Surgical Instruments Identification Quiz
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Questions and Answers

What is the purpose of stabilizing grafts with ortho hardware?

  • To avoid contamination during the procedure
  • To support proper alignment until fusion occurs (correct)
  • To assist in immediate mobility post-surgery
  • To ensure they fuse together independently

    • Which instrument is specifically designed to grasp and remove intervertebral disc material?

  • Pituitary Rongeur (correct)
  • Scalpel
  • Kerrison Rongeur
  • Bone Curette

    • What should nurses verify before passing powered surgical drills to the surgeon?

  • The drill's color matches the surgical instruments
  • The drill is clean and free from any debris
  • The safety lock is on and the correct cord is attached (correct)
  • The drill has been sterilized and packaged properly

    • Which type of table is used for patients undergoing spinal surgery?

    <p>Jackson Spinal Table</p> Signup and view all the answers

    What is the primary purpose of pneumatic tourniquets during surgery?

    <p>To create a bloodless surgical field</p> Signup and view all the answers

    What is the maximum recommended inflation pressure for a pneumatic tourniquet on the thigh?

    <p>300 mmHg</p> Signup and view all the answers

    How long can a pneumatic tourniquet be inflated on the lower extremity before requiring documentation?

    <p>120 minutes</p> Signup and view all the answers

    Which procedure should not utilize external fixation?

    <p>Closed Reduction</p> Signup and view all the answers

    Which category of strabismus is characterized by one eye being higher than the other?

    <p>Hypertropia</p> Signup and view all the answers

    What is the primary function of cycloplegics in ophthalmology?

    <p>Dilate the pupil and inhibit focusing</p> Signup and view all the answers

    Which approach involves removing a segment of muscle and reattaching the shortened muscle to the eye?

    <p>Resection</p> Signup and view all the answers

    What precaution should be taken regarding access to laser rooms?

    <p>Warning signs should be present at all entrances</p> Signup and view all the answers

    Which ethical principle is essential for preventing conflicts in a therapeutic nurse-client relationship?

    <p>Ability to communicate beliefs and values</p> Signup and view all the answers

    What is the primary purpose of adding Barium Sulfate to the powder component in PMMA preparation?

    <p>To make the cement radiopaque</p> Signup and view all the answers

    Which of the following is NOT a reason for handling prostheses meticulously during surgery?

    <p>To simplify the sterilization process</p> Signup and view all the answers

    Which type of bone fracture surgery involves manipulation of fragments without incising the skin?

    <p>Closed Reduction</p> Signup and view all the answers

    What is a critical safety consideration when working with the liquid component of PMMA in the OR?

    <p>It requires special hoods to avoid fumes</p> Signup and view all the answers

    What is the most common infectious process associated with bone fractures?

    <p>Osteomyelitis</p> Signup and view all the answers

    Why is a biological indicator essential for an implant's sterilization process?

    <p>To confirm that sterilization has been successful</p> Signup and view all the answers

    Which statement correctly describes external fixation?

    <p>It provides rigidity while allowing soft tissue management</p> Signup and view all the answers

    What is the main benefit of using a splint or cast in closed reduction procedures?

    <p>To immobilize the fracture for healing</p> Signup and view all the answers

    Which of the following accurately describes the goals of fracture surgery?

    <p>To restore anatomical function and alignment of bones</p> Signup and view all the answers

    What potential complication is associated with open fractures in orthopedic surgery?

    <p>Increased risk of infection</p> Signup and view all the answers

    What is the primary advantage of using ORIF over closed methods for treating fractures?

    <p>The surgeon has direct access to the fracture site for proper alignment.</p> Signup and view all the answers

    Which type of fracture is characterized by being extracapsular with intact blood supply and is commonly fixed with plates and screws?

    <p>Intertrochanteric Fractures</p> Signup and view all the answers

    What technique is primarily used for stable fixation in femoral neck fractures?

    <p>Cannulated Screws (AO Technique)</p> Signup and view all the answers

    Which complication is most associated with unstable femoral neck fractures?

    <p>Avascular necrosis of the femoral head</p> Signup and view all the answers

    In open reduction internal fixation, which is NOT a reason to use lead gowns?

    <p>To protect against infection</p> Signup and view all the answers

    What is the primary function of the guide pin when using Dynamic Hip Screw instrumentation?

    <p>To create a channel for the lag screw</p> Signup and view all the answers

    Which procedure is generally recommended when a femoral neck fracture is unstable?

    <p>Total Hip Arthroplasty (THA)</p> Signup and view all the answers

    Why is external fixation not typically used in the initial treatment of femoral neck fractures?

    <p>It cannot provide adequate alignment of the fracture.</p> Signup and view all the answers

    What is a common indication for using a Dynamic Hip Screw (DHS)?

    <p>Extracapsular hip fractures in the elderly</p> Signup and view all the answers

    Which fixation method is typically employed for the treatment of intertrochanteric fractures?

    <p>Dynamic Hip Screw (DHS)</p> Signup and view all the answers

    What type of clips are used specifically for hemostasis of the scalp?

    <p>Raney clips</p> Signup and view all the answers

    Which of the following is NOT a common position used in neurosurgery?

    <p>Sitting</p> Signup and view all the answers

    What is the purpose of using a Mayfield head fixation device in neurosurgery?

    <p>To prevent movement of the head</p> Signup and view all the answers

    Which hemostatic agent is characterized by being radiopaque and moistened before use?

    <p>Neuro patties</p> Signup and view all the answers

    What type of flap keeps its original blood supply intact during transfer?

    <p>Pedicle flap</p> Signup and view all the answers

    What instrument is typically used to open the dura during surgical procedures?

    <p>Metz scissors</p> Signup and view all the answers

    During neurosurgery, what is the term for the count performed when closing the dura?

    <p>Dura count</p> Signup and view all the answers

    Which device is primarily used for harvesting split thickness skin grafts?

    <p>Dermatome</p> Signup and view all the answers

    Which is a necessary nursing consideration for patients undergoing neurosurgery?

    <p>Padding pressure points well</p> Signup and view all the answers

    What technique involves severing the original blood supply and reattaching it microscopically?

    <p>Free flap technique</p> Signup and view all the answers

    What procedure involves the reattachment of a muscle at a point further back from the front of the eye?

    <p>Recession</p> Signup and view all the answers

    Which of the following is NOT classified as a type of strabismus?

    <p>Anisotropia</p> Signup and view all the answers

    Which medication is specifically used to constrict the pupil?

    <p>Miotics</p> Signup and view all the answers

    What is a key component of laser safety in medical settings?

    <p>Use of non-reflective surfaces</p> Signup and view all the answers

    Which ethical aspect is fundamental for a nurse to communicate to prevent conflicts in care?

    <p>Personal beliefs and values</p> Signup and view all the answers

    Which type of bone tissue is soft and spongy, and contains red bone marrow?

    <p>Cancellous bone</p> Signup and view all the answers

    What is the primary role of ligaments in the skeletal system?

    <p>Hold bone to bone and provide joint stability</p> Signup and view all the answers

    Which procedure requires stripping away the periosteum during bone repair?

    <p>Fracture fixation</p> Signup and view all the answers

    What is the purpose of the epiphyseal plate in long bones?

    <p>To allow for bone lengthening during growth</p> Signup and view all the answers

    Which type of bone graft is harvested from the patient's own body?

    <p>Autograft</p> Signup and view all the answers

    Which instrument is specifically designed to create a stable canal for the screw in bone surgery?

    <p>Drill</p> Signup and view all the answers

    What is the main advantage of using cancellous bone for grafting purposes?

    <p>It can promote faster growth into the host bones</p> Signup and view all the answers

    Which structural feature of long bones is involved in the separation of the epiphysis from the diaphysis?

    <p>Epiphyseal plate</p> Signup and view all the answers

    What is a critical requirement for a graft to survive during burn surgery?

    <p>Adequate vascularity of the recipient area</p> Signup and view all the answers

    Which of the following is NOT a goal of dressings in burn surgery?

    <p>Provide aesthetic enhancement</p> Signup and view all the answers

    What is a disadvantage of Split Thickness Skin Grafts (STSG)?

    <p>Increased risk of skin contractures long term</p> Signup and view all the answers

    What characterizes Full Thickness Skin Grafts (FTSG) compared to STSG?

    <p>They include both epidermis and dermis</p> Signup and view all the answers

    During cataract surgery, which method involves leaving the posterior capsule intact?

    <p>Extra Capsular Cataract Extraction (ECCE)</p> Signup and view all the answers

    Why is it important for the surgical room to be warm during burn surgery?

    <p>To mitigate the risk of hypothermia from tissue loss</p> Signup and view all the answers

    What is the primary rationale for incorporating Barium Sulfate into the powder component of PMMA?

    <p>To provide a radiopaque quality</p> Signup and view all the answers

    Which procedure is characterized by the removal of the lens within its capsule using a cryoprobe?

    <p>Intra Capsular Cataract Extraction (ICCE)</p> Signup and view all the answers

    Which of the following actions is NOT crucial when handling prostheses?

    <p>Placing on a sterile surface only</p> Signup and view all the answers

    What is the primary reason for placing a dressing over the donor site of a split thickness skin graft?

    <p>To prevent infection at the donor site</p> Signup and view all the answers

    What is a significant risk associated with the manipulation of the liquid methyl monomer in PMMA preparation?

    <p>It is highly flammable and can produce harmful fumes</p> Signup and view all the answers

    What does cataract surgery involve when phacoemulsification is used?

    <p>Controlled rupture of the anterior capsule for lens removal</p> Signup and view all the answers

    Which surgical procedure primarily focuses on restoring the anatomical function of fractured bones?

    <p>Open reduction internal fixation</p> Signup and view all the answers

    What is a typical characteristic of a skin graft that is meshed?

    <p>It can cover more extensive burn areas</p> Signup and view all the answers

    Which benefit is NOT associated with performing a closed reduction for fracture alignment?

    <p>No need for further surgical intervention</p> Signup and view all the answers

    What type of fractures usually warrant the use of external fixation as a treatment method?

    <p>Severe open fractures</p> Signup and view all the answers

    What role does Bacitracin play in orthopedic surgical procedures?

    <p>It serves as an irrigating solution for contaminated tissue</p> Signup and view all the answers

    Which condition is commonly linked to the need for fracture surgery due to infection?

    <p>Osteomyelitis</p> Signup and view all the answers

    What type of surgical manipulation is confirmed using radiography during a closed reduction procedure?

    <p>Alignment of bone fragments</p> Signup and view all the answers

    Which of the following is a potential complication associated with open fractures?

    <p>Higher risk of infection</p> Signup and view all the answers

    Which of the following statements is true regarding the procedure of tympanoplasty?

    <p>It involves reconstruction of both the tympanic membrane and the ossicles.</p> Signup and view all the answers

    In what position should a patient be placed during a radical neck dissection procedure?

    <p>Supine with a shoulder roll</p> Signup and view all the answers

    What role does lidocaine serve during laryngeal surgeries?

    <p>To prevent the patient from coughing during the procedure</p> Signup and view all the answers

    What is the main purpose of performing a tracheostomy?

    <p>To facilitate long-term airway management in critical situations</p> Signup and view all the answers

    Which component is typically avoided for preparing patients undergoing head and neck surgeries due to its ototoxic properties?

    <p>Chlorhexidine</p> Signup and view all the answers

    What procedure is primarily indicated for treating conditions such as sinuses blockage and polyps?

    <p>FESS</p> Signup and view all the answers

    During which surgical procedure is it critical to perform an initial and final count of instruments?

    <p>Radical Neck Dissection</p> Signup and view all the answers

    What is the main goal of using absorbable sutures in surgical procedures?

    <p>To promote faster recovery by avoiding suture removal procedures</p> Signup and view all the answers

    Which of the following best describes the main component of a commando procedure?

    <p>Oral resection combined with radical neck dissection</p> Signup and view all the answers

    Which instrument is primarily used to manipulate the back into place during surgery?

    <p>Boies elevator</p> Signup and view all the answers

    What is the main advantage of using Open Reduction and Internal Fixation (ORIF) over the closed method?

    <p>It provides a direct view of the fracture for better alignment.</p> Signup and view all the answers

    Which type of fracture is most likely to require Total Hip Arthroplasty (THA) as a fixation method?

    <p>Unstable femoral neck fractures.</p> Signup and view all the answers

    What characteristic distinction allows intertrochanteric fractures to be fixed with plates and screws?

    <p>They are extracapsular and maintain intact blood supply.</p> Signup and view all the answers

    Which procedure involves the use of a guide pin for securing a lag screw within hip-screw instrumentation?

    <p>Dynamic Hip Screw (DHS) procedure</p> Signup and view all the answers

    In femoral neck fractures, what is the primary concern leading to the need for reduction before internal fixation?

    <p>Potential for loss of blood supply to the femoral head.</p> Signup and view all the answers

    What is the primary function of the lag screw in the Dynamic Hip Screw instrumentation?

    <p>To compress the fracture site for stability.</p> Signup and view all the answers

    Following an intertrochanteric fracture, which instrumentation is primarily employed?

    <p>Dynamic Hip Screw (DHS) with a barrel compression plate.</p> Signup and view all the answers

    What is a key consideration when treating femoral neck fractures with internal fixation?

    <p>Unstable fractures may lead to avascular necrosis if not properly aligned.</p> Signup and view all the answers

    What is the primary advantage of using intramedullary (IM) rods over plate/screw fixation methods?

    <p>IM rods reduce the weight-bearing stresses at the fracture site.</p> Signup and view all the answers

    In a bilateral total hip replacement using the modular method, what is the main purpose?

    <p>To ensure symmetrical length and alignment of both legs.</p> Signup and view all the answers

    Which type of fixation system is commonly used for addressing subtrochanteric fractures?

    <p>Intramedullary rods and nails.</p> Signup and view all the answers

    Which key component is integral to the advantages of arthroscopy compared to open surgery?

    <p>Visualization using a scope and smaller incisions.</p> Signup and view all the answers

    What is a major benefit of using saline irrigation during arthroscopic procedures?

    <p>It facilitates better visualization of the joint space.</p> Signup and view all the answers

    Which statement regarding the fixation techniques described is correct?

    <p>IM fixation minimizes blood loss and scarring.</p> Signup and view all the answers

    Which virtue is most closely associated with actively focusing on the best interests of the patient in perioperative nursing?

    <p>Compassion</p> Signup and view all the answers

    Which ligaments provide reinforcement to the knee capsule?

    <p>Medial and lateral collateral ligaments.</p> Signup and view all the answers

    What key ethical value emphasizes respecting the dignity of life in perioperative nursing?

    <p>Respect for Life</p> Signup and view all the answers

    In terms of fixation, how do IM rods affect recovery from fractures?

    <p>They facilitate quicker recovery and rehabilitation.</p> Signup and view all the answers

    Which element is essential for establishing a trustful relationship between healthcare providers and patients?

    <p>Trustworthiness</p> Signup and view all the answers

    Which type of fracture is most commonly treated with the Gamma system?

    <p>Intertrochanteric fractures.</p> Signup and view all the answers

    What is the primary focus of the nursing process in perioperative care?

    <p>Effective clinical decision-making</p> Signup and view all the answers

    What is a significant disadvantage of traditional open surgery practices compared to minimally invasive arthroscopy?

    <p>Increased postoperative scarring.</p> Signup and view all the answers

    Which virtue involves ensuring that actions taken are in the best interest of the patient, devoid of personal biases?

    <p>Conscientiousness</p> Signup and view all the answers

    What is the primary purpose of using a vasoconstrictor solution during rhinologic surgeries?

    <p>To reduce bleeding</p> Signup and view all the answers

    In the context of tympanoplasty, what is the primary indication for performing the surgery?

    <p>Conductive hearing loss</p> Signup and view all the answers

    Which surgical procedure involves the use of an endoscope to address issues in the sinuses?

    <p>Functional endoscopic sinus surgery</p> Signup and view all the answers

    What is the critical airway management step required before a radical neck dissection?

    <p>Perform a tracheostomy</p> Signup and view all the answers

    Which instrument is NOT commonly used in the context of performing tympanoplasty?

    <p>Otoscope</p> Signup and view all the answers

    What type of solution is applied topically over the larynx during laryngeal surgeries to prevent coughing?

    <p>Lidocaine</p> Signup and view all the answers

    Which component is crucial for adequately testing cuff leaks in a tracheostomy before the procedure?

    <p>Sterile water</p> Signup and view all the answers

    During neurosurgery, what is the primary goal of the layers of dissection?

    <p>To provide optimal exposure</p> Signup and view all the answers

    What type of dissection results in the removal of cervical nodes and some surrounding tissue?

    <p>Modified neck dissection</p> Signup and view all the answers

    What is used to close the incision post-operatively in neurosurgery?

    <p>Absorbable and non-absorbable sutures</p> Signup and view all the answers

    What is a major drawback of using a Split Thickness Skin Graft (STSG)?

    <p>Increases the risk of skin contractures in the long term</p> Signup and view all the answers

    Which of the following best describes the purpose of immobilizing a graft in burn surgery?

    <p>To maintain contact between the graft and recipient area for survival</p> Signup and view all the answers

    What is a characteristic of Full Thickness Skin Grafts (FTSG) when compared to STSG?

    <p>They cause minimal contracture and have a more aesthetic appearance</p> Signup and view all the answers

    What is the primary reason for ensuring that the surgical room is warm during burn surgery?

    <p>To prevent hypothermia in the patient due to large tissue exposure</p> Signup and view all the answers

    Which goal is NOT one of the five critical purposes of dressings in burn surgery?

    <p>Enhance the blood flow to the graft</p> Signup and view all the answers

    During cataract surgery, what is a key distinction between Extra Capsular Cataract Extraction (ECCE) and Intra Capsular Cataract Extraction (ICCE)?

    <p>ECCE retains the posterior capsule while ICCE does not</p> Signup and view all the answers

    What does the meshing of a Split Thickness Skin Graft (STSG) allow for?

    <p>Coverage of a larger burn surface area while sacrificing vascularity</p> Signup and view all the answers

    What is typically the most significant concern when using the Full Thickness Skin Graft (FTSG)?

    <p>The inability to reuse the donor site for future grafts</p> Signup and view all the answers

    What does the acronym STSG stand for in the context of skin grafting?

    <p>Split Thickness Skin Graft</p> Signup and view all the answers

    Which of the following methods of cataract extraction is typically less common due to its technique?

    <p>Intra Capsular Cataract Extraction (ICCE)</p> Signup and view all the answers

    What is the primary outcome of a recession procedure in strabismus surgery?

    <p>Realignment of the eye by relocating the muscle attachment</p> Signup and view all the answers

    Which category of strabismus is defined by an outward turning of one or both eyes?

    <p>Exotropia</p> Signup and view all the answers

    In the context of laser precautions, what is the significance of labeling with wavelength and ocular density?

    <p>To inform about the safety level for eye protection</p> Signup and view all the answers

    Which class of medication is primarily used to inhibit focusing by dilating the pupil?

    <p>Cycloplegics</p> Signup and view all the answers

    What element of ethical frameworks is essential for preventing conflicts in the operating room?

    <p>Effective communication of beliefs and values</p> Signup and view all the answers

    What is the maximum duration a pneumatic tourniquet can be safely inflated on the upper extremity?

    <p>60 minutes</p> Signup and view all the answers

    What are the necessary conditions for establishing inflation pressure in pneumatic tourniquets?

    <p>Systolic blood pressure, age, and extremity circumference</p> Signup and view all the answers

    Which instrument is primarily used for grasping and resecting lamina bone during a surgical procedure?

    <p>Kerrison Rongeur</p> Signup and view all the answers

    What should be done to prevent accidental activation of powered surgical drills?

    <p>Never allow the drill to rest on the patient/drapes</p> Signup and view all the answers

    Which external fixation-related procedure is not indicated for initial treatment of femoral neck fractures?

    <p>Closed Reduction</p> Signup and view all the answers

    What role does a C-Arm play during orthopedic surgery?

    <p>Facilitating fluoroscopy throughout the procedure</p> Signup and view all the answers

    Which table is specifically designed for patients undergoing femoral fixation operations?

    <p>Fracture Table</p> Signup and view all the answers

    What is a critical documentation step during the use of pneumatic tourniquets?

    <p>Documenting the duration and intervals of inflation and deflation</p> Signup and view all the answers

    What is a primary advantage of using Open Reduction and Internal Fixation (ORIF) over closed methods for fracture treatment?

    <p>It allows for direct visualization of the fracture site.</p> Signup and view all the answers

    Which type of fixation is commonly used for intertrochanteric fractures in elderly patients?

    <p>Dynamic Hip Screw (DHS)</p> Signup and view all the answers

    What distinguishes femoral neck fractures from intertrochanteric fractures in terms of treatment?

    <p>Femoral neck fractures have compromised blood supply.</p> Signup and view all the answers

    What method is employed for stable fixation of a femoral neck fracture when blood supply is intact?

    <p>Cannulated screws</p> Signup and view all the answers

    Which of the following is a disadvantage of using external fixation for fractures?

    <p>It does not directly stabilize the fracture site.</p> Signup and view all the answers

    Which instrument is primarily used to create a channel for screw insertion in Dynamic Hip Screw fixation?

    <p>Reamer</p> Signup and view all the answers

    Which statement correctly defines the type of fracture that requires internal fixation due to the risk of avascular necrosis?

    <p>Femoral Neck Fracture</p> Signup and view all the answers

    What characterization is unique to intertrochanteric fractures when compared to other hip fractures?

    <p>They are extracapsular fractures with intact blood supply.</p> Signup and view all the answers

    Which of the following is true regarding lead gowns used in orthopedic surgery?

    <p>They provide radiation protection for the surgical team.</p> Signup and view all the answers

    What is a key concern when performing internal fixation on femoral neck fractures?

    <p>Risk of nonunion and avascular necrosis.</p> Signup and view all the answers

    Which of the following statements about tympanoplasty is correct?

    <p>It involves reconstruction of ossicles and repair of the tympanic membrane.</p> Signup and view all the answers

    Which device is primarily used to secure a patient's head during neurosurgery?

    <p>Sugita Pins</p> Signup and view all the answers

    What is the main purpose of using a tracheostomy in surgical procedures?

    <p>To provide a route for long-term ventilatory support.</p> Signup and view all the answers

    In radical neck dissection, which structures are typically removed?

    <p>Cervical nodes, fascia, jugular vein, and associated muscles.</p> Signup and view all the answers

    What type of flap involves severing the original blood supply and reattaching it to another area?

    <p>Free flap</p> Signup and view all the answers

    Which hemostatic agent is used specifically for scalp hemostasis?

    <p>Raney clips</p> Signup and view all the answers

    Which patient preparation is essential before laryngeal surgery?

    <p>Application of lidocaine directly to the vocal cords.</p> Signup and view all the answers

    During Functional Endoscopic Sinus Surgery (FESS), which condition is NOT an indication for the procedure?

    <p>Chronic ear infections.</p> Signup and view all the answers

    What instrument is primarily used to close the dura during surgery?

    <p>Non-absorbable nylon suture</p> Signup and view all the answers

    Which of the following is NOT a hemostatic agent used in neurosurgery?

    <p>Surgical tape</p> Signup and view all the answers

    What is the reason for using a shoulder roll in head and neck surgeries?

    <p>To promote better facial nerve visualization.</p> Signup and view all the answers

    What is the major consideration when using chlorhexidine for surgical prep in patients undergoing head and neck surgeries?

    <p>It can cause ototoxicity in certain surgical procedures.</p> Signup and view all the answers

    What type of instrument is a Love Adson?

    <p>Elevator</p> Signup and view all the answers

    What is a necessary nursing consideration for patients undergoing lengthy neurosurgical procedures?

    <p>Padded positioning of pressure points</p> Signup and view all the answers

    Which of the following instruments is NOT typically used in tracheostomy procedures?

    <p>Nasal speculum.</p> Signup and view all the answers

    What is a significant risk associated with prolonged intubation in patients with a tracheostomy?

    <p>Increased risk of tracheal necrosis.</p> Signup and view all the answers

    What is the characteristic of a TRAM flap?

    <p>It retains its original blood supply.</p> Signup and view all the answers

    In the nursing process, what is the primary aim of facial nerve monitoring during surgery?

    <p>To detect potential nerve damage during the procedure.</p> Signup and view all the answers

    Which count is performed specifically during the closure of the dura in neurosurgery?

    <p>Dura count</p> Signup and view all the answers

    Which component is important to apply to skin grafts before using dermatomes?

    <p>Mineral oil</p> Signup and view all the answers

    Which of the following is a key component of a family-centered approach in perioperative nursing?

    <p>Assessing and respecting family values and preferences</p> Signup and view all the answers

    Which virtue exemplifies the ability to discern the most helpful actions in patient care?

    <p>Discernment</p> Signup and view all the answers

    What ethical value emphasizes the importance of maintaining patient confidentiality in perioperative nursing?

    <p>Privacy and Confidentiality</p> Signup and view all the answers

    Which aspect of perioperative nursing practice focuses on collaboration with a multidisciplinary team?

    <p>Provision of safe patient care</p> Signup and view all the answers

    Which of the following virtues is primarily associated with actively promoting the best interests of patients?

    <p>Compassion</p> Signup and view all the answers

    What is the primary function of tendons in the musculoskeletal system?

    <p>To transmit forces from muscles to bones</p> Signup and view all the answers

    Which type of bone graft is harvested from the patient's own body?

    <p>Autograft</p> Signup and view all the answers

    Which layer must be stripped away when repairing a bone fracture?

    <p>Periosteum</p> Signup and view all the answers

    What is the purpose of the epiphyseal plate in long bones before skeletal maturity?

    <p>To allow for bone growth in length</p> Signup and view all the answers

    What sequences of instruments is used to stabilize a fracture before securing it with a screw?

    <p>Bone holder, drill, tap</p> Signup and view all the answers

    Which type of bone tissue is described as spongy and contains red bone marrow?

    <p>Cancellous bone</p> Signup and view all the answers

    What type of connective tissue primarily provides joint stability by connecting bone to bone?

    <p>Ligaments</p> Signup and view all the answers

    In what context is cancellous bone primarily harvested for grafting?

    <p>To fill bony defects and promote healing</p> Signup and view all the answers

    What is the primary indication for performing tympanoplasty?

    <p>Conductive hearing loss</p> Signup and view all the answers

    What is the primary purpose of performing a tracheostomy?

    <p>To secure an airway during surgery</p> Signup and view all the answers

    Which type of surgery involves the use of a cannula inserted through the cricoid cartilage?

    <p>Tracheostomy</p> Signup and view all the answers

    During a radical neck dissection, which structures are typically removed?

    <p>Cervical nodes, fascia, and jugular vein</p> Signup and view all the answers

    For which surgical procedure is topical lidocaine typically applied?

    <p>Laryngeal surgeries</p> Signup and view all the answers

    What is the main purpose of using a nasal vasoconstrictor solution during rhinologic surgeries?

    <p>To minimize intraoperative bleeding</p> Signup and view all the answers

    What is the preferred position of a patient undergoing a radical neck dissection?

    <p>Supine with a shoulder roll</p> Signup and view all the answers

    Which of the following instruments is commonly used in ear surgical procedures?

    <p>Frazier suction</p> Signup and view all the answers

    What is a common contraindication for using chlorhexidine in surgical procedures?

    <p>Ototoxicity</p> Signup and view all the answers

    Which condition is indicated for a Functional Endoscopic Sinus Surgery (FESS)?

    <p>Sinus blockage</p> Signup and view all the answers

    What is the significance of documenting the inflation, deflation, and total time of pneumatic tourniquet use in a patient’s chart?

    <p>It ensures compliance with surgical safety protocols.</p> Signup and view all the answers

    Which of the following best describes an inherent risk when powered surgical instruments are not properly prepared before use?

    <p>There may be a risk of accidental activation, causing injury.</p> Signup and view all the answers

    What is the primary purpose of using a Fracture Table during surgical procedures?

    <p>To provide proper alignment and stabilization of the limbs.</p> Signup and view all the answers

    What safety feature must be ensured before using powered surgical drills?

    <p>The safety lock must be engaged when not in use.</p> Signup and view all the answers

    How long should the inflation time for pneumatic tourniquets not exceed on the upper extremity?

    <p>60 minutes</p> Signup and view all the answers

    Which statement is true regarding the use of C-Arms during orthopedic procedures?

    <p>All personnel must wear X-Ray led gowns before using them.</p> Signup and view all the answers

    What is a key consideration related to the use of external fixation devices during procedures?

    <p>They may result in higher infection rates than internal fixation methods.</p> Signup and view all the answers

    For proper operation of pneumatic tourniquets, which of the following is NOT a recommended maximum inflation pressure for thigh applications?

    <p>400 mmHg</p> Signup and view all the answers

    What best describes the use of a Jackson Spinal table?

    <p>It permits positioning the patient for spinal surgeries.</p> Signup and view all the answers

    Which parameter should be considered when setting the inflation pressure of a pneumatic tourniquet?

    <p>The patient's age</p> Signup and view all the answers

    What is a significant risk associated with the lack of adequate warmth in the operating room during burn surgery?

    <p>Hypothermia</p> Signup and view all the answers

    Which dressing goal is aimed at maintaining an optimal environment for the wound during burn surgeries?

    <p>Collect drainage</p> Signup and view all the answers

    What is a notable characteristic of a Full Thickness Skin Graft (FTSG) compared to a Split Thickness Skin Graft (STSG)?

    <p>Causes minimal skin contracture</p> Signup and view all the answers

    Which statement about the meshing of Split Thickness Skin Grafts (STSG) is true?

    <p>It can cover a larger burn surface area.</p> Signup and view all the answers

    Which type of cataract surgery involves the removal of the lens while preserving its capsule?

    <p>Intra Capsular Cataract Extraction (ICCE)</p> Signup and view all the answers

    Which complication is commonly associated with the use of Split Thickness Skin Grafts (STSG)?

    <p>Skin contractures</p> Signup and view all the answers

    What is an accurate description of the process involved in Extra Capsular Cataract Extraction (ECCE)?

    <p>The anterior capsule is ruptured and the lens is expressed.</p> Signup and view all the answers

    In the context of burn surgery, what is the purpose of immobilizing the surgical part with dressings?

    <p>To prevent the displacement of the graft</p> Signup and view all the answers

    During burn surgery, which aspect of skin grafting is essential to ensure the graft's survival?

    <p>Adequate vascularity of the recipient area</p> Signup and view all the answers

    Which characteristic distinguishes Full Thickness Skin Grafts (FTSG) regarding their donor site management?

    <p>The donor site is closed primarily with sutures.</p> Signup and view all the answers

    What characterizes bipolar hip prostheses compared to unipolar ones?

    <p>They have an inner head to reduce friction.</p> Signup and view all the answers

    What is the primary advantage of using intramedullary nails in fracture surgeries?

    <p>They enhance weight distribution across the fracture site.</p> Signup and view all the answers

    Which ligaments reinforce the knee joint capsule?

    <p>Medial collateral ligament (MCL) and lateral collateral ligament (LCL)</p> Signup and view all the answers

    What is a common benefit of arthroscopic surgeries?

    <p>Decreased scarring and faster recovery.</p> Signup and view all the answers

    Which feature makes intramedullary rods a preferred choice for treating fractures?

    <p>Their minimally invasive insertion method.</p> Signup and view all the answers

    Which aspect is essential for successful knee arthroscopy?

    <p>Infusing saline to create joint distention.</p> Signup and view all the answers

    What is a significant risk associated with using plates in fracture fixation?

    <p>The focus of stress at the fracture site.</p> Signup and view all the answers

    What are the two types of articulations found in the knee joint?

    <p>Femur and tibial plateau, patella and femur.</p> Signup and view all the answers

    Which focal virtue emphasizes understanding and judgment in the context of patient care?

    <p>Discernment</p> Signup and view all the answers

    Which of the following is NOT listed as a value that should be implemented in perioperative nursing care?

    <p>Cost-effectiveness</p> Signup and view all the answers

    What is a primary consideration that perioperative nurses need to ensure regarding patient care?

    <p>Ensuring the confidentiality of patient information</p> Signup and view all the answers

    Which standard emphasizes the importance of professional accountability in perioperative nursing practice?

    <p>Provision of safe patient care</p> Signup and view all the answers

    Which virtue reflects the commitment to act in the best interests of the patient while avoiding biased opinions?

    <p>Conscientiousness</p> Signup and view all the answers

    What is a major disadvantage of using a split thickness skin graft?

    <p>Potential for long-term skin contractures</p> Signup and view all the answers

    What is an essential condition for a graft to successfully survive on a recipient site?

    <p>Contact between the graft and the recipient must be maintained</p> Signup and view all the answers

    What is the primary goal of applying dressings in burn surgery?

    <p>To immobilize the surgical part and protect the wound</p> Signup and view all the answers

    In cataract surgery, what is the purpose of phacoemulsification?

    <p>To remove the opaque lens through fragmentation</p> Signup and view all the answers

    What is a key characteristic of full thickness skin grafts compared to split thickness skin grafts?

    <p>They cause minimal wound contracture and can be aesthetically pleasing</p> Signup and view all the answers

    Which of the following statements about the donor site of a split thickness skin graft is true?

    <p>It heals rapidly via regeneration of the epithelium</p> Signup and view all the answers

    What happens during the extra capsular cataract extraction (ECCE) procedure?

    <p>The anterior capsule is carefully ruptured before lens removal</p> Signup and view all the answers

    What best describes the role of the deep inferior epigastric perforator vessel in skin grafts?

    <p>It provides essential vascular supply to the graft</p> Signup and view all the answers

    Which surgical technique is used for maximum exposure of the lens during cataract surgery?

    <p>Extra Capsular Cataract Extraction (ECCE)</p> Signup and view all the answers

    Which category of strabismus involves one or both eyes turning outward?

    <p>Exotropia</p> Signup and view all the answers

    What procedure weakens the eye muscle by reattaching it further back from the front of the eye?

    <p>Recession</p> Signup and view all the answers

    Which type of medication is used to dilate the pupil and inhibit focusing?

    <p>Cycloplegics</p> Signup and view all the answers

    In laser safety, what is a critical precaution regarding access to laser rooms?

    <p>Providing warning signs at all entrances</p> Signup and view all the answers

    Which ethical principle is important for navigating conflicts in the operating room?

    <p>Beneficence</p> Signup and view all the answers

    What type of precaution is essential for eye protection when using lasers?

    <p>Wearing goggles labeled with specific wavelength</p> Signup and view all the answers

    Which type of strabismus is defined by one eye being lower than the other?

    <p>Hypotropia</p> Signup and view all the answers

    Which type of solution is specifically designed to lubricate and support during ocular procedures?

    <p>Viscoelastics</p> Signup and view all the answers

    What is a common feature of both recession and resection procedures in strabismus repair?

    <p>They both involve cutting the muscle</p> Signup and view all the answers

    Which ethical framework supports effective communication of beliefs in nursing?

    <p>Care ethics</p> Signup and view all the answers

    What is the primary reason for the necessity of maintaining soft tissue balance during Total Knee Arthroplasty?

    <p>To allow for normal movement and function of the knee</p> Signup and view all the answers

    What type of graft is most commonly used in Arthroscopic Anterior Cruciate Ligament Repair?

    <p>Patellar tendon graft</p> Signup and view all the answers

    Which component of the knee replacement implant is responsible for articulating with the femur?

    <p>Femoral component</p> Signup and view all the answers

    What is a key characteristic of menisci in the knee joint?

    <p>They distribute load across the knee joint</p> Signup and view all the answers

    What is commonly indicated for a patient experiencing instability in their activities of daily living due to a torn ACL?

    <p>Arthroscopic ACL repair</p> Signup and view all the answers

    What is the main health condition leading to the need for Total Knee Arthroplasty?

    <p>Arthritis</p> Signup and view all the answers

    Which structure in the middle ear is responsible for amplifying received sound?

    <p>Ossicles</p> Signup and view all the answers

    Which hormonal secretion is primarily regulated by the pituitary gland?

    <p>Thyroid hormones</p> Signup and view all the answers

    What would happen if there is too much calcium in the blood in relation to parathyroid hormones?

    <p>Decreased absorption in the intestines</p> Signup and view all the answers

    What method is primarily used for the repair of a meniscus tear?

    <p>Arthroscopic resection</p> Signup and view all the answers

    Study Notes

    Stabilization of Grafts

    • Ortho hardware (wires/screws) is necessary to stabilize grafts as they do not fuse independently.

    Key Instruments

    • Kerrison Rongeur: Grasp and resect lamina bone.
    • Pituitary Rongeur: Used for grasping and removing intervertebral discs.

    Surgical Equipment and Nursing Considerations

    • Powered Surgical Instruments:
      • Ensure drills are not resting on patients or drapes to prevent injury from accidental activation.
      • Must have safety lock engaged when not in use; test prior to passing to the surgeon.
      • Correct cord attachment and proper size indication are essential.

    Operation Tables

    • Fracture Table: For femoral neck, shaft fixation.
    • Jackson Spinal Table: Used for patients in prone position during spinal surgeries.
    • Emergency stretcher should be ready outside the OR for immediate patient transport if necessary.

    Imaging Use

    • C-Arm: Provides fluoroscopy during orthopedic procedures and operated by either the surgeon or x-ray technician.
    • All personnel are required to wear X-ray lead gowns for safety.

    Pneumatic Tourniquets

    • Create a bloodless field for surgeries on extremities.
    • Inflation pressures should be based on systolic blood pressure and extremity circumference.
    • Maximum inflation times: 60 minutes for arms, 120 minutes for legs; documentation is crucial.

    Bone Cement (PMMA)

    • PMMA is a mixture of powder (10% Barium Sulfate) and liquid, creating a radiopaque cement for orthopedic applications.
    • Mixed in a closed system; highly flammable and requires good ventilation.
    • Antibiotic-impregnated PMMA can help reduce infection rates.

    Handling Prostheses

    • Prostheses must be meticulously handled and placed on lint-free surfaces to prevent contamination.
    • Visual inspection for defects is mandatory, and details (serial number, lot number, expiry, etc.) need to be documented.
    • Biological indicators must be present for sterilization confirmation.

    Fracture Surgery Overview

    • A fracture signifies a break in bone continuity; common causes include trauma, infection, and diseases like osteoporosis.
    • Goals: restore length, shape, alignment, and function of fractured bones or joints.

    Types of Fracture Treatment

    • Closed Reduction: Non-surgical manipulation confirmed via radiography; less infection risk.
    • External Fixation: Allows treatment of severe open fractures without a cast; maintains soft tissue integrity.
    • Open Reduction and Internal Fixation (ORIF): Allows for direct visualization and placement of fixation devices to correct fractures directly.

    Hip Fractures

    • Intertrochanteric Fractures: Common in elderly women; can be fixated with plates/screws; blood supply remains intact.
    • Femoral Neck Fractures: Require careful reduction due to the risk of nonunion; can be treated with cannulated screws or total hip arthroplasty (THA).

    Neurosurgery Considerations

    • Long surgeries (3-8 hours) necessitate careful padding and securing of patient to OR bed.
    • Common positions: supine, lateral, prone; requires meticulous counts and hemostatic agents.

    Plastic Surgery Techniques

    • Dermatomes: For removing split-thickness skin grafts; mineral oil should be readily available for ease.
    • Flaps:
      • Pedicle Flaps: Retain original blood supply during transfer.
      • Free Flaps: Blood vessels are rerouted and reanastomosed microscopically.

    Strabismus Repair

    • Involves correcting ocular misalignment; common in pediatric patients.
    • Categories include esotropia, exotropia, hypertropia, and hypotropia.
    • Two methods: recession (weakening) and resection (strengthening).

    Medications for Eye Procedures

    • Mydriatics: Dilate pupils for focusing.
    • Cycloplegics: Dilate pupils, inhibit focusing.
    • Miotics: Constrict pupils; used to manage intraocular pressure.

    Laser Safety Precautions

    • Eye protection with labeled goggles and controlled access to laser areas are essential.
    • Regular education on fire safety and laser protocols is required for personnel.

    Ethical Considerations

    • Ethics guide decision-making and standards of conduct in surgery.
    • Understanding and communication of ethical beliefs are critical to prevent conflicts in the operating room.

    Orthopedics Surgery Anatomy

    • Muscles enable movement in the skeletal system by covering bones.
    • Ligaments stabilize joints by connecting bone to bone.
    • Tendons transmit muscular forces to bones or cartilage at muscle ends.
    • Cartilage, an elastic tissue, provides structural support at end of bones.
    • Joints connect bones, allowing for movement and functionality.

    Bone Tissue / Blood Supply

    • Two primary types of bone tissue:
      • Cortical bone: Hard outer shell that supports tissue.
      • Cancellous bone: Soft, spongy tissue found in specific areas like the iliac crest and ends of long bones; contains red bone marrow.
    • Long bones feature a shaft (diaphysis) and ends (epiphysis), with cancellous bone at both ends.
    • The periosteum covers bones, crucial for repair; stripped during fracture surgery with periosteal elevators.
    • Synovial membrane surrounds and lubricates joint surfaces.

    Instrumentation in Bone Fixation

    • Sequence of fixation:
      • Stabilize with a bone holder.
      • Drill a hole for screw insertion.
      • Tap the hole for a secure screw channel.
      • Measure depth to determine screw length.
      • Insert screw using a screwdriver.
    • A minor count is performed for all orthopedic procedures.

    Bone Grafts

    • Aim to fill voids left by bone removal, stabilize fractures, and promote healing.
    • Allografts utilize bone from tissue banks.
    • Autografts use the patient’s own bone, typically from the iliac crest, containing both types of bone tissue.
    • Cancellous bone is porous and vascular, enhancing integration into host bones.

    Bone Cement (PMMA)

    • PMMA is a radiopaque cement mixed from powder (with Barium Sulfate) and liquid (methyl monomer); requires ventilation due to flammability.
    • Excessive exposure during mixing can irritate respiratory and eye tissues.
    • Antibiotic-impregnated PMMA helps reduce infection risks.

    Handling Prosthesis

    • Ensure meticulous handling to avoid contamination or damage.
    • Visual inspection by scrub nurse and surgeon for defects is essential.
    • Document all implant information, including serial and lot numbers.

    Fracture Surgery

    • A fracture is characterized by the break in bone continuity due to trauma or disease; osteoporosis is a common cause.
    • Closed reduction manipulates bone fragments externally, minimizing infection risks and promoting healing.
    • External fixation offers rigid support, particularly for severe fractures or soft tissue management.

    Neuro Surgery and Layers of Dissection

    • Skin incision and subcutaneous tissue infiltration is performed for access, ensuring proper movement of necessary muscle segments.

    Burn Surgery (Skin Grafts)

    • Conduct surgery in a warm environment to combat hypothermia risks.
    • Graft survival relies on recipient area vascularity and stable contact with the graft.
    • Dressings must immobilize, compress, collect drainage, provide comfort, and protect the wound.

    Skin Graft Types

    • Split Thickness Skin Graft (STSG): Quick vascularization and donor site healing but can lead to long-term contractures.
    • Full Thickness Skin Graft (FTSG): Aesthetically superior, minimizes contractures, and is primarily closed with sutures.

    Ophthalmology: Cataracts and Strabismus

    • Cataracts involve lens clouding; extraction can be performed via ECCE or ICCE methods.
    • Strabismus repair corrects ocular misalignment; involves recession (weakening) or resection (strengthening) techniques.

    Medications in Ophthalmology

    • Mydriatics, Cycloplegics, Miotics, and various lubricants are used to prepare the eye for surgery and enhance patient comfort.

    Laser Precautions in Ophthalmology

    • Eye protection, restricted access, fire safety, and documentation are crucial for safe laser use during procedures.

    Ethics in Nursing

    • Ethical systems guide decision-making and interactions in healthcare settings.
    • Understanding ethical frameworks can prevent conflicts in perioperative nursing.

    External Fixation

    • External fixation stabilizes fractures without a cast, allowing for further soft tissue procedures if necessary.
    • It is particularly useful in managing injuries requiring skin grafts.

    Open Reduction and Internal Fixation (ORIF)

    • ORIF is used when closed reduction fails to correct a fracture.
    • Internal fixation relies on metal plates, screws, pins, or intramedullary (IM) rods.
    • Provides direct visualization of fractures, ensuring anatomical alignment.

    Hip Fractures

    Intertrochanteric Fractures

    • Common in elderly women, particularly those with osteoporosis.
    • Occur between the greater and lesser trochanters; are extracapsular and preserve blood supply.
    • Treated effectively with plates and screws, typically using Dynamic Hip Screw (DHS) instrumentation.

    Femoral Neck Fractures

    • Require reduction prior to internal fixation due to compromised blood supply, with risks of nonunion and avascular necrosis.
    • Fixed with either cannulated screws for stable fractures or Total Hip Arthroplasty (THA) for unstable cases.

    Subtrochanteric Fractures

    • Usually treated with IM nails, minimizing incision size.
    • IM rods and nails distribute weight-bearing stresses, reducing scar formation and infection risk.

    Arthroscopy Surgery

    • Commonly performed on knee, shoulder, and wrist joints for diagnostic and therapeutic purposes.
    • Features include small incisions, reduced inflammation, and quick recovery times.
    • Normal saline is used for joint distention during the procedure.

    Nursing Considerations

    • Close monitoring for facial nerve integrity during surgeries near the head & neck.
    • Use of vasoconstrictors, topical anesthetics, and proper positioning to ensure optimal surgical outcomes.
    • Surgical counts are essential throughout procedures to maintain safety and accountability.

    Tympanoplasty

    • Focused on repairing the tympanic membrane and reconstructing ossicles to address conductive hearing loss.

    Functional Endoscopic Sinus Surgery (FESS)

    • Involves inserting an endoscope through the nasal cavity to address sinus issues like polyps and blockages.

    Radical Neck Dissection

    • Involves the removal of malignant tissues in the head and neck area, including nodes and surrounding structures.
    • Modified versions can limit removal to only cervical nodes.

    Tracheostomy

    • Involves creating an airway opening through the trachea, indicated for prolonged intubation or severe airway compromise.
    • Essential instruments include tracheal dilators, suction devices, and absorbable sutures for securing the trach tube.

    Neuro Surgery

    • Skin incisions followed by careful dissection of subcutaneous tissue are critical for successful surgical outcomes.

    Burn Surgery and Skin Grafts

    • Ensuring a warm environment is crucial to prevent hypothermia in patients undergoing burn surgeries.
    • Successful grafts require adequate vascularity and immobilization to promote healing.
    • Important dressing goals include immobilization, pressure application, drainage collection, comfort, and wound protection.

    Split Thickness Skin Graft (STSG)

    • Involves using epidermis and partial dermis, quick to vascularize, donor site heals rapidly.
    • Aesthetic concern includes potential for long-term skin contractures.

    Full Thickness Skin Graft (FTSG)

    • Comprises both epidermis and dermis, minimizing contracture risk and providing better cosmetic outcomes.
    • Donor site closure is achieved primarily, but future grafting from the same site is not possible.

    Cataracts and Surgery

    • Cataracts involve lens clouding; surgical methods like Extra Capsular Cataract Extraction (ECCE) and Intra Capsular Cataract Extraction (ICCE) are used for removal.
    • Emphasizes the importance of patient-centered care in perioperative settings.

    Five Focal Virtues

    • Compassion, discernment, trustworthiness, integrity, and conscientiousness are essential virtues in patient care.

    CNO Ethical Values

    • Focus on client well-being, choice, privacy, respect for life, and fairness in practice.

    Perioperative Nurse Practice Standards

    • Incorporates knowledge across disciplines, effective use of the nursing process, professional accountability, and collaboration with multidisciplinary teams.

    Orthopedic Surgery Considerations

    • Stabilization of grafts requires ortho hardware like wires and screws; they do not fuse independently.
    • Kerrison Rongeur is used for grasping and resecting lamina bone; Pituitary Rongeur is for removing intervertebral discs.

    Equipment and Nursing Considerations

    • Powered surgical drills should never rest on patients or drapes; they must be tested before use and locked when not active to prevent accidents.
    • Fracture Table is utilized for femoral neck or tibial fixation; Jackson Spinal Table is for prone spinal surgeries.
    • C-Arm imaging is crucial, with all OR personnel mandated to wear X-ray lead gowns.

    Pneumatic Tourniquets

    • Employed for extremity procedures to create bloodless surgical fields and enhance visualization.
    • Inflation pressures are patient-specific; should not exceed 250-300 mmHg for arms and 300-350 mmHg for thighs.
    • Cuffs must not be inflated for more than 60 minutes on upper extremities and 120 minutes on lower extremities.

    Open Reduction and Internal Fixation (ORIF)

    • ORIF is necessary when closed methods fail; internal fixation uses metal plates and screws for alignment.
    • Intertrochanteric fractures commonly occur in elderly women due to osteoporosis and are fixable without blood supply compromise.
    • Femoral neck fractures need careful reduction due to high risks of nonunion and avascular necrosis.

    Surgical Techniques and Instrumentation

    • Dynamic Hip Screw (DHS) is often used to fix intertrochanteric fractures with guide pins and lag screws.
    • Cannulated screws are used for stable fixation in femoral neck fractures; Total Hip Arthroplasty (THA) is for unstable cases.

    Neurosurgery Considerations

    • Layers of dissection include skin, galea, pericranium, skull, and dura; each layer has specific closure techniques.
    • Hemostatic agents like Raney clips and neuro patties are essential for maintaining scalp hemostasis.
    • Positioning devices (e.g., Mayfield fixation) prevent head movement during surgery.

    Plastic Surgery Techniques

    • Dermatomes are employed for harvesting split-thickness skin grafts; skin meshers create slits in grafts for coverage.
    • Pedicle flaps maintain original blood supply, while free flaps require microsurgical reattachment.

    Ocular Surgery (Strabismus Repair)

    • Strabismus involves misalignment due to neuromuscular issues, categorized as esotropia, exotropia, hypertropia, or hypotropia.
    • Repair methods include recession (weakening) and resection (strengthening) of ocular muscles.

    Medications in Surgery

    • Mydriatics and cycloplegics are used to dilate pupils; miotics constrict pupils for various surgical needs.
    • Irrigants, such as Balanced Salt Solution (BSS), lubricate and hydrate tissues.

    Laser Safety Protocols

    • Eye protection includes goggles labeled with specific safety measures; controlled access to laser areas is crucial.
    • Fire safety knowledge is mandatory, and documentation is a critical component of laser safety protocols.

    Ethical Considerations in Surgery

    • Ethics governs decision-making and behavior related to conduct and character.
    • Understanding ethical frameworks helps nurses navigate potential conflicts in perioperative settings, ensuring effective communication of values.

    Orthopedics Surgery

    • Muscles enable movement of the skeletal system by covering bones.
    • Ligaments provide joint stability by connecting bone to bone.
    • Tendons transmit force from muscles to bones or cartilage.
    • Cartilage offers support and stability at the end of bones.
    • Joints are articulations that connect bones.

    Bone Tissue and Blood Supply

    • Cortical Bone: Hard outer shell providing structural support.
    • Cancellous Bone: Soft, spongy tissue found in areas like the iliac crest and ends of long bones; contains red bone marrow.
    • Long Bones: Comprise a shaft (diaphysis) and ends (epiphysis), separated by the epiphyseal plate until skeletal maturity.
    • Periosteum: Connective tissue covering all bones; must be removed for fracture repair.
    • Synovial Membrane: Covers articulating surfaces within joints.

    Instrument Sequence for Bone Fixation

    • Stabilize fractures with a bone holder.
    • Drill holes in bone for screws.
    • Tap holes to prepare stable canals for screw insertion.
    • Measure hole depth to determine screw length.
    • Insert screws using a screwdriver.

    Bone Grafts

    • Purpose: Fill cavities, stabilize defects, and promote fracture healing during open reduction.
    • Allograft: Bone from a tissue bank.
    • Autograft: Harvested from the patient, typically from the iliac crest.
    • Cancellous Bone: Vascular, harvested from the iliac crest, facilitates growth into host bone.
    • Cortical Bone: Dense, harvested from iliac crest, tibia, or ribs; requires stabilization with hardware.

    Instruments Used in Orthopedics

    • Kerrison Rongeur: Grasping and resecting lamina bone.
    • Pituitary Rongeur: Grasping and removing intervertebral discs.

    Equipment Considerations

    • Powered Surgical Instruments: Must be kept safe to prevent accidental activation; check functionality before use.
    • Fracture Table: Utilized for femoral neck, femoral shaft, or tibial fixation surgery.
    • Jackson Spinal Table: Used for prone spinal surgeries.
    • C-Arm: Provides fluoroscopy; personnel must wear lead gowns for radiation protection.

    Pneumatic Tourniquets

    • Create a bloodless surgical field for extremity procedures.
    • Maximum inflation pressures: 250-300 mmHg for arms, 300-350 mmHg for thighs.
    • Cuffs should overlap by 3-6 inches; inflation time should not exceed 60 minutes for arms and 120 minutes for legs without further request.

    Surgical Procedures

    • Tympanoplasty: Repair of tympanic membrane, indicated for conductive hearing loss.
    • Functional Endoscopic Sinus Surgery (FESS): Endoscopic resection of sinuses to relieve blockages; indicated for polyps and severe allergies.
    • Radical Neck Dissection: Removal of malignant tissues and surrounding structures; may require a tracheostomy.

    Tracheostomy

    • Insertion of a cannula into the trachea via cricoid cartilage.
    • Indicated for prolonged intubation, severe injuries, and airway obstructions.
    • Test cuff for leaks prior to surgery.

    Burn Surgery

    • Maintain a warm room to prevent patient hypothermia.
    • Graft survival requires adequate vascularity and immobilization of contact between graft and recipient area.
    • Dressing goals: immobilization, pressure application, drainage collection, comfort, and wound protection.

    Skin Graft Types

    • Split Thickness Skin Graft (STSG): Includes epidermis and part of dermis; quick healing but may lead to skin contractures.
    • Full Thickness Skin Graft (FTSG): Contains both layers; aesthetically better with minimal contracture but donor site cannot be reused.

    Cataract Surgery

    • Cataracts: Clouding of the eye lens.
    • Extraction Methods:
      • Extra Capsular Cataract Extraction (ECCE): Controlled rupture of capsule, removal of lens.
      • Intra Capsular Cataract Extraction (ICCE): Removal of lens within its capsule; rare.

    Perioperative Nursing Considerations

    • Focus on family-centered care and ethical decision-making in patient interest.
    • Key values include client well-being, privacy, truthfulness, and fairness.
    • Knowledge of the nursing process is essential for safe patient care and collaboration.

    Five Focal Virtues in Nursing

    • Compassion: Focus on patient best interests.
    • Discernment: Insight and understanding for helpful action.
    • Trustworthiness: Building relationships with patients and families.
    • Integrity: Practicing with respect for dignity.
    • Conscientiousness: Ensuring unbiased actions serve the patient.

    Hip Replacement and Fixation

    • Unipolar and Bipolar hip prosthetics involve varying components to reduce friction at the femoral joint.
    • Bilateral Total Hip Replacement utilizes a modular approach for symmetrical leg lengths and alignment.
    • Surgical procedure sequence: acetabulum preparation followed by femur preparation.
    • Intramedullary (IM) fixation uses rods, nails, and pins for bone fractures, employed under fluoroscopy and considered a closed reduction method.
    • Common IM systems include Nancy, Russell-Taylor, and Gamma, recognized for reduced scarring and infection risk.

    Knee Anatomy and Surgical Procedures

    • Knee joint comprises two key articulations: femur-tibial plateau and patella-femur connections.
    • Reinforced by medial (MCL) and lateral (LCL) collateral ligaments and two menisci (medial and lateral).
    • The anterior (ACL) and posterior cruciate ligaments provide stability by attaching to intercondylar surfaces.
    • Arthroscopy recognizes both diagnostic and surgical uses, particularly for knee, shoulder, and wrist.
    • Normal saline irrigation assists in joint distention during arthroscopic procedures.
    • Common knee injuries include torn MCL, medial meniscus, and ACL tears, often treated via arthroscopic techniques.

    Total Knee Arthroplasty (TKA)

    • TKA is performed to replace damaged knee surfaces often due to arthritis.
    • Aims to enhance joint mobility and stability while preserving normal ligament function.
    • Proper identification of left and right knee prostheses is crucial for surgical accuracy.

    Otolaryngology (ENT) Surgery

    • Middle ear anatomy includes tympanic membrane, Eustachian tube, and ossicles (malleus, incus, stapes) crucial for sound amplification.
    • Thyroid and parathyroid glands regulate hormones and calcium levels in the blood.

    Burn Surgery and Skin Grafts

    • Operating room warmth is essential to prevent patient hypothermia during burn surgery procedures.
    • Successful graft survival requires adequate vascularity, proper contact, and immobilization.
    • Dressing in burn surgery must immobilize, apply pressure, collect drainage, ensure comfort, and protect the wound.
    • Split Thickness Skin Graft (STSG) involves epidermis and part of dermis, heals quickly but may result in long-term skin contractures.
    • Full Thickness Skin Graft (FTSG) encompasses complete dermis and provides minimal contracture risks with better aesthetic outcomes.

    Ophthalmology (Eye Surgery)

    • Cataracts denote lens clouding, necessitating cataract extraction, performed via various surgical methods.
    • Extra Capsular Cataract Extraction (ECCE) and Intra Capsular Cataract Extraction (ICCE) are two primary techniques for lens removal.
    • Strabismus surgery addresses eye misalignment, commonly dividing into esotropia, exotropia, hypertropia, and hypotropia categories.
    • Muscle repair for strabismus can employ recession (weakening) or resection (strengthening) techniques.

    Laser Safety in Eye Surgery

    • Eye protection protocol includes specially labeled goggles with wavelength and ocular density information.
    • Operating rooms must control access, minimize reflectivity, and ensure fire safety measures are in place.
    • Documenting compliance through safety checklists is critical in laser surgeries.

    Ethics in Nursing

    • Ethics guides decision-making and professional conduct, emphasizing moral principles.
    • Ethical conflicts may arise in perioperative settings; understanding diverse beliefs is essential for effective communication.
    • Five focal virtues crucial for perioperative nurses include compassion, discernment, trustworthiness, integrity, and conscientiousness.
    • CNO Ethical Values underline principles such as client well-being, choice, and confidentiality, guiding nursing practices.

    Perioperative Nurse Practice Standards

    • Knowledge from nursing, sciences, and humanities is foundational for clinical competence.
    • Employing the nursing process effectively is paramount in decision-making.
    • Maintaining professional responsibility and ensuring collaboration with interdisciplinary team members are key for safe patient care.

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    Description

    Test your knowledge on various surgical instruments and their uses. This quiz covers essential tools like the Kerrison and Pituitary Rongeur, as well as critical safety considerations with powered surgical instruments. Perfect for nursing students and surgical staff!

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