Midterm Review 1409

Evidence-based practice

provide(s) rationales for all the standards and recommendations made by professional organizations in disease transmission, biotechnology, patient safety, and advances in surgical practice.

Antiseptic liquid soap

__ is used in the healthcare setting for routine hand washing. Plain soap with antiseptic, is effective in removing soluble fatty acids, soil, and debris from the skin surface.

alcohol-based skin cleaner, foams, and creams

When used correctly ___ produce(s) high levels of destruction of both gram + and gram - bacteria.

event related

Handwashing is the simplest and most important preventive measure for reducing infection in the operating room. Hand washing is ____.

scalpels blades and other sharps

When supplies and instruments are opened for a case, for safety reasons __ should be passed directly to the surgical technologist or placed in an area on the sterile field where they are clearly visible.

15 to 20 minutes before the start of surgery

Depending on the complexity of the surgery, the amount of equipment to be prepared, and the emergent nature of the procedure, the surgical technologist and the circulator will begin to open the case __.

draped patient

The __ is the center of the sterile field during surgery.

never

Nonsterile team members ____ lean over or reach over a sterile surface to distribute sterile goods to the field.

only at table height

Tables draped with sterile drapes are considered sterile ____.

unless it is constantly monitored for contamination

When sterile supplies have been opened, the setup is vulnerable to contamination. The longer a setup remains exposed, the greater the risk of contamination. It is recommended that supplies not to be left open before a case ____.

front to front or back to back

Sterile personnel must pass other sterile personnel ___.

in the front, from the mid-chest to the table top

Sterile gowns are considered sterile ___.

12 inches or more

The amount of space that should be left between sterile and nonsterile surfaces is ___.

a risk that blood, or other body fluids, or particles of tissue could splash on the face

Protective goggles, masks, or face shields are required during any procedure in which there is ___.

remove all jewelry

Jewelry of any kind is a potential source of pathogens. The recommended standard is to __.

aseptic technique

The basis of ___ is the concept of barriers between contaminated and sterile surfaces. Sterile objects or surfaces are contained or confined to prevent contact with nonsterile objects.

contaminated

If water is found in a basin when the sterile wrapper is opened, the basin is considered ___.

pathogenic

All nonsterile surfaces are considered potentially contaminated with __ microorganisms.

Surgical-site

___ infection is a postoperative infection of the surgical wound.

Sterile drapes

___ provide a barrier between a nonsterile surface and the working area of the sterile field

only

The top ___ of a sterile table is the only part considered sterile.

Aseptic technique

__ is based on surgical conscience: that is, the ethical and professional motivation that regulates a professional’s behaviors regarding disease transmission.

Contamination

__ is when the surgeon’s gloved hand accidentally touches the nonsterile edge of the surgical drape.

scrub suit

The ___ is/are worn by both sterile and nonsterile surgical personnel in the perioperative equipment.

have the circulator pull from the shoulders down

When removing a contaminated gown during surgery, the scrub should ___.

integrity

Before opening a sterile pack, the scrub should also check the outside package for the ___.

Back table

What OR furniture should the large pack be placed on before opening?

Small table (prep stand)

What OR furniture should a large instrument tray be placed on before opening?

Ring stand

What OR furniture should the basin set be placed on before opening?

push the hands and forearms into the sleeves, advancing the hands just to the proximal edge of the cuff.

The scrub person is preparing to self-don a wraparound gown before surgery. Select the best practice to follow for the self-gowning procedure.

it can only be used for the initial gloving.

Closed gloving is the technique of choice for the initial donning of sterile gloves by the scrubbed team member; however:

Gowns, gloves, mask

Which of the following lists the correct order of the proper steps in the removal of soiled sterile attire when breaking scrub?

remove transient microorganisms and suppress resident microorganisms

The surgical hand scrub is designed to:

False=

Sterile drapes are allowed to be readjusted if needed. =

12-18 inches

In positioning the sterile back table in accordance with aseptic technique, the CST knows that the table should be placed ___ from the unsterile wall.

Antiseptics

Chemicals that reduce the # of microorganisms in the body tissue or on skin

Aseptic technique

Takes time and practice to develop

Asepsis

AsepsisIn surgery, it is a state of the presence of no pathogens

Aseptic technique \*

Methods or practices in health care that promote and maintain a state of asepsis \*

“Asepsis”

“Without infection”

Asepsis \~

The absence of pathogenic microorganisms on an animate surface or on body tissue \~

Antiseptics =

May prevent recolonization for a limited period =

Antiseptics \*

Patient skin preparation

sterile

Draped back table top

contaminated

Cuff of gown after downing gloves

contaminated =

Armpits =

contaminated \*

Tiny hole in glove\*

Sterile +

Draped patient+

Surgical rub

The application of an approved antiseptic to all surfaces of the hands and fingers.

Surgical scrub

Counted strokes

Surgical rub =

Should be used only when no soil is visible on the hands =

Surgical scrub \~

Brushes must be sterile \~

Masks filter 99% of particles

Which is the correct statement about masks?

strike-through contamination

When water is exposed to a sterile drape or gown, it can cause ___ , which occurs when moisture from either side of the drape serves as a vehicle for bacteria to infiltrate the drape form the nonsterile surface.

False ^

Microorganisms that do not normally reside in the tissue of an individual are called resident flora. ,

The process by which a team of professionals evaluates a health care institution’s practices and policies and the outcomes of patient care is called.

Accreditation

all of the above

The surgical department is structured and engineered to provide a safe and efficient environment for patients and staff members. Many different designs can be used, but all must achieve the following objectives:

\
\-infection control

\-environmental safety

\-efficient use of personnel, time, space, and resources

clean and contaminated

__ and __ areas (those with the greatest potential sources of infection) are physically separated when possible.

personnel policies

All of the following are core principles of operating room design except.___.

\
\-infection control

\-environmental safety

\-efficiency

Traffic patterns

___ create(s) boundaries between areas that carry the highest potential sources of infection and those that are the cleanest.

Decontamination

___ is the area where instruments and equipment are cleaned and disinfected:

@@semirestricted@@

@@The clean utility room within the surgical department is a(n)___ area.@@

Hair cap, mask, facial hair covering, complete scrub suit

What attire is required to enter to restricted area?

infection control

The purpose of floor plan is to provide efficiency, environmental safety, and __ in the surgical department.

10%

The air pressure in the surgical suite is maintained at a level of ___ higher than the air pressure in adjacent semi restricted areas.

15; 20

The standard for air exchange in the OR is a minimum of - and a maximum of _filtered air exchanges per hour.

positive; out

When the operating room door is opened, the *_pressure from within the room pushes air* -.

20%-60%\`

The current standard for humidity in the OR is __.

Fresh; existing

__ filtered air enters the operating room ceiling vents and is combine with _ air in the room.

0\.3 micrometers

High efficiency particulate air (HEPA) filters that are installed in the OR ventilation system and remove particles equal to or larger than.

all of the above

Some types of surgical procedure require a specialized room that contains the equipment and technology of that specialty. This room is called a ___.

\-specialized room

\-cysto room

\-special procedure room

humidity

High __ may increase the risk of mold and bacterial growth on surfaces.

68 to 73 degrees Faranheit

The temperature in the OR is maintained at ___.

LED sources and halogen

Modern surgical lighting is usually derived from ____.

velocity

A laminar airflow (LAF) system moves a contained volume of air in layers at a continuous ___.

suction

All of the following are compressed gases except __.

\
\-oxygen

\-nitrogen

\-nitrous oxide

\-compressed air

\-suction

operating table

Which piece of equipment is covered with a firm removable pad where the patient is placed?

Back table

Which piece of equipment is the sterile pack opened onto that provides a sterile surface for instrument and supplies?

Mayo stand

Which piece of equipment is covered with a sterile drape and placed over the patient during the procedure for quick access to instruments?

Ring stand

Which piece of equipment is designed to contain sterile basins that are used during surgery?

True \*

All doors into a restricted area must remain closed during an operation to preserve positive air \*

True -

Infectious, blood-saturated and dripping, regulated medical waste should be contained and discarded in red bags with a biohazard symbol.

unrestricted area

family waiting room

restricted area

surgical suite

restricted area

sterile instrument room

semirestricted area

anesthesia workroom

%%restricted area%%

%%sub sterile room%%

^^restricted area^^

^^closed areas for the scrub sinks^^

^^semirestricted area^^

^^personnel must wear surgical attire (mask no necessary)^^

==restricted area==

==personnel must wear surgical attired (mask not necessary)==

^^unrestricted area^^

^^personnel dressed in street clothes^^

semirestricted area

corridors between surgical rooms

Sub sterile room

Is adjacent to the OR

Anesthesia department

Contains clean respiratory equipment, anesthetic agents, and adjunctive drugs

Surgery waiting area

Patient’s family is located outside

Surgical offices

A front office situated near the main entry doors serves as a central communication area for the department

Clean processing area

Items that are particularly delicate or that are used infrequently may be processed in this area

Integrated OR system

Provides centralized control of surgical devices and equipment through a sterile remote or voice activated system

Locker room/lounge area

A transitional area for those who need to change from street clothes to surgical attire

Sterile instrument room

Sterile wrapped supplies are stored in designated restricted areas adjacent to the operating suites nearby