REVISION

Question 1

DESIGN

Answer 1

• RACETRACK STYLE
• SINGLE CORRIDORS
• SMALL CLUSTERS

Question 2

LAYOUT

Answer 2

4 ZONES

1. TRANSITION EG. CHANGEROOMS
2. UNRESTRICTED EG. PREOP AND RECOVERY ROOM (STREET CLOTHES PERMITTED)
3. SEMI-RESTRICTED EG. PERIPHERAL SUPPORT AREA (TRAFFIC IS LIMITED, APPROPRIATE ATTIRE WORN)
4. RESTRICTED EG. SCRUB AREAS AND OPERATING ROOM

Question 3

PERIOPERATIVE PHASES

Answer 3

• DAY SURGERY/ WARD
• PREOP BAY / HOLDING BAY
• ANAESTHETIC ROOM
• OPERATING THEATRE
• RECOVERY ROOM / PACU

Question 4

PERIOPERATIVE TEAM

Answer 4

1. ANAESTHETIST
2. ANAESTHETIC TECHNICIAN
3. SURGEONS
4. PERFUSIONIST
5. ORDERLY
6. ORTHOPAEDIC TECHNICIANS
7. RADIOGRAPHERS
8. CSSD STAFF
9. SUPPORT STAFF
10. PRODUCTIVE REPRESENTATIVE

Question 5

CIRUCLATING NURSE (SCOUT)

Answer 5

• Checks and prepares the operating theatre and required equipment
• Assists the instrument nurse and surgical team to gown
• Opens and dispenses items to create a sterile field (checking integrity)
• Records the surgical count
• Checks the patient prior to the commencement of anaesthetic
• Assists with patient positioning
• Applies the diathermy plate
• Arranges theatre equipment
• Turns on the operating lights
• Assists the surgeons to gown
• Receives the skin preparation dish
• Assists with positioning of surgical drapes PRN
• Attaches the diathermy plate and active electrode to the diathermy machine
• Attaches the suction tubing to the suction canister
• Records intraoperative events
• Monitors blood loss
• Anticipates surgical events and acts accordingly
• Sends for the next patient
• Documents the surgical count
• Assists with removal of the drapes
• Assists with the attachment of wound drainage systems
• Assists with the patient transfer
• Transports the patient to the recovery room and provides a handover
• Assists with the end of case cleanup.

Question 6

THE INSTRUMENT NURSE (SCRUB)

Answer 6

• Checks and prepares equipment
• Surgical scrub
• Gowning and gloving
• Create and maintain a sterile field
• Completes surgical count
• Prepares/applies skin preparation
• Provides patient drapes
• Provides instrumentation
• Anticipates intraoperative events and acts accordingly
• Monitors sterile field
• Initiates the 2nd/3rd surgical count
• Assists with dressing the wound
• Assists with removal of the drapes
• Assists with the attachment of wound drainage systems
• Signs the count sheet
• Prepares instrument trolley for decontamination
• Disposes of sharps
• Disposes of waste.

Question 7

THE 8 P’S WHEN CONSIDERING SURGICAL PROCEDURE

Answer 7

• PROPER PLACEMENT
• PROPER FUNCTION
• PLACE IT ONCE
• POINT OF CONTACT
• POSITION OF FUNCTION
• POINT OF USE
• PROTECTED PARTS
• PERFECT PICTURE

Question 8

ASEPTIC TECHNIQUE

Answer 8

• “The methods by which microbial contamination is prevented in the environment”
• Also called Sterile technique
• And, To reduce service providers’ risk of exposure to potentially infectious blood and tissue during clinical procedures.

Question 9

COMPONENTS OF ASEPETIC TECHNIQUE

Answer 9

• Handwashing/Surgical scrub
• Using barriers
• Client prep
• Maintaining a sterile field
• Using safe operative technique
• Maintaining a safer environment in the surgical/procedure area

Question 10

NURSING ROLE IN OPERATING SUITE

Answer 10

• THE NURSE MANAGER
• THE FLOOR COORDINATOR
• THE STAFF DEVELOPMENT NURSE
• THE PRE-OP NURSE
• ANAESTHETIC NURSE
• THE INSTRUMENT (SCRUB) NURSE
• THE CIRCULATING (SCOUT) NURSE
• THE RECOVERY ROOM NURSE

Question 11

PRE-OP CHECKLIST

Answer 11

• Pre-op nurse verifies information (i.d., consent, right patient, right procedure on the list
• Mandatory examination results
• Allergies
• Patient property/ personal effects
• Dietary and fluid restrictions
• Any meds administered as ordered

Question 12

TYPE OF ANAESTHESIA

Answer 12

• GA Definition: reversible, unconcious state. Characterized by: Amnesia (sleep), Analgesia (freedom from pain), Depression of reflexes, Muscle relaxation “put to sleep”
• Regional Anesthesia Definition:a reversible loss of sensation in a specific area or region of the body when a local anaesthetic is injected to purposefully block or anesthetize nerve fibres in and around the operative site.
  e. g. spinal, epidural, and major peripheral blocks.
• _Local Anesthesia _Definition: administration of an anesthetic agent to one part of the body by local infiltration or topical application.Nurse monitors.

Question 13

PRE-MEDICATION

Answer 13

• Sedatives/tranquilizers
• Narcotics
• Anticholinergics
• Antiemetics
  
  • Desired Effects
  • decrease anxiety
  • reduce bronchial secretions
  • analgesia
  • amnesia

Question 14

PROCESS OF GA

Answer 14

• Induction – begins with administering of anaesthetic agents until pt ready for positioning or surgical prepping INTUBATION
• Maintenance – from this point until near completion of the procedure
• Emergence – starts as the pt begins to “emerge” and ends when pt ready to leave the OR. EXTUBATION
• Recovery from anaesthesia can be considered a 4th phase of GA.

Question 15

INHALATIONAL AGENTS

Answer 15

• NITROUS OXIDE (GAS)
• HALOTHANE (VAPORISER)
• ENFLURANE (VAPORISER)
• ISOFLURANE (VAPORISER)

Question 16

INTRAVENOUS AGENTS

Answer 16

• THIOPENTONE
• PROPOFOL
• DEPOLARISING
• NON-DEPOLARISING

Question 17

CARE OF PATIENT DURING A GA

Answer 17

• EQUIPMENT CHECK
• AIRWAY EQUIP SIZE GUIDE
• PATIENT CHECK AND PREPARATION
• INTUBATION
• POST INDUCTION
• CARE OF UNCONSCIOUS PT
  
  • MONITORING
  • PROTECTION
  • HYDRATION
  • SKIN INTEGRITY
  • TEMP CONTROL

Question 18

CATEGORIES

Answer 18

• Cutting and Dissecting Instruments
• Clamps
• Grasping Forceps
• Retractors
• Suction
• OTHER
  
  • Specialty
    Drills, Saws – Orthopaedics
    Joint replacement-implants
    Fibreoptic scopes
    Robotic Surgery