Intra-Operative Nursing Care & Aseptic Technique

These flashcards cover fundamental principles, roles, procedures, and safety measures associated with intra-operative nursing care and aseptic technique, preparing the student for exam review.

What are the three primary goals of care during the intra-operative period?

Asepsis & infection control, hemostasis, and safe administration of anesthesia.

Define "surgical conscience."

A vigilant commitment to aseptic principles that involves continuous inspection, monitoring, and regulation of the patient, environment, personnel, and equipment during the peri-operative period.

State the four key phrases that summarize surgical conscience principles.

“Sterile to sterile,” “Sterile individuals keep within sterile area,” “Non-sterile to non-sterile,” and “No compromise to sterile technique.”

Into what three areas is the surgical suite divided?

Unrestricted, semi-restricted, and restricted areas.

Who may enter an unrestricted area and how are they dressed?

Personnel in street clothes; no surgical attire required.

What attire is required in the semi-restricted area of the OR suite?

Surgical attire with head and facial hair completely covered.

When is a mask mandatory in the OR suite?

In all restricted areas, including the OR, scrub sink areas, and clean core.

Give two main purposes of the Preoperative Holding Area.

Final patient identification/assessment and performance of last-minute procedures (e.g., IV insertion, medication administration).

List three key functions of the Operating Room environment.

Geographically controlled, environmentally controlled, and bacteriologically controlled setting for surgery.

Name two ventilation measures used to reduce infection risk in the OR.

High-efficiency filters with controlled airflow and positive air pressure rooms.

Identify four core OR resources.

OR table (furniture), equipment/instruments, specialized lighting, and a communication system.

Who are the five core members of the surgical team?

Surgeon, assistant surgeon, anesthesia care provider (anesthesiologist or CRNA), scrub nurse, and circulating nurse.

Give three room-setup duties of the circulating nurse.

Prepare the room, check mechanical/electrical equipment, and monitor aseptic technique.

What documentation is the circulating nurse responsible for intra-operatively?

Intra-operative care record, specimen labels, blood/fluid loss, and drugs used for local anesthesia.

Which team member passes instruments and anticipates the surgeon’s needs?

The scrub nurse.

List three counting responsibilities shared by scrub and circulating nurses.

Counting sponges, needles, and instruments before closure.

State two key pre-operative responsibilities of the surgeon.

Pre-operative history & physical assessment and choice of surgical procedure.

What is the primary role of the assistant surgeon during the operation?

Expose the surgical area, assist with hemostasis, and perform suturing or delegated tasks.

Who qualifies as an Anesthesia Care Provider (ACP)?

An anesthesiologist or a Certified Registered Nurse Anesthetist (CRNA).

Give two core functions of the ACP.

Medical management of patients rendered unconscious/insensible to pain and protection of life functions under anesthesia.

Which two identifiers must be verified when admitting a patient to the OR?

Correct patient name and the planned surgical procedure/site.

List four common elements of the pre-operative assessment database.

History & physical, allergies, CBC, and serum electrolyte values (others include UA, CXR, ECG, pregnancy test, etc.).

Name three valuables-related questions asked before surgery.

Presence of valuables, prostheses, and time of last food/fluid intake.

What is the purpose of counting sponges, needles, and instruments?

Ensure accurate retrieval and prevent retention of foreign objects in the patient.

Identify four components of proper OR attire.

Scrub suit, hair cover/hood, mask, and shoe covers.

During hand scrubbing, how should the hands be positioned relative to the elbows?

Hands held higher than elbows at all times.

What is the recommended number of brush strokes for scrubbing nails and cuticles?

30 brush strokes for nails and cuticles.

Why must elbows remain bent while moving to the OR after scrubbing?

To keep hands elevated and prevent contamination by water runoff.

During self-gowning, to what point should the hands advance inside the sleeves?

Fingers should stop at the cuff edge, not protrude through, until gloves are applied.

What is the central point of the sterile field during surgery?

The site of the surgical incision.

State the rule regarding sterile items that contact an unsterile surface.

They are considered contaminated and must be removed from the sterile field.

At what height is a table considered sterile?

Only at tabletop level; anything below is non-sterile.

Why are the edges of an opened sterile package considered contaminated?

They have been exposed to the non-sterile exterior and environment.

Explain the proper sequence for a circulating nurse opening a sterile package.

Open the top flap away from the body, then side flaps, and finally pull the last flap toward the body.

Where should hands be kept when wearing a sterile gown?

Above waist/table level and below mid-chest; never folded in axillary region.

How close may a non-sterile person approach a sterile field?

Maintain at least a 12-inch (30 cm) distance.

Describe the correct way two sterile team members pass each other.

Face to face or back to back while rotating 360 degrees; never front-to-back.

When pouring sterile fluids, how far above the basin should the bottle be held?

Approximately 12–18 inches (30–45 cm) without reaching over the basin.

What is the rule if sterility of an item is in doubt?

Consider it non-sterile and do not use it.

Why must stockinette cuffs of the gown be covered by glove cuffs?

They are non-sterile fabric and must be completely enclosed by sterile gloves.

Give two key safety considerations when positioning the surgical patient.

Maintain airway/circulation and protect skin, joints, and nerves from injury.

State one guideline for draping a non-sterile table to create a sterile field.

Cuff hands inside the drape, open the drape away from self first, then toward self.

What movement guideline helps minimize airborne contamination in the OR?

Limit traffic and unnecessary movement within and around the sterile field.

Which member of the team remains in the unsterile field and manages non-sterile tasks?

The circulating nurse.