Perioperative Nursing Roles and Aseptic Technique

Questions and Answers

Which responsibility is NOT associated with the scrub nurse during the surgical procedure?

Anticipate needs of the surgical team

Assist the anesthetist with direct patient care (correct)

Initiate surgical counts

Maintain asepsis

What is a key responsibility of the circulating nurse?

Provide sterile dressings

Perform wound management

Complete OR documentation (correct)

Assist with surgical counts

In which phase does the surgical count take place?

Intraoperative Care (correct)

Preoperative Care

Preoperative Assessment

Postoperative Care

What is emphasized as imperative to preventing surgical site infections?

Aseptic Technique Signup and view all the answers

Which of the following tasks is typically handled by the registered nurse first assistant (RNFA)?

Dissecting tissues Signup and view all the answers

What is the primary role of the scrub nurse during surgery?

To pass instruments to the surgical team Signup and view all the answers

Which of the following duties is primarily associated with the circulating nurse?

Completing patient assessments Signup and view all the answers

What are the three phases of perioperative nursing care?

Preoperative Set Up, Intraoperative Care, Postoperative Care Signup and view all the answers

What is the primary goal of the collaboration between the scrub and circulating nurses?

To ensure patient safety and enhance care quality Signup and view all the answers

Which statement best describes the role of the scrub nurse regarding the sterile field?

Works within the sterile field to assist the surgical team Signup and view all the answers

Which wound class represents non-infected procedures without inflammation and does not involve entry into the respiratory, alimentary, or genitourinary tracts?

Class I: Clean Signup and view all the answers

Which classification of wounds involves entry into the respiratory, alimentary, or genitourinary tracts but shows no signs of infection?

Class II: Clean Contaminated Signup and view all the answers

What is the main characteristic of Class III: Contaminated wounds?

Open wounds or incisions with signs of infection Signup and view all the answers

Which class of wounds is defined by existing infections and is indicative of the worst contamination?

Class IV: Dirty/Infected Signup and view all the answers

In assessing airborne precautions, which additional protective equipment is needed alongside gloves and an N-95 mask for eye protection?

Face shield Signup and view all the answers

What is the primary purpose of administering prophylactic antibiotics before surgical incision?

To prevent surgical site infections Signup and view all the answers

How often should air exchange occur in an operating room?

20 times per hour Signup and view all the answers

What is indicated by the presence of chemical indicators during sterile setup?

The sterilization process was successful Signup and view all the answers

What distance must circulating personnel maintain from the sterile setup?

12 inches Signup and view all the answers

Which pathogen is most resistant according to the microbiology section?

Staphylococcus (MRSA) Signup and view all the answers

What should be assumed if the sterility of an item is questioned?

The item is unsterile Signup and view all the answers

Which of the following best describes the role of maintaining good surgical conscience?

Being aware of potential contamination risks Signup and view all the answers

Which attire is typically required under droplet precautions?

N-95 mask, gown, and gloves Signup and view all the answers

Study Notes

Perioperative Environment Overview

Perioperative patient care consists of three phases: Preoperative, Intraoperative, and Postoperative.
Nursing roles in the perioperative environment include scrub and circulating nurses, each with distinct responsibilities.
Collaboration and effective communication between nursing roles enhance patient safety and procedural efficiency.

Nursing Roles

Scrub Nurse

Works within the sterile field, directly assisting the surgical team.
Responsible for assembling required instruments and supplies.
Possesses in-depth knowledge of surgical procedures and anticipates the needs of the surgical team.
Performs surgical counts and maintains aseptic conditions.

Circulating Nurse

Functions as a non-scrubbed individual who manages the overall operating room environment.
Conducts patient assessments and develops personalized nursing care plans.
Assists the anesthetist with patient positioning, surgical preparation, and documents all relevant care activities.
Coordinates room management and ensures surgical safety protocols are followed.

Three Phases of Perioperative Care

Preoperative Set Up: Involves preparing the operating room, checking surgical equipment, and ensuring the environment is ready before the patient's arrival.
Intraoperative Care: Focuses on managing the surgical case, maintaining asepsis, and ensuring effective communication among nursing and surgical staff.
Postoperative Care: Encompasses cleaning the operating room, completing documentation, and transferring patients post-surgery.

Aseptic Technique and Infection Prevention

Aseptic technique is crucial for preventing Surgical Site Infections (SSIs).
Highlights include maintaining strict asepsis, adhering to transmission-based precautions, and using prophylactic antibiotics prior to incision.
Operating rooms should have controlled air exchange and minimized traffic to maintain a sterile environment.

Surgical Wound Classification

Class I: Clean: Non-infected; no signs of inflammation; no entry of respiratory, alimentary, or genitourinary tracts.
Class II: Clean Contaminated: Where tracts are entered but no infection or breaks in aseptic technique occur.
Class III: Contaminated: Open wounds or incisions with signs of infection; GI tract entered with no aseptic breaks.
Class IV: Dirty/Infected: Wounds already infected, with signs of existing infection.

Microbiology and Resistance

Notable resistant pathogens include:
- Staphylococcus (MRSA) at 43% resistance
- Enterococcus faecium (VRE) at 62% resistance
- Escherichia coli at 11% resistance
- Pseudomonas aeruginosa at 10% resistance

Best Practices for Aseptic Techniques

Establish and maintain a sterile field, utilize effective surgical scrub protocols.
Adhere to sterile parameters, including distance when passing items within sterile areas.
Ensure safe handling and disposal of sharps and unsterile items.

Transmission-Based Precautions

Contact Precautions: Use of gowns, gloves, and masks as necessary.
Droplet Precautions: Similar attire with emphasis on potential airborne transmission.
Airborne Precautions: Ensures isolation and protection, requiring specific PPE including N-95 masks.

Additional Notes

Registered Nurse First Assistants (RNFA) collaborate directly with surgeons to assist in dissection, hemostasis, and suturing.
Continuous monitoring and adherence to aseptic technique are imperative in the operating room to safeguard patient outcomes.

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Description

This quiz explores the essential roles within the perioperative environment, focusing on the scrub and circulating nurse functions. It also covers key concepts in surgical asepsis, best practices for preventing infections, and the classification of surgical wounds. Test your understanding of these crucial aspects of perioperative nursing practice.