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Periop 101 Final Exam Study Guide
Solutions
Major components of medical video imaging include: - ANSWER✔✔-Fiber optic light cable, Camera
Control Unit (CCU)
Special considerations when using a endoscopic light source are: - ANSWER✔✔-Place in "standby" mode,
do not turn on until light cable is connected to the telescope, set according to manufacturer's
parameters
Special considerations when using insufflation (establishing a pneumoperitoneum) - ANSWER✔✔-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
Advantage of endoscopic surgery versus open surgery - ANSWER✔✔-Smaller incisions
Special considerations when using laparoscopic instruments - ANSWER✔✔-Scrub should inspect more
closely because of unapparent defects that may not be apparent with casual observation, focus on
insulation because of risk for thermal burns if not intact
Special considerations for patient undergoing MIS/Endoscopic Surgery - ANSWER✔✔-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
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Correct fluid management procedures in MIS - ANSWER✔✔-Monitor overload of IV/irrigation fluids
dispensed and returned during procedure (prevent hypervolemia/fluid overload)
Mechanical Methods of Hemostasis - ANSWER✔✔-Manual pressure (sponges), hemostatic clamps,
sutures, staples, clips, ligatures, and/or pledgets
What is a ligature? - ANSWER✔✔-Also known as a tie, strand tied around a blood vessel to occlude
bleeding; large vessels may require transfixion suture (crosscriss stitch)
What is a pledget? - ANSWER✔✔-Non-absorbable suture support used when possibility of sutures
tearing through tissue
Where is a pledget most commonly used? - ANSWER✔✔-Vascular closure, septal repair, heart repair and
hepatic repair
What is bone wax? - ANSWER✔✔-A mixture of beeswax, isopropyl, and a softening agent
Where is bone wax used? - ANSWER✔✔-Ortho, neuro, and the sternum during heart procedures
Chemical Methods of Hemostasis - ANSWER✔✔-Pharmocological methods (meds such as epi, vit K,
protamine, lysine, tranexamic acid)
Topical methods (thrombins, collagen gelatins, phenol sealants)
Thermal Methods of Hemostasis - ANSWER✔✔-ECU via coagulation, bipolar sealing devices, lasers,
ultrasonic energy, Argon gas
Types of Surgical Sponges - ANSWER✔✔-Laps, tonsils, neuro-patties, dissector sponges, raytecs (4x4)
Counting of Sponges - ANSWER✔✔-Before, during and after surgical procedures
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Separate as you count
Two people, one of whom is RN should count
Participation in Sponge Counts - ANSWER✔✔-All personnel in case are responsible for counts including
remaining aware of location of sponges
RN responsibilities in Sponge Counts - ANSWER✔✔-Initiate count (any team member can initiate
count??), perform count, document count activities, reporting count deficiency
Drainage is achieved by ________ or ___________ means - ANSWER✔✔-passive (gravity) or active
(suction)
Types of Drains - ANSWER✔✔-Penrose, nasogastric, T-tube, suction drains, chest tubes
What are Suction Drains and their purpose? - ANSWER✔✔-Remove blood, pus, necrotic material from
wounds via suctions (Jackson-Pratt for abdominal/breast, Hemovac for ortho)
What is a Neutral Zone? - ANSWER✔✔-Designated area on surgical field where scrub and surgeon place
all sharp instruments
What is a Crile? - ANSWER✔✔-A hemostat used to control bleeders in SQ tissue
What is a Mosquito? - ANSWER✔✔-A hemostat used to control superficial bleeders in delicate surgery
(hand/plastic)
What is a Kelly? - ANSWER✔✔-A hemostat used to control bleeders in muscle tissues
What are the Surgical Powered Cutting Instruments? - ANSWER✔✔-Bone reamers, variable speed saws,
tissue shavers
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Care and handling of powered cutting instruments? - ANSWER✔✔-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 - ANSWER✔✔-Geographic isolation
Bacteriologic isolation through specific practices (attire, delivery/disposal systems)
Centralize equipment and supplies
What is Individualized Care? - ANSWER✔✔-Reflects art of nursing, meets individual needs of pt, provide
comfort measures
What is Standardized Care? - ANSWER✔✔-Derived from body of scientific knowledge developed through
research and clinical practice such as counting sponges
What is the Restricted Zone? - ANSWER✔✔-Located in the semi-restricted area and only accessible via
semi-restricted area; includes actual OR
How should air be cleaned in OR rooms? - ANSWER✔✔-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? - ANSWER✔✔-Equipment and sterile supply storage, SPD
What is the Unrestricted Zone? - ANSWER✔✔-Pre-Op Holding Area, Waiting Rooms, Blood/Specimen
processing
Important points about the 2 Piece Scrub Suit - ANSWER✔✔-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 - ANSWER✔✔-Can be re-usable or disposable, required by sterile
team and resistant to strike-through by fluids
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