Chapter 20: Surgical Skin Prep and Draping
- ANS-Case Study 1: Your surgical patient has been released to you for prepping and draping
by the anesthesia provider. The surgeon has requested placement of a Foley catheter for this
procedure.
- ANS-Labeling: Abdomen
- ANS-Labeling: Anterior head and neck
- ANS-Labeling: Anterior shoulder
- Allergies
- Chemical Burns
- Fire
- Thermal Burns - ANS-What are the risks involved in improper use of prep solutions?
- containers for the antiseptic or saline
- foley catheter
- gauze prep sponges
- antiseptic solution (water-based)
- sterile lubricant
- sterile gloves
- 10-mL syringe prefilled with water
- Perineal drape
- Forceps
- Cotton balls
- Drainage tubing and a urine collection unit - ANS-List the supplies needed for urinary
catherization.
- continuous drainage prevents distension of the bladder during lengthy procedures.
- surgery of the lower abdominal and pelvic cavity requires decompression (collapse) of the
bladder to protect it from injury during procedures
- Catherization allows measurement of urine and thus assessment of renal output on patients at
risk. - ANS-Urinary catherization is necessary in selected procedures and circumstances. What
are they?
1. A *towel* is wrapped around the *pneumatic tourniquet.*
2. Place a *rolled stockinet* over the foot or hand and unroll it to cover the limb.
3. Secure a *split drape* around the proximal (upper) part of the limb. 4. Apply a *fenestrated
drape* to complete the surgical field. - ANS-Case Study 2: You are about to scrub for a knee
arthroscopy. Your patient is asleep under general anesthesia. He has been prepped, and you
, are about to drape him. What will you need to have ready for the surgeon so that you can drape
the patient? List your supplies in the order you will use them.
1. Layering begins with a plain sheet, half-sheet, or body sheet. In upper body surgery, this is
used to cover the patient's legs and lower torso. The plain sheet may also be called a half-sheet
or cover sheet. 2. Surgical towels made of heavy absorbent cloth are used to make a frame
around the incision site. Towels are folded along one edge before they are positioned on the
patient. Framing the incision means providing a fenestration in the drapes for the incision. The
fenestration can be square, oblong, or oval if a disposable fenestrated drape is used.
3. Plastic drapes and towels are used to cover the patient's skin and are used in many different
applications. The towel drape, also called a sticky drape, is a sheet of smooth plastic or bonded
draping material with one adhesive edge. The towel drape is commonly used to exclude an area
from the prep. For example, during the skin prep for eye surgery, a towel drape - ANS-List the
technique in draping.
1. Square the periphery of the prep site with sterile towels.
2. Begin at the incision area and apply prep solution in a circular pattern, continuing to the
periphery. Complete this pattern at least twice, beginning again at the incision site and working
outward to the surface of the operating table. - ANS-The flank and back areas are prepped in
the same manner as the abdomen; describe the technique.
1) position the patient
2) check for jewelry
3) place prep sponges in the antiseptic.
4) test the balloon for leakage
5) place a small amount of lubricant in a sterile area of the prep tray or on the tip of the catheter
6) If in lithotomy position, impervious drape is placed under the buttocks.
7) If in supine position, pace fenestrated drape over genitalia.
8) Female prep
9) Male prep
10) Maintain traction
11) Guide catheter into the urethra with slow, steady pressure. Don't force it.
12) Connect the distal end of the catheter to the sterile tubing and calibrated urine collection
unit.
13) Make sure no tension is placed on the catheter tubing once it is in place.
14) Remove your gloves. - ANS-List the steps of urinary catherization.
A nonretention urinary catheter used to drain the bladder one time (sometimes called a or
Robinson catheter). - ANS-Straight catheter
a plain sheet - ANS-A draping routine usually begins with:
A plastic adhesive drape that is positioned over the incision site after the surgical skin prep. The
incise drape creates a sterile surface over the skin. - ANS-Incise drape
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