Pre-operative preparation- preparing different sites

Question 1

what hygiene steps should be taken before admission for surgery

Answer 1

bath & toilet

Question 2

factors that can influence surgical wound infection

Answer 2

• virulence of the organism and resistance of the patient
• duration of surgery
• surgical technique
• length of time between surgical prep and incision

Question 3

how does length of surgery affect infection rate

Answer 3

doubles for every hour of operating time

Question 4

how long before incision should a surgical clip be done

Answer 4

no more than 24 hours

Question 5

what should be monitored when tying limbs to operating table

Answer 5

swollen paw or cold toes

Question 6

what recumbency should the patient be in for abdominal surgery

Answer 6

dorsal

Question 7

how should limbs be secured when in dorsal recumbency

Answer 7

crossed over thorax, ensuring not restricting chest movement

Question 8

how should patients be positioned for abdominal surgery

Answer 8

• dorsal
• trough or sandbags
• limbs crossed and tied
• tilt table

Question 9

how does tilting the patient aid abdominal surgery

Answer 9

takes pressure of abdominal contents off diaphragm, aids venous return

Question 10

how should a patient be positioned for orthopaedic/extremity surgery

Answer 10

• lateral recumbency, limb of interest on top
• paw wrapped in glove, tape over top and suspend

Question 11

what type of bandage may be needed for orthopaedic/extremity surgery

Answer 11

esmarch bandage or torniquet

Question 12

how should a patient be positioned for tail and peri-anal surgery

Answer 12

• ventral
• forelimbs secured in natural position
• hindlimbs hang over table, rolled up towel under caudal abdomen
• tail tied away

Question 13

why would a purse-string suture be used for peri-anal surgery & when must it be removed

Answer 13

to prevent faecal contamination. removed at the end of surgery

Question 14

how must a patient be positioned for back surgery

Answer 14

• ventral in a trough/sandbags
• place forelimbs cranially
• hindlimbs placed naturally or squatting
• can tape over thorax to stabilise

Question 15

how should patients be positioned for thoracic surgery

Answer 15

• lateral or dorsal
• extend forelimbs cranially

Question 16

how should clippers be held

Answer 16

pencil grip

Question 17

limb/tail surgery- what to do with tip of tail or foot?

Answer 17

no need to clip, covered in sterile bandage

Question 18

most common blade size in practice

Answer 18

40 or 50

Question 19

which sites should be clipped

Answer 19

• intravenous
• -centesis
• surgical

Question 20

what surgical complications can clipper rash cause

Answer 20

• increased risk of SSI
• increased risk of self trauma

Question 21

function of first skin scrub of a patient

Answer 21

removes dirt and grease & reduces bacterial load

Question 22

disadvantages of povidone-iodine

Answer 22

• stain skin
• little residual activity
• can be impaired by organic matter

Question 23

povidone-iodine has a narrow spectrum of antimicrobial activity. true or false?

Answer 23

false

Question 24

dilution of chlorhexidine for surgical scrub

Answer 24

50:50

Question 25

advantages of chlorhexidine gluconate for surgical scrub

Answer 25

- excellent residual activity - good antimicrobial activity - relatively low toxicity to tissues

Question 26

where must chlorhexidine not be used

Answer 26

mucous membranes

Question 27

why can chlorhexidine not be used around the eyes & ears

Answer 27

ototoxic & causes corneal ulcers

Question 28

how long should an esmarch bandage be in situ

Answer 28

no longer than 45 minutes

Question 29

function of an esmarch bandage

Answer 29

acts as a torniquet, so surgery can be performed in a blood free environment

Question 30

what other solution is 70% isopropyl alcohol used with often

Answer 30

chlorhexidine gluconate

Question 31

why is isopropyl alcohol and chlorhexidine often used together

Answer 31

residual activity of chlorhexidine is enhanced when alcohol used

Question 32

__% isopropyl alcohol

Answer 32

70

Question 33

why must alcohol not be used on open wounds or mucous membranes

Answer 33

coagulates protein

Question 34

advantages of isopropyl alcohol

Answer 34

- quick prepping agent without diluting subsequent products - has some antibacterial activity

Question 35

disadvantages of isopropyl alcohol

Answer 35

- extreme cooling effect - will burn if using electrocautery

Question 36

povidone-iodine aqueous __% solution

Answer 36

10

Question 37

povidone-iodine dilution rate

Answer 37

1:10

Question 38

dilution rate of povidone-iodine for corneal surfaces

Answer 38

1:50

Question 39

what should povidone-iodine be diluted with for corneal surfaces

Answer 39

sterile saline

Question 40

how should a limb be scrubbed for surgery

Answer 40

circumfrerentially distal to proximal

Question 41

how are drapes placed on the patient using the quadrant method

Answer 41

1) between the surgical site and the sterile person 2) furthest from the sterile person 3&4) the sides

Question 42

what is the quadrant method for draping

Answer 42

four drapes used top folded over, edge away from you