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213 Cards in this Set
- Front
- Back
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State primary goal of surgical intervention
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To return pt. to the best physical and psychological state possible
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To prevent the occurrence of a disease of illness is called what?
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Prophylactic
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To relieve or alleviate symptons without curing the underlying cause or disease is?
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Palliative
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To regain the pt's health and strength to resume normal activities
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Restorative
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To determine the nature and cuase of an illness
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Diagnostic
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List the 3 types of hospitals
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Nonprofit - revenue not taxed
For Profit - Owned by group of individuals revenues taxable Surgical Facilities - Undertakes minor surgeries with no postoperative care necessary |
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List 4 facilities where surgery can be performed
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ambulatory care
satellite surgery center physician's office hospital |
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Describe typical hospital organizational chart
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BOD = hires CEO
Medical Staff - delivers services Admin - designs and implements procedures and policies |
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Describe typical organizational structure for surgical services
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Surgical Board Charge Nurse
Surgeons Staff Nurses, ST, and nurse's assistant |
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Departments that deliver direct patient care
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doctors
nurses surgical techs |
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Department that deliver indirect patient care
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blood bank
central supply bioengineering foo services |
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List 4 broad categories of surgery today
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emergent
urgent elective optional |
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List 3 phases of surgical case management
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preoperative
intraoperative postoperative |
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List members of the surgical team
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surgeon
anesthesia care provider OR Director Nurse Manager OR Educator RN, PA, CST-FA, LVN Unit secretary, orderly |
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List 5 areas of employment for sugical tech
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vet clinic
private physician (surgeon instructor sterilization sales rep |
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List 2 ways of receiving training as a ST
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military - 9 and 18 month programs
2 year college |
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Define and give brief description of AORN
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Association of PeriOperative Registered Nurses
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Define and give brief descrip of AST
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Association of Surgical Technologists
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Define and give brief descrip of CAAHEP
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Commission on Accreditation of Allied Health Education Programs
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Define and give brief description of LCC-ST
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Liason Council on Certification for Surgical Technologists -- Body responsible for developing and adm the national certification
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Sterile
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Free from living microorganisms
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Delegation
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Transfer of responsibility from licensed person to nonlicensed person (licensed person assumes responsibility
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Dependent Task
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Task delegated to another person and require direct supervision by the person delegating task
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Independent Task
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Tasks that are transferred to another person and do not require supervision
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Proprietary School
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Private -- for nonprofit
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What event is associated with development of role of sT
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WW II
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What were first STs called
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ORTs Operating Room Technicians
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What year did formal schooling of ORTs begin
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1968
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When was AST formed
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1973
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What year did the title of ORTs change to STs
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1973
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What is the mission statement of a hospital
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A statement that reflects the overall goal and ethics of that institution
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What is the chain of command
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the heirarcy of administrative positiions
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What is accreditation
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Process by which a team visits hospital and inspects practices, policies and outcomes of patient care
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What organization accredits hospitals in the US
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JCAHO Joint commission on accreditation of healthcare organizations
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OSHA
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Occupational Safety and Health Administration govers infection control and safety
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CDC
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Centers for Disease Control - governs infection control and safety
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What are the rules regarding blood being transported and used at the hospital
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Blood may be transfused only after two licensed personnel have together verified the id number of the patient and confirmed the corresponding information on the blood unit bag, including contents, type and cross-matching identification. ID process is performed at least twice before blood is administered.
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patient-centered care means
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surgical team bases assessment, planning, and intervention on the unique needs of the individual patient
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Critical thinking means what
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Application of knowledge and experienced gained in the past to solve a current problem
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What are Maslow's hierachy of human needs?
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Physiological
Security and Safety Love Self Esteem Self Actualization |
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What is considered a high risk patient
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one who requires surgery but has one or more comorbid diseases
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What are the basic physiological needs of a patient
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nutrition, water; shelter, air and oxygen, rest and sleep, elimination, movement and freedom from pain
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List some instances where a patient would be considered high risk
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malnourished
diabetic respiratory disease alcoholic or drug addicted immunosuppressed patient trauma patient patient with aids |
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What are some of the different behaviors seen in OR regarding children of different development ages
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infants -- need to by physically close to caretakers
toddlers -- suffer frustration and loss of autonomy and anxiety when separated from parents preschoolers -- suffer extreme fear in OR (will view as deliberate abandonment) school aged children are more compliant and cooperative. The fear mutiliation but are curious about their care. adolescents are very sensitive about their bodies...fear loss of control and body exposure. |
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What are some problems in OR with geriatric patients
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Increased injury due to loss of adipose tissue and loss of skin elasticity, Loss of body heat from lack of body fat.
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What are the characteristics of therapeutic communication
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goal directed
unique to each patient it requires active engagement it requires excellent observation and listening skills |
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What are some qualities of good communication skills
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assertiveness
(express your needs but respect the right and needs of others) Respect Clarity Feedback |
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What is groupthink
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a collective behavior and thinking. It is based on peer pressure and occurs when members of a group are polarized in their opinions
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How is tone defined
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Tone is the environment of the message. It reflects the sender's emotions
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What is cultural differences
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reflects the values, social practices and communication methods of a group of people
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Win-Lose
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in conflict resolution, a situation in which one party is satisfied and the other is not
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Win-Win
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In conflict resolution, both parties in a conflict gain by the solution
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Feedback
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Physical response to a message, a component of effective communication
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Consensus
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Agreement among members of a group
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Ethical dilemma
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A situation is which ethical choices involve conflicting values
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Liable
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legally responsible and accountable
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Negligence
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ommission to do something that a reasonable person and prudent person would not do.
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Sentinel event
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An unexpected occurrence involving death or serious physical inury. Sentinent signals the need for immediate investigative response
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Consensus
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Agreement among members of a group
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Ethical dilemma
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A situation is which ethical choices involve conflicting values
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Liable
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legally responsible and accountable
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Negligence
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ommission to do something that a reasonable person and prudent person would not do.
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Sentinel event
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An unexpected occurrence involving death or serious physical inury. Sentinent signals the need for immediate investigative response
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Consensus
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Agreement among members of a group
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Ethical dilemma
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A situation is which ethical choices involve conflicting values
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Liable
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legally responsible and accountable
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Negligence
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ommission to do something that a reasonable person and prudent person would not do.
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Sentinel event
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An unexpected occurrence involving death or serious physical inury. Sentinent signals the need for immediate investigative response
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Morals are described as
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personal standards
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laws are described as
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social standards
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ethics are described as
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a group of standards
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A ST is allowed to pass drugs to surgeon what should a ST do during passing the drugs
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always acknowledge the name and amount of medication
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Advance directive
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instructions about your medical care in event you can't speak
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Living Will
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Specifically states what types of interventions or treatments a patient wants
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The failure to stay with a patient who is under one's care is called
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Abandonment
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Money awarded in a civil lawsuit to compensate the injured party is
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Damages
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Defamation in writing is called
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Libel
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Testimony of a witness under oath and transcribed by a court reporter
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deposition
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Crime of intentionally lying or falsifying information
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perjury
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Spoken defamation
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Slander
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Medical Power of Attorney
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Legal document signed by a person giving another the power to make health care decisions
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Doctrine of respondent superior liability
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Dictates that the employer can be sued if an employee commits negligence during his scope of employment
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Doctrine of forseeability
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Dictates the extent to which an event or action could have been anticipated and prevented by reasonable and prudent action.
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Doctrine of res ipsa loquitor
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Indicates the thing speaks for itself (someone leaving in a sponge)
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doctrine of detrimental reliance
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a surgeon may in certain cases rely on the professionalism of the scrub and circulator and therefore may deflect responsibility for an injury
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Primum Non Nocere
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First, do no harm
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Aeger Primo
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the patient first
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What are some of the most common areas of negligence
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retained objects
burns falls improper positioning patient identity and operative site specimen handling medications abandonment failure to communicate loss of patient property |
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What is HIPPA
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The Health Insurance and Portability and Accountability Act of 1996
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What does HIPPA do
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Protects a patient's privacy
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Who created HIPPA
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HHS Department of Health and Human Services
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Civil Assault
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the threat or attempt to strike or harm, whether or not it is carried out or not
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Civil Battery
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the actual unlawful touching or striking another person
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False Imprisonment
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Depriving a person of his/her freedom
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Subpoena
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A written order to appear in court
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Summons
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A summons is different from a subpoena because it actually makes you a party to the lawsuit
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Judgment
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a claim for tortuous injury and the judgment is the amount of money awarded to plaintiff for damages
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Who can sign a consent form?
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Legal guardian, spouse or other authorized person. The attenting PHYSICIAN MAY NOT WITNESS THE CONSENT
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What does DNR mean
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Do Not Resuscitate
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What are the Code of Ethics of the Association of Surgical Technologists
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Codes that reflect the expectations of those professionals as they make decisions involving ethical issues
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Plaintiff
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The person that initiates a lawsuit
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Defendant
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The person whom a lawsuit is filed against
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Intentional Torts
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Intentional acts are willful and violate the civil rights of a patient...assault, battery, defamation, false imprisonment
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Unintentional Torts
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they include negligence and malpractice...patient identification, incorrect procedure, sponges left in patient, burns, falls.....
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Informed consent is the responsibility of....
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The physician
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Informed consent must include
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Patient's legal name,
surgeon's name procedure to be performed patient's legal signature signature of witness date and time of signature |
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List five causes of stress in the operating room
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hunger
lack of sleep drug and/or alcohol abuse burned out poor communication |
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Communication using words
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Verbal
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Communication in which words are written; depends on the ability to write, read and see
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Written
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Communication sent in ways other than by words; depends on the five basic senses
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Non verbal
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Communication in which words are spoken aloud; depends on the abilities to speak and hear
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Verbal
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What are the essential elements of effective communication
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the sender, the receiver, the content and the feedback
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List effective listening skills
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Focus on sender,
do not judge sender, watch for nonverbal clues rephrase content ask for clarification |
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The violation of the obligation to keep a patient's records and confidences private
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breach of confidentiality
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An injury induced by a doctor or caregiver
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Iatrogenic injury
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The expectation that an individual may be called to account for actions taken that were consistent with responsibilities
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Accountability
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Law established on the basis of previous court decisions
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Common Law
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The degree of negligence in which each of the parties involved may be shown to have been responsible for the injury involved
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Comparative negligence
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A serious crime punishable b law with penalties ranging from imprisonment to death
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Felony
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A private or civil wrong or injury for which the court provides a remedy through an action for damages
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tort
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Being unqualified or inadequate to perfom duty or duties
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incompetence
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An act or omission that is the result of actual conscious indifference to rights, safety or welfare of persons
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gross/criminal negligence
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A lawsuit
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Litigation
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Legal liability of a manufacturer
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Product liability
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Definition of a surgical conscience
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a developed skill of constant committment to aseptic technique. It also involved a personal moral of accepting responsibility for ones actions
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List three resources that help a surgical tech interpret and follow professional standards of conduct
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medical journals,
continuing ed web |
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Risk is defined as
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the statistical probability of a harmful event. defined as the number of harmful events that occur in a given population
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taking risks means
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trying to beat the odds
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Risk management means
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taking specific precautions to reduce the risk
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What are the risk factors for surgical personnel
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blood and body fluids
harmful chemicals heat and powerful electrical devices lift heavy objects and frequent handling of sharp objects and stress |
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EPA means
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Environmental Protection Agency
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What are the 3 components that a fire requires
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fuel, a source of ignition, and oxygen
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What are some Fuel sources
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preparation solutions, particularly those containing alcohol,
medical devices (rubber, plastic) surgical drapes patient hair intestinal gases laser energy bovie ligh sources harmonic scalpel |
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What is OEA
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Oxygen -rich environment
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What is lanugo
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fine patient body hair
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What are some prep solutions and other chemicals used in surgery that are flammable
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alcohol
betadine (Povidone iodine solution) fibrin glue bone cement |
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What is the first thing to remember in a patient fire
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PATIENT FIRST
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What three steps do you take to protect the patient and stop the fire
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shut off flow of all gases to patient's airway
remove any burning objects from surgical site assess the patient for injury and repond apropriately |
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What is the plan to follow if a structural fire occurs
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RACE
RESCUE ALERT CONTAIN EVACUATE |
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What is a Class A Fire
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Water
involves wood, paper and cloth |
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What is a Class B Fire
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Carbon Dioxide
involves flammable liquid |
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What is a Class C Fire
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bromochlorodifluoromethane
involves electrical and laser fires |
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Three steps to use a fire extinguisher PASS mean what
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pull, aim, squeeze, and sweep
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On the diamond NFPA hazard triangle what do the different colors and symbols stand for
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yellow-instability- #1
red - flammability - #2 Blue - Health - #3 White - Special #4 W or Ox |
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In the mavcc worksheets on page 31 of Module 1B know the symbols and what they mean
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Corrosive
Explosive Flammable Harmful to Food stuff Infectious Oxidizing Poisonous Radioactive |
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Breathing in gases, vapors, fumes and other forms of material
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Inhalation
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By mouth
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Ingestion
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Through the skin
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Absorption
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What is the correct standing posture
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Align ears, shoulders, hips knees and ankles
Keep shoulders relaxed and knee slightly bent |
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Good body mechanics prevent what
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Injury and fatigue
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Using the body correctly results in what
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Coordination and Endurance
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List four types of emergencies
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Fires
Mechanical Failures Bomb Threats and Severe weather |
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What are the fire extinguisher symbol shapes for classification
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Triangle --- Class A
Square -- Class B Circle Class C Star -- Class D |
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What are 3 osha regulations required of employers
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Provide written training and policies
follow CDC guidelines keep MSDS sheets |
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What does OSHA operate under
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US Department of Labor
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The bloodborne pathogens that concern operating room professionals are
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hepatitis B, hepatitis C and HIV
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Bloodborne pathogens are found in
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Contaminated Blood
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Infections can occur if infected blood enters a person's bloodstream through any of the following routes
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unprotected opening in the skin such as cuts, scrapes and dermatitis
unprotected mucous membrane openings such as eyes, nose and mouth penetration into the skin by a sharp object such as a broken glass, a needle or knife blade |
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List examples of devices that can cause sharps injuries
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Wire sutures
hollow injection needles guide wires stylets drain trocars laparascopic trocars orthopedic drill bits |
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Mount the needle where in the needle holder
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Midcurve rather than 3/4 of the way back, to prevent slippage or bending of the needle
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Universal Precautions
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Basic guidelines for infection control published in 1988 by the CDC
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Identify 8 substances that require hand protection
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Blood, sputum, urine, feces, nasal secretions, vomitus, spinal fluid, and semen
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The most penetrating of the three types of radiation is
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Gamma
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Cannot be stopped by a sheet of paper, and though some can be stopped by human skin, others need a thicker shield to stop them
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Beta
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Can be prevented from penetrating the body by a sheet of paper by human skin
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Alpha
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Cylinder Color Gray
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Carbon Dioxide
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Cylinder Color Black
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Nitrogen
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Cylinder Color Blue
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Nitrogen Oxide
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Cylinder Color Brown
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Helium
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Cylinder Color Yellow (black and white international)
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Air
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Cylinder color Green (white international)
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Oxygen
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Cylinder Color Orange
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Cyclopropane
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Flammable Anesthetic Gases
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Cyclopropane
divinylether ethyl ether ethy chloride ethylene |
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Contact with corrosive or irritating chemicals such as acids or alkalines
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Chemical
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Overexposure to radiant energy
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Radiation
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Resulting from overexposure to electricity
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Electrical
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Contact with fire, hot objects, or hot fluids
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Thermal
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Genetic mutation
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having the ability to cause permanent change in genetic structure
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a naturally occurring sap obtained from rubber trees used in manufacture of medical devices
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Latex
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A method of transferring sharp instruments on the surgical field without hand to hand contact
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neutral zone
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Post exposure prophylaxis
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recommended procdures to help prevent the development of blood-borne diseases after an exposrue
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Define Standard Precautions
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Guidelines recommended by CDC to reduce risk of transmission of blood-borne and other pathogens
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What is smoke plume
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95% water and 5% other chemicals, blood cells, infected or fragmented bacteria and viruses Toxic smoke from lasers
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What is used to measure the cumulative radiation dose for those who are frequently exposed
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Dosimeters
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What color are waste bags for infectious material
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Red
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Some chemicals found in the smoke plume are
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toluene - liver and kidney damage
acrolein - causes eye, nose and throat irritation formaldehide - used to preserve tissue, causes irritation to mucous membranes, causes kidney damage hydrogen cyanide - used commercially for pest control, causes nausea, dissiness and headache |
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What can happen with severe allergic reaction to latex
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antiphilactic shock
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Before any surgical procedure a patient must sign what
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Informed Consent
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NPO means what
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Nothing by Mouth
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Patient should be transported head first or feet first
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Feet First
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Patient should enter an elevator head first or feet first
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Head
First |
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When the patient is lying flat on back with arms next to body it is what position
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Supine
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When the patient is lying on back and head is lowered and feet are raised it is what position
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Trendelenburg
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When patient is in supine position with feet lower than head it is what position
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Reverse Trendelburg position
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A modified sitting position is called what
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Fowler's position
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When lying flat on back with feet in stirrups
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Lithotomy position
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What position when you are face down on belly with arms at side
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Prone position
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What position if head down and butt up in the air
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Kraske Jackknife
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What position if you are lying on side
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Right or left lateral position
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What position if on right side and the kidney roll is placed under body
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Right or left kidney position
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What position if on left side and right leg is flexed
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Sims position
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Control of body temp is important, what if too much body temp is lost
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Hypothermia
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What is normal temp for adults -- oral, rectal and axillary
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98.6 oral
99.6 rectal 97.6 axillary |
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What are normal pulse values for birth through adults
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Birth 130-160
infants 110-130 children 1-7 80-120 over 7 80-90 adults 60-80 |
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What are some of the pulse points in the body
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radial artery, (wrist)
femoral artery brachial artery (middle of arm) popliteal artery (knee) temporal artery carotid artery apical (apex of heart) |
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what is slow heart rate
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bradycardia
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what is fast heart rate
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tachycardia
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what are normal respiration rates
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infants 30 to 60
children 1-7 18-30 adults 12-20 |
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No breathing
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Apnea
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normal breathing
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eupnea
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rapid breathing
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tachypnea
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What are normal bp readings for newborn through adult
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newborn 50-52 systolic and 25-30 diastolic
child under 6 95/62 child to 10 100/65 adolescent 118/75 adult 120/80 |
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what is homologous
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blood donated by another person
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