Perioperative 101 Final Exam | 100 Questions with Verified Correct Answers | Graded A

Perioperative 101 Final Exam | 100 Questions with Verified Correct Answers | Graded A Hydrogel dressing - anshydrate and soothe tissue (tegagel, nu-gel, vigilon, karaya, collonplast) Pressure dressing - ansminimize intracellular fluid, eliminate dead space, distribute pressure evenly fluffed gauze, non-radiopaque and gauze covered pads Biological dressing - anscontrol infection in denuded area, prevent loss of serum, decrease pain allograft of human skin, xenograft of porcine skin, added antimicrobial or chemotherapeutic ointments (silver) silvadene, scarlet red Rigid support dressing - ansimmobilize cast, splint Sponge counts are done for all the following reasons EXCEPT a) account for used sponges b) prevent injury by retained foreign object c) bc state law requires specific count procedure - ansC Reasons to avoid using radiopaque sponges in dressing - ans1) possible invalidation of subsequent count if returns to OR with dressing 2) may appear as foreign body on post op x ray Cardiac Agents - ansused to reduce mammary artery spasm, test patency and integrity of graft, and sustain radial artery dilatation Otic Agents - ansanesthetize, stop or slow bleeding, irrigate, anti-infective Hormonal Agent - ansstimulate smooth muscle Side effects of diagnostic imaging agents - anscell sickling renal failure Characteristics of Antimicrobial Agents - ansBroad Spectrum High log reduction capability persistent nonirritating nontoxic fast acting Chlorhexidine Gluconate (CHG) - ansTOPICAL skin prep, commonly used for pt w/ iodine allergy do NOT USE ABOVE NECK can cause corneal and ototoxicity can cause nerve tissue damage not for vaginal or mucus membrane Povidone Iodine - ansScrub (with detergent) Paint (without detergent) Iodophors are safe for mucus membrane use Alcohol prep - ansacts by denaturing proteins used w other prep DISPERSE FUMES BEFORE DRAPING PCMX - anschloroxylenol, cocamidopropyl PG dimonium chloride phosphate cationic phenolic mixture safe for mucus membranes Vaginal Preps - anspovidone-iodine scrub and paint or chloroxylenol 3% Monopolar Electrosurgery - ansuses dispersive electrode to remove current from patient in fluid filled cavity must be used with isotonic fluid ex. dextran 10, dextran 70, glycine 1.5%, sorbitol, mannitol near head/neck fire risk Bipolar Electrosurgery - anscurrent flows between the tips of the two-poled instrument Argon Enhanced Coagulation (AEC) - anscombo of electrosurgical energy and argon gas creates more direct pathway for electrosurgical energy to travel to target tissue argon gas helps clear site of blood and fluid *** CAN CAUSE GAS EMBOLI *** Ultrasonic Electrosurgery - ansConverts electrical energy into mechanical energy Components of the electrosurgical circuit include a) active electrode, dispersive electrode, generator b) dispersive electrode, fiber, generator c) active electrode, dispersive electrode, generator, scratch pad d) dispersive electrode, fiber, generator, key - ansa Needle Aspiration - ansa fine gauge needle and syringe are used to aspirate an area of abnormal appearing tissue or body fluid Incisional Biopsy - ansA small portion of tissue is incised and sent for examination excisional biopsy - ansan entire section of tissue is sent for examination 5 Rights of Specimen Handling - ansRight Patient Right date/time Right laboratory test Right surgeon Right specimen Routine Specimen - ansspecimen that does not require immediate processing by the pathologist Frozen Section Specimen - ansspecimen that require immediate examination by the pathologist Biopsy Specimen - ansspecimens that will be microscopically studied by the pathologist and may undergo histologic or cytologic analysis Culture Specimens - ansspecimens of tissue or fluid suspected of being infected Slide Specimens - ansspecimens of tissue or fluid that is smeared on a slide for microscopic examination Cytology Specimens - ansspecimens obtained for studying cell biology Forensic Specimens - ansphysical evidence retrieved from a person involved as a suspect or victim in a crime Gross Examination Specimens - ansspecimens that will only receive a macroscopic visual inspection with the naked eye Explanted Medical Devices - ansspecimens may be sent to pathology for gross examination Organ Donation - ans"organ" specimens obtained from a living donor or a cadaver Amputated digits and limbs - ansspecimens that are to be reimplanted Breast Biopsy - ansFROZEN IMMEDIATE ANALYSIS Biopsy of tumor - ansFROZEN IMMEDIATE ANALYSIS Biopsy of lesions - ansFROZEN IMMEDIATE ANALYSIS Rectal biopsy for ganglion cells - ansFROZEN IMMEDIATE ANALYSIS Lymph nodes - ansmay be frozen for diagnostic purposes Require special handling to preserve cells - ansnerve muscle bone marrow testicular biopsies bone marrow biopsy - ansrequires specialized needle that can puncture bone muscle biopsy - ansrequires special forcep that are applied to muscle before removal to keep it stretched during processing breast biopsy - anssent to radiology/mammography to ensure entire lesion is obtained may have needle placed prior to surgery to pinpoint lesion cytology - anstissue and body fluid obtained during procedure can be sent for cytology to identify the function and origin of cells within fluid/tissue done with suspected malignancy can be obtained through "washings" inject saline and aspirate fluid through "luken trap" ex: bronchial, bladder, pelvic Forensic Specimen (fluid) - anscollect in tube or specimen container, swab around wounds, absorb on clean cotton, air dry, paper envelope Forensic Specimen (hair and fiber) - anscollect and place in separate paper envelope Forensic Specimen (fingernail) - ansplace in paper envelope Forensic Specimen (debris) - ans(ex. glass, paint chip, splinter, animal teeth) collect and place in paper envelope Forensic Specimen (foreign object) - ans(ex. bullet, fragment, pellet, knife) rubber tipped clamps, latex gloves, do not mark, no metal basin Forensic Specimen (fabric/clothing) - anskeep as intact as possible, air dry if possible, place on paper, paper between layers, separate bags semi-rigid endoscope - ansincludes a deflectable-tip video laparoscope that will allow movement through the tip to allow a complete view from a variety of different angles operative endoscope - anschanneled scopes that provide the ability to irrigate, suction, insert, and connect a variety of accessories capacitive coupling - anstransfer of electrical current from the active electrode through intact insulation to adjacent conductive items (tissue, trocars) Based on your knowledge of laparoscopic surgery, identify the potential complications related to it: a) pneumonia b) hypoxemia c) hypercarbia d) cardiac dysrhythmia e) hypocarbia f) CO2 embolism - ansb) hypoxemia c) hypercarbia d) cardiac dysrhythmia f) CO2 embolism Which are the major components of medical video imaging? a) electrosurgical unit b) fiber-optic light cable c) verres needle d) camera control unit - ansb) fiber-optic light cable d) camera control unit Based on your knowledge of cameras in endoscopic surgery, identify the tasks that should be completed while setting up the camera before surgery a) inspect the camera head for smudges or debris b) clean the camera head using sterile water c) plug the camera into the CCU and turn on the unit d) complete white balancing of the camera - ansa) inspect the camera head for smudges and debris c) plug the camera into the CCU and turn on the unit d) complete white balancing of the camera Metal Halide Light Source - ansemits continuous blue light, cheaper but less bright than xenon light source Xenon light source - ansemit pulsing high intensity white light, expensive but brigher Pneumoperitoneum - ansair or gas introduced into the body cavity as a distention medium (ex. carbon dioxide, nitrous oxide, helium) Verres needle (blunt tipped trocar) - ansused to deliver CO2 into the peritoneal cavity, creates working space Laparoscopic instruments with small, blunt tips are used for: a) cutting tissue b) dissecting tissue c) grasping tissue d) moving tissue from one place to other - ansb) dissecting tissue Identify the instruments that can be used in laparoscopic surgery a) babcocks forceps b) mosquitoes forceps c) needle holder forceps d) dissector forceps - ansa) babcocks forceps