Questions and Answers
Which type of precaution is necessary for Tuberculosis?
What attire is required when dealing with Infectious Diseases that require Droplet Precaution?
Which of the following is NOT a recommended action following surgery in a room with C.Difficile?
Which disease requires patients to be transferred wearing a mask?
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What is a key characteristic of Acute Respiratory Syndrome (SARS) regarding precautions?
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Which of the following diseases is classified under Contact Precaution?
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What additional role does the circulating nurse play when managing an environment with Droplet Precautions?
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What is the recommended temperature range for the operating room to ensure a proper aseptic environment?
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What should be done after surgery in an OR handling C.Difficile infections?
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Which of the following practices is essential for maintaining the sterile field in the operating room?
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What is the minimum number of air exchanges recommended per hour in the operating room?
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What should be done if a package containing sterile items is found to have a compromised integrity?
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When should items in the operating room be opened or dispensed?
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For what reason should air exchange in the operating room be positive pressure?
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What is a critical factor in ensuring that large bundles of sterile items are opened correctly?
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What is the key principle of the sterile boundary when using peel packs?
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What should be done at the end of the day when scheduling surgeries?
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What defines a Clean Wound (Class I)?
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Which of the following is an example of a Clean Contaminated Wound (Class II)?
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How long should an OR room remain vacant after surgery?
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What is a key factor in determining the classification of a wound?
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In which scenario would a surgical mask not be necessary during a patient transfer?
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What must be ensured when classifying a Clean Contaminated Wound?
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Which surgical procedure can be classified as a Clean Wound (Class I)?
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What type of wound is characterized by being fresh, open, and involving obvious spillage from the GI tract?
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Which closure method involves healing without tissue loss and prompt approximation of wound edges?
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What is required for wounds healed by secondary intention?
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What distinguishes third intention wound closure?
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Which situation would classify a wound as Class IV?
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In which wound healing process is extensive scar tissue typically formed?
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What is a characteristic of a wound closed by primary intention?
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What is associated with major breaks in aseptic technique?
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What should be done with items that have been dropped on the floor?
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How should sterile personnel pass by each other to maintain sterility?
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Which of the following statements about sterile gowns is accurate?
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What must be done with opened sterile setups when left unattended?
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What is considered a sign of contamination in sterile barriers?
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What precautions must circulating personnel take in relation to the sterile field?
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Which of the following is true regarding liquids that remain after a surgical case?
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Which type of microorganisms is the most common cause of surgical site infections?
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Study Notes
Surgical Asepsis and Infection Control
- Surgical asepsis is crucial for preventing surgical site infections (SSIs) and ensuring optimal patient outcomes.
- The operating room (OR) environment is specifically designed to minimize contamination and maintain the integrity of sterile supplies.
Aseptic Environment
- Doors must remain closed to prevent contamination.
- Positive pressure air exchange is set to approximately 20 air exchanges per hour.
- Ideal temperature range is 20-23°C; humidity should be between 30-60%.
- Minimize traffic in and out of the OR to reduce exposure.
Establishing the Sterile Field
- Surfaces must be dry and dust-free before placing sterile packs.
- Drains and working surfaces should maintain sterility at table level only.
- Items should be opened only when needed and assessed for package integrity.
- Expiry dates should be checked; peeled packages must remain intact to maintain sterility.
- Movement near the sterile field should be conducted carefully to avoid contamination.
Maintaining Sterile Field
- Unattended opened sterile setups are deemed contaminated.
- Items of questionable sterility are treated as unsterile.
- Sterile gowns are sterile only from the chest to table level and sleeve regions.
- Non-sterile personnel must maintain a distance of at least 30 cm from sterile setups.
- Any objects dropped on the floor or otherwise compromised are considered contaminated.
Microbiology and Transmission-based Precautions
- Microorganisms, including bacteria, fungi, and viruses, are primary concerns in SSIs; bacteria are the most common cause.
- Common pathogens include MRSA, VRE, influenza, and tuberculosis.
- Contact, droplet, and airborne precautions are established, including specific OR attire for each type.
Wound Classifications
- Clean Wounds (Class I): No signs of infection; generally low risk for SSIs (e.g., hernia repair, nephrectomy).
- Clean Contaminated Wounds (Class II): Entered gastrointestinal or respiratory tracts without infection (e.g., bowel surgery).
- Contaminated Wounds (Class III): Involves breach in asepsis or spillage from viscera (e.g., trauma).
- Dirty or Infected Wounds (Class IV): Existing infections or wound drainage present.
Wound Healing
- Primary Intention: Uneventful healing of clean wounds where edges are approximated.
- Secondary Intention: Healing occurs through granulation where there is tissue loss.
- Third Intention: Delayed closure allows for further assessment and possibly multiple sutures.
Best Practices to Prevent SSIs
- Adhere to infection prevention protocols as established by ORNAC Standards.
- Terminal cleaning of the OR after procedures is mandatory for infection control.
- Schedule cases requiring extensive cleaning or special attention towards the day's end.
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Description
Test your knowledge on surgical asepsis and infection control as outlined in Module 4. This quiz covers essential concepts related to the operating room environment and standards for infection prevention, drawing from Alexander’s Care of the Patient in Surgery and ORNAC Standards. Prepare to demonstrate your understanding of key practices for maintaining a sterile surgical environment.
