Term
| How should you detach and attach a scalpel blade? |
|
Definition
|
|
Term
| At what angle should the blade of the scalpel be held to the skin? |
|
Definition
|
|
Term
| When are scissors most effective? |
|
Definition
| when kept in the axis of the forearm |
|
|
Term
| What direction is the most efficient cut when using scissors? |
|
Definition
|
|
Term
| What instrument is used for manipulation and fine traction in surgery? |
|
Definition
|
|
Term
| What is the best retractor? |
|
Definition
|
|
Term
| What should be placed between tissue and a metal retractor? |
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Definition
|
|
Term
| If excessive retraction is necessary for exposure, what can you conclude? |
|
Definition
| the incision is too small |
|
|
Term
| What is the major cause of post-op bleed? |
|
Definition
| over coagulation using electrocoagulation |
|
|
Term
| What is the best way to prevent surgical complications? |
|
Definition
|
|
Term
| What are the 3 phases of recovery from major surgery? |
|
Definition
Immediate
Intermediate (hospitalization period)
Convalescent (from d/c to full recovery) |
|
|
Term
| What are the major causes (in general) of early post-surgical complication and death? |
|
Definition
Acute pulmonary derangement
Cardiovascular derangement
Fluid derangement |
|
|
Term
| Post-surgery, which team member is generally responsible for cardiopulmonary fxn? operative site and all other care? |
|
Definition
cardiopulmonary fxn - anesthesiologist
operative site and all other care - surgeon |
|
|
Term
| How often should a pt be turned post-surgery, why? |
|
Definition
Every 30 min until conscious, then every 8 - 12 hrs
To minimize atelectasis |
|
|
Term
| What is the BEST way to detect complications during the intermediate post-op period? |
|
Definition
| Requires repeated eval of the pt |
|
|
Term
| What is early respiratory failure (within 1-2 hrs) is most commonly due to? |
|
Definition
Major abdominal & chest operation
severe chest trauma
pre-existing lung disease
too much anesthetic agents |
|
|
Term
| What is late respiratory failure (beyond 48 hrs) is most commonly due to? |
|
Definition
cardiac failure/pulmonary edema
pulmonary embolism
abdominal distention
narcotic overdose |
|
|
Term
| What is the MC post-op pulmonary complication? |
|
Definition
|
|
Term
| In which pts is post-op atelectasis MC in? |
|
Definition
elderly
pts who smoke
overweight pts
those with sx of respiratory dz |
|
|
Term
| How can post-op atelectasis be prevented? |
|
Definition
| Early mobilization, frequent changes in position, encouragement to cough, use of incentive spirometer |
|
|
Term
| What are the MC cardiac complications after operations under general anesthesia? |
|
Definition
Dysrhythmia (PVC)
MI (MC occurs during operation)
Cardiac failure |
|
|
Term
| MC cause of PVC after surgical procedure? |
|
Definition
hypoxia
hypokalemia
digitalis toxicity
alkalosis |
|
|
Term
| What wound complication is described as a collection of blood and clot in the wound? |
|
Definition
|
|
Term
| What wound complication is described as a collection of clear fluid in the wound? |
|
Definition
|
|
Term
| What wound complication is described as a collection of lymph fluid in the wound? |
|
Definition
|
|
Term
| What do a hematoma, seroma, or lymphocele increase a pts risk of post-op? |
|
Definition
| wound infection and delayed wound healing |
|
|
Term
| What wound complication is described as a partial or complete disruption of operative wound due to systemic &/or local factors? |
|
Definition
|
|
Term
| What is the MCC of wound dehiscence? |
|
Definition
| Technical problem in wound closure |
|
|
Term
| In which pt population is wound dehiscence MC? |
|
Definition
|
|
Term
| On what post-op day is wound dehiscence MC? |
|
Definition
| btwn 5th and 8th post-op day |
|
|
Term
| What body area is a common place of wound dehiscence? |
|
Definition
|
|
Term
| What systemic factors can lead to wound dehiscence? |
|
Definition
poor nutrition
immunosuppressive condition
disease
renal failure
obesity
cancer |
|
|
Term
| In what post-op day does a wound infection usually occur? |
|
Definition
|
|
Term
| How soon may clostridium or staphylococci wound infections occur? |
|
Definition
|
|
Term
| What is the MC post-op COD? |
|
Definition
|
|
Term
| How is atelectasis best diagnosed? |
|
Definition
|
|
Term
| What is the MCC of post-op fever in the 1st 48 hrs? |
|
Definition
|
|
Term
| When does aspiration MC occur? |
|
Definition
| During intubation for emergency operation |
|
|
Term
|
Definition
|
|
Term
| What is the MC COD from pulmonary complications? |
|
Definition
|
|
Term
| What is the MC source of pulmonary embolism? |
|
Definition
| lower extremity venous thrombosis |
|
|
Term
| What are the risk factors for a thromboembolism? |
|
Definition
prolonged preoperative bed rest
obese patient
previous history of DVT
cancer patient
pelvic operations
orthopedic surgery |
|
|
Term
| What is the treatment for a PE? |
|
Definition
| immediate anti-coagulation with heparin followed by coumadin |
|
|
Term
| What is the best prophylaxis for PE? |
|
Definition
| early mobilization after surgery |
|
|
Term
| What are the MC COD with fat embolism? |
|
Definition
|
|
Term
| What is a common cause of fat embolization? |
|
Definition
| fracture of the shafts of long bones (most commonly femur) |
|
|
Term
| What are some sources of air emboli? |
|
Definition
surgery around head and neck
vascular surgery
insertion of a central line |
|
|
Term
| What are the 5 W's of post-op fever? |
|
Definition
Wind
Water
Wound
Walking
Wonder drugs |
|
|
Term
| What is the MC cause of nosocomial infection? |
|
Definition
|
|
Term
| What is the MCC of post-op bleeding? |
|
Definition
|
|
Term
| What is the MC cause of post-op shock? |
|
Definition
|
|
Term
| What is the most important way to prevent infection during surgery? |
|
Definition
| Skin prep before incision |
|
|
Term
| Where should you scrub to? |
|
Definition
|
|
Term
| When do you put your facemask on? |
|
Definition
|
|
Term
| Where should you start scrubbing? |
|
Definition
|
|
Term
| How long should a scrub be? |
|
Definition
|
|
Term
| How many brush strokes per surface during scrubbing? |
|
Definition
|
|
Term
| What is the MC site for glove perforation? |
|
Definition
| Non-dominant index finger |
|
|
Term
| What is the most important feature about a surgical gown? |
|
Definition
| impermeability to moisture |
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