs administered -
-Recreational drug use may affect choice of preoperative sedation -
-Smoking may affect circulatory and respiratory system assessment results -
List 4 team members who wear sterile gowns and gloves.
-Scrub person -
-Surgical assistant -
Name 3 risks to patients and staff members associated with laser use:
-Eye injury -
-Fire hazards -
-Inhalation of laser plume -
Name 4 types of powered cutting instruments used in surgery
-Bone reamers -
- Saws -
- Tissue shavers -
Name 2 ways that health care workers are most likely to become sensitized to latex
-Airborne contact -
-Cutaneous contact -
During admission of a patient to Phase 1 in PACU, what is the Perianesthesia nurse responsible for?
-Assessing patient's level of consciousness -
-Assessing the patient's pain level -
-Assessing the surgical dressing -
-Maintaining a patent airway -
- Monitoring BP, HR, and O2 saturation -
Name 4 types of biopsies that require specialized methods of preparation and preservation to preserve the cells
List 4 items necessary included in Preoperative documentation
-Administration of ordered preoperative medications-
- Oral verification by the pt of the procedure to be performed-
- Patient allergies to medications and materials used in the surgical suite-
- Patient identification, using oral verification and patient records-
List Clinical manifestation of a true allergic response to latex
-Periorbital edema and itching-
List 4 components that should be included in documentation of intraoperative patient position.
-Names of personnel assisting with positioning-
-Placement of arms-
- Position that pt is placed in for procedure-
- Use of specific positioning devices-
AORN guidelines for a "time-out" specify that all surgical team members must agree on the following 3 things
- Name of pt-
-Procedure to be performed-
-Site of procedure-
4 Barriers to effective pt and family education in the perioperative setting.
-Anxiety about an uncertain outcome-
-Discomfort or pain-
- Fear of unknown-
- Short period of time for assessment and teaching-
The purposes of the surgical hand scrub
-Reduce risk of microbial contamination-
-Remove soil and debris-
-Suppress growth of microorganisms-
List Recommended Practices for sponge count procedures
- Count all sponges at the beginning of the case-
-Separate sponges as they are counted-
-Simultaneous counting by two people, including an RN circulator-
- Count out loud
-Document all counts
List 2 ways that the Perioperative nurse assists with general anesthesia induction
-Apply cricoid pressure if needed during intubation-
-Remain at the pts side to offer reassurance and promote safety-
List 3 steps that should be followed to remove of the gown and gloves at the end of the procedure
-Grasp gown at shoulders and pull downward, turning sleeves inside out-
- Remove gown first-
-Use a glove-to-glove and skin-to-skin technique to remove gloves-
List 5 actions that should be included in the perioperative nursing care of a pt with a suspected latex allergy.
-Assess pts cross-sensitivities and previous reactions to latex-
-Indicate latex precaution on door signs for every room pt occupies-
- Use latex-free supplies for IVs, hair covering, dressing materials, etc.-
-Verify surgeon is aware of the allergy-
- Schedule pt as first case of the day if possible
List 5 steps that should be followed in correctly draping the sterile field
- Drape from sterile to unsterile areas-
-Drape from operative site outward-
-Form a cuff with the drape and place gloved hands under the cuff-
-Handle each drape as little as possible-
-If draping without assistance, walk around the OR bed to drape the other side-
State 4 reasons why perioperative pt and family education is important
-Conveying genuine caring for the pts well-being-
-Increasing pt and family adherence to the plan of care-
-Increasing pts and family satisfaction with quality of care-
- Legal, ethical, and regulatory mandates-
2 Characteristics included in the elements of a culture of safety within a healthcare organization:
-Commitment to safety as the first priority in providing care*
-Trust among healthcare team members*
4 things the perioperative nurse should do when setting up the insufflation equipment for an abdominal endoscopic procedure
-Have a back up tank available-
-Verify that CO2 pressure and supply alarms are on and functioning-
-Position the insufflator at pts heart level or above
-Verify that the tank valve is open
Name 2 methods or items that accomplish hemostasis by occluding a severed blood vessel, and causing platelets to clump together
Name 4 ways to prevent or minimize ESU injuries to the pt
-Assure that prep solutions have dried and vapors evaporated before the device is used-
-Confirm each requested power setting change orally with the surgeon-
-Inspect each circuit component if the surgeon repeatedly requests higher power settings-
- Inspect the ESU unit before use to verify electrical integrity
List 3 things the perioperative nurse should do when a Bier Block is used during a procedure
- Check the calibration of the tourniquet before applying it-
- Monitor the length of time the tourniquet is inflated-
-Deflate the tourniquet slowly
-Inflate the proximal cuff first
Name 2 unique identifiers to ensure proper handling of surgical specimens verified by the perioperative nurse before the pt enters the OR.
-Pts medical record number-
- Spelling of pts name-
A psychosocial assessment of your pt should include:
- Cultural beliefs and practices-
-Expectations of perioperative care-
-Spiritual or religious beliefs-
-Understanding of the surgical procedure-
The Perioperative nurse's documents of the skin prep procedure should include
-Body area prepped-
-Name of person performing prep-
-Preoperative assessment of skin at the operative site-
- Skin prep agent-
-Type and extent of hair removal if ordered-
What special care procedures are required for microsurgical instruments
- Keep stainless steel and titanium instruments separated-
-Use a non-fibrous sponge wipe to clean the instrument tip if recommended-
- Use tip covers or protective sleeves when instruments are not being used-
Name factors regarding the proper attire of surgical team member
-Sterile gowns should resist fluid strike-through-
-Head covering should be donned before pulling on the scrub top-
-Scrub top must be secured at the waist or tucked into the pants-
- Shoe covers are optional
-Masks are changed after each patient
What phases of the nursing process that the perioperative nurse practices during the preoperative phase of the surgical experience?
-dentification of desired outcome-
- Nursing diagnosis-
Name 4 practices you should follow during the surgical scrub procedure
- Fingernails should be cleaned under running water-
-Stand slightly back from the sink and lean over to prevent splashing scrub suit-
-Forearms scrubbed 2" above the elbow
-Hands held higher than the elbows to scrub and rinse
What are practices from AORN RP V that states "a sterile field should be maintained and monitored constantly."
-The sterile field should be constantly monitored-
- The sterile field should be prepared as close as possible to the time of use-
-The sterile field may be covered with a sterile drape-
What are 3 Safety precautions when handling and caring for powered instrument
-Hand the powered instrument to the surgeon with the safety mechanism on-
-Have irrigation ready to use with the drill or saw-
- Use the instrument with the blade or drill guard in place-
A patient is unable to transfer independently to the procedure bed. To achieve the PNDS outcomes related to safe patient transfer, which measures may be used to prevent shearing injury?
-Request additional personnel to assist with pt transfer-
-Use a friction-reducing transfer sheet-
-Use a slider or roller board-
- Use the draw sheet to lift the pt slightly to allow the skin to realign with skeletal structure-
What Practices are recommended during decontamination of used instruments
- Open box locks and disassemble instrument with multiple parts-
-Use enzymatic detergent on heavily soiled instruments-
What is the Perioperative nurses role in preparing and administering meds
-Assess pts medication allergies and use of herbal or dietary supplements-
-Verify the administration of the correct med, dose, and route-
-Writing down and reading back the surgeons oral orders before preparing medication-
-Verify expiration date
The OR management team has responsibility for safety in the surgical suite which includes:
-Establishing policies related to electrical, fire, radiation, pt management safety-
-Monitoring adherence to safety policies and practices-
-Providing education to staff members regarding safety policies and procedures-
-Reporting safety hazards and violations to appropriate authorities-
The OR staff members are responsible for maintaining a safe OR environment which include:
-Adhering to facility policies related to safety-
-Consistently applying OR-specific safety practices-
-Reporting safety hazards and violations to appropriate authorities-
The EPA registered germicides labeled as hospital disinfectants must demonstrate effectiveness against these 3 microorganisms:
-Salmonella cholera suis-
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