Periop 101 Final Exam: IT'S GETTING
REAL
Special considerations when using insufflation (establishing a pneumoperitoneum) -
ANS-Always have a backup tank available, position at the level of the patients heart or
higher to prevent gases from contaminating the device, make sure alarm is on and
audible, maintain pressure under 12 mm/Hg
Special considerations for patient undergoing MIS/Endoscopic Surgery - ANS-Previous
incisions (Hasson minilap) that may require additional sterile supplies, hx of DVT,
consent for possibility of open procedure, voiding to empty bladder and prevent
puncture during trocar placement/unnecessary catheterization
Mechanical Methods of Hemostasis - ANS-Manual pressure (sponges), hemostatic
clamps, sutures, staples, clips, ligatures, and/or pledgets
What is a ligature? - ANS-Also known as a tie, strand tied around a blood vessel to
occlude bleeding; large vessels may require transfixion suture (crosscriss stitch)
Where is a pledget most commonly used? - ANS-Vascular closure, septal repair, heart
repair and hepatic repair
What is bone wax? - ANS-A mixture of beeswax, isopropyl, and a softening agent
Chemical Methods of Hemostasis - ANS-Pharmocological methods (meds such as epi,
vit K, protamine, lysine, tranexamic acid)
Topical methods (thrombins, collagen gelatins, phenol sealants)
RN responsibilities in Sponge Counts - ANS-Initiate count (any team member can
initiate count??), perform count, document count activities, reporting count deficiency
Drainage is achieved by ________ or ___________ means - ANS-passive (gravity) or
active (suction)
Types of Drains - ANS-Penrose, nasogastric, T-tube, suction drains, chest tubes
,What are Suction Drains and their purpose? - ANS-Remove blood, pus, necrotic
material from wounds via suctions (Jackson-Pratt for abdominal/breast, Hemovac for
ortho)
What is a Neutral Zone? - ANS-Designated area on surgical field where scrub and
surgeon place all sharp instruments
What is a Crile? - ANS-A hemostat used to control bleeders in SQ tissue
What is a Mosquito? - ANS-A hemostat used to control superficial bleeders in delicate
surgery (hand/plastic)
What is a Kelly? - ANS-A hemostat used to control bleeders in muscle tissues
What are the Surgical Powered Cutting Instruments? - ANS-Bone reamers, variable
speed saws, tissue shavers
Care and handling of powered cutting instruments? - ANS-Always hand to surgeon with
safety on, always use with drill guard in place, always have irrigation ready because of
heat generation
What are the Critical Concepts to the Periop Environment - ANS-Geographic isolation
Bacteriologic isolation through specific practices (attire, delivery/disposal systems)
Centralize equipment and supplies
What is Individualized Care? - ANS-Reflects art of nursing, meets individual needs of pt,
provide comfort measures
What is Standardized Care? - ANS-Derived from body of scientific knowledge
developed through research and clinical practice such as counting sponges
What is the Restricted Zone? - ANS-Located in the semi-restricted area and only
accessible via semi-restricted area; includes actual OR
How should air be cleaned in OR rooms? - ANS-Via HEPA filter, under POSITIVE
pressure and by 20 air exchanges per hour (minimum of 4 exchanges from outdoor air)
What is the Semi-Restricted Zone? - ANS-Equipment and sterile supply storage, SPD
, What is the Unrestricted Zone? - ANS-Pre-Op Holding Area, Waiting Rooms,
Blood/Specimen processing
Important points about the 2 Piece Scrub Suit - ANS-Lint free, minimize bacterial
shedding; secure at waist, tuck into pants and fit closely to the body to prevent skin cells
from shedding
Important points about Sterile Gowns - ANS-Can be re-usable or disposable, required
by sterile team and resistant to strike-through by fluids
Important points about perioperative personnel's hair - ANS-Cover BEFORE surgical
attire is donned, no skull caps unless covered by bouffant, wear in areas where
equipment is processed and stored
Circulating RN responsibilities include? - ANS-Emotional support during induction
Ongoing patient assessment
Accurate and complete prep of supplies, instruments, and equipment preop for each pt
Implementing/enforcing policies and procedures
Preparing specimens
Coordinating nursing care from other health care team members
Communicating info to family and other health care team members
Documenting
Activities that are made possible with periop nursing documentation - ANS-Billing for
finance and accounting
Supply and equipment inventory
Communication of patient care by caregivers
Planning perioperative care
Evaluation of care rendered
Documentation provides a basis for future reference for things like? - ANS-Ensure
quality of patient care
Reconstruct a personal experience record
Evidence in a court of law
Commonly accepted nursing tools: - ANS-Nursing process
PNDS (Perioperative Nursing Data Set)
WHO (World Health Organization)/Joint Commission/AORN surgical safety checklists
What statements reflect the concept of critical thinking? - ANS-Informed practice
REAL
Special considerations when using insufflation (establishing a pneumoperitoneum) -
ANS-Always have a backup tank available, position at the level of the patients heart or
higher to prevent gases from contaminating the device, make sure alarm is on and
audible, maintain pressure under 12 mm/Hg
Special considerations for patient undergoing MIS/Endoscopic Surgery - ANS-Previous
incisions (Hasson minilap) that may require additional sterile supplies, hx of DVT,
consent for possibility of open procedure, voiding to empty bladder and prevent
puncture during trocar placement/unnecessary catheterization
Mechanical Methods of Hemostasis - ANS-Manual pressure (sponges), hemostatic
clamps, sutures, staples, clips, ligatures, and/or pledgets
What is a ligature? - ANS-Also known as a tie, strand tied around a blood vessel to
occlude bleeding; large vessels may require transfixion suture (crosscriss stitch)
Where is a pledget most commonly used? - ANS-Vascular closure, septal repair, heart
repair and hepatic repair
What is bone wax? - ANS-A mixture of beeswax, isopropyl, and a softening agent
Chemical Methods of Hemostasis - ANS-Pharmocological methods (meds such as epi,
vit K, protamine, lysine, tranexamic acid)
Topical methods (thrombins, collagen gelatins, phenol sealants)
RN responsibilities in Sponge Counts - ANS-Initiate count (any team member can
initiate count??), perform count, document count activities, reporting count deficiency
Drainage is achieved by ________ or ___________ means - ANS-passive (gravity) or
active (suction)
Types of Drains - ANS-Penrose, nasogastric, T-tube, suction drains, chest tubes
,What are Suction Drains and their purpose? - ANS-Remove blood, pus, necrotic
material from wounds via suctions (Jackson-Pratt for abdominal/breast, Hemovac for
ortho)
What is a Neutral Zone? - ANS-Designated area on surgical field where scrub and
surgeon place all sharp instruments
What is a Crile? - ANS-A hemostat used to control bleeders in SQ tissue
What is a Mosquito? - ANS-A hemostat used to control superficial bleeders in delicate
surgery (hand/plastic)
What is a Kelly? - ANS-A hemostat used to control bleeders in muscle tissues
What are the Surgical Powered Cutting Instruments? - ANS-Bone reamers, variable
speed saws, tissue shavers
Care and handling of powered cutting instruments? - ANS-Always hand to surgeon with
safety on, always use with drill guard in place, always have irrigation ready because of
heat generation
What are the Critical Concepts to the Periop Environment - ANS-Geographic isolation
Bacteriologic isolation through specific practices (attire, delivery/disposal systems)
Centralize equipment and supplies
What is Individualized Care? - ANS-Reflects art of nursing, meets individual needs of pt,
provide comfort measures
What is Standardized Care? - ANS-Derived from body of scientific knowledge
developed through research and clinical practice such as counting sponges
What is the Restricted Zone? - ANS-Located in the semi-restricted area and only
accessible via semi-restricted area; includes actual OR
How should air be cleaned in OR rooms? - ANS-Via HEPA filter, under POSITIVE
pressure and by 20 air exchanges per hour (minimum of 4 exchanges from outdoor air)
What is the Semi-Restricted Zone? - ANS-Equipment and sterile supply storage, SPD
, What is the Unrestricted Zone? - ANS-Pre-Op Holding Area, Waiting Rooms,
Blood/Specimen processing
Important points about the 2 Piece Scrub Suit - ANS-Lint free, minimize bacterial
shedding; secure at waist, tuck into pants and fit closely to the body to prevent skin cells
from shedding
Important points about Sterile Gowns - ANS-Can be re-usable or disposable, required
by sterile team and resistant to strike-through by fluids
Important points about perioperative personnel's hair - ANS-Cover BEFORE surgical
attire is donned, no skull caps unless covered by bouffant, wear in areas where
equipment is processed and stored
Circulating RN responsibilities include? - ANS-Emotional support during induction
Ongoing patient assessment
Accurate and complete prep of supplies, instruments, and equipment preop for each pt
Implementing/enforcing policies and procedures
Preparing specimens
Coordinating nursing care from other health care team members
Communicating info to family and other health care team members
Documenting
Activities that are made possible with periop nursing documentation - ANS-Billing for
finance and accounting
Supply and equipment inventory
Communication of patient care by caregivers
Planning perioperative care
Evaluation of care rendered
Documentation provides a basis for future reference for things like? - ANS-Ensure
quality of patient care
Reconstruct a personal experience record
Evidence in a court of law
Commonly accepted nursing tools: - ANS-Nursing process
PNDS (Perioperative Nursing Data Set)
WHO (World Health Organization)/Joint Commission/AORN surgical safety checklists
What statements reflect the concept of critical thinking? - ANS-Informed practice
