Nurse1St Semester: Skills Q3: Elkin Ch5

Front 1

Places where surgical asepsis is used

Back 1

Operating Rooms (OR)
Labor & Delivery areas
Major diagnostic or special procedure areas
During procedures that require intentional perforation of a client's skin, such as insertion of an IV catheter,
When the skin's integrity is broken, such as with a surgical incision or burn
During procedures that involve insertion of devices or surgical instruments into normally sterile body cavities (such as urinary catheter)

Front 2

A sterile barrier that has been permeated by punctures, tears, or moisture must be considered _______.

Back 2

contaminated

Front 3

After a sterile package is opened, a ____cm or ____ inch border around the edges is considered unsterile

Back 3

2.5 cm or 1 inch

Front 4

Tables draped as part of a sterile field are considered sterile only at ___ ___.

Back 4

table level

Front 5

If there is any question or doubt about an item's sterility, it is considered ______

Back 5

unsterile

Front 6

A sterile object or field out of the range of vision or an object held below a person's waist is _______.

Back 6

contaminated

Front 7

When is a sterile field established?

Back 7

immediately before the procedure, because there is a direct relationship between the time the sterile field is open and the presence of airborne contaminants.

Front 8

Should we cover a sterile field to be used at a later time?

Back 8

No. Open sterile items just before use.

Front 9

What standard precautions are established by the CDC as the minimum standard for infection-control practice?

Back 9

The use of standard precautions calls for the wearing of masks in combination with eye protection devices such as goggles or glasses with with solid side shields whenever splashes, sprays, splatter, or droplets of blood or other infectious fluids may be generated. Gowns are to be worn when there is risk of being splattered with blood or infectious materials.

Front 10

Who is generally less compliant with complying in these standard precautions?

Back 10

Older nurses because they may resist changing their behavior because of years of experience/tradition

Front 11

What are some perceived barriers to compliance with the standard precautions?

Back 11

lack of time, perceived "low risk" clients, PPE interfering with care activities or unavailable

Front 12

A nursing diagnosis for clients who have latex allergies

Back 12

ineffective protection

Special precautions are needed during sterile aseptic procedures to avoid exposing clients to rubber products such as gloves.

Front 13

If the nurse has a respiratory infection, avoid performing or wear a ____

Back 13

mask

Front 14

S/S of localized infection

Back 14

redness, tenderness, edema, drainage

Front 15

S/S of systemic infection

Back 15

fever, change in WBC count

Front 16

Expected outcomes for sterile procedure include client remaining afebrile (without fever ) for ___ to ___ hrs after procedure or during course of repeated procedures and displaying no signs of localized or systemic infection ___ hours after procedure

Back 16

24 to 48,
24

Front 17

When applying a mask, it usually has a thin metal strip along the edge, where does the metal fit?

Back 17

It fits snugly against bridge of nose

Front 18

Where should you hold the mask when applying?

Back 18

by top two strings or loops, keeping top edge above bridge of nose to prevent contact of hands with clean facial portion of mask. Mask will cover all of nose.

Front 19

How should the strings of a mask be tied?

Back 19

Tie top 2 strings in a bow at top of back of head, over cap (if worn) with strings above ears. Tie 2 lower ties in a bow snugly around neck with mask well under chin. Then gently pinch upper metal band around bridge of nose.

Front 20

What is the order for removing the PPE?

Back 20

Remove gloves, then eyewear (avoiding placing hands over soiled lens), remove mask (untie top strings of mask first, hold strings, untie bottom strings, and pull mask away from face while holding strings), remove cap (grasp outer surface of cap and lift from hair- dispose of proplerly) perform hand hygeine

Front 21

After a sterile procedure, monitor patient's temperature every ___ hours

Back 21

4

Front 22

Before beginning to prepare for your sterile procedure, verify that the procedure ____ surgical aseptic technique

Back 22

requires

Front 23

Before preparing for your sterile procedure, what do you need to assess?

Back 23

Assess client's comfort, oxygen requirements, elimination needs .
Assess for latex allergies.
Check that sterile package does not have any damaged or an expired date. Check sterilization indicator if applicable. Anticipate number and variety of supplies needed for procedure

Front 24

Can the skill of preparing a sterile field be delegated?

Back 24

No, except in the case of surgical technicians trained in surgical aseptic techniques

Front 25

Can the skill of applying PPE be delegated?

Back 25

Yes. Instruct personnel to be available to hand off equipment or assist with client positioning during a sterile procedure.

Front 26

In preparing a sterile field, select a clean, flat, dry work surface above ___ level

Back 26

waist

Front 27

When opening sterile commericail kit, open outermost flap ___ from the body, keeping arm outstretched and ____ from sterile field.

Back 27

away, away

Front 28

Open sterile items while holding outside wrapper in ________ hand

Back 28

nondominant hand, frees dominant hand for unwrapping outer wrapper

Front 29

When pouring sterile solutions, remove sterile seal and cap from bottle in an upward motino. With solution bottle held away from sterile field, and bottle lip __ to ___ inches above insude of sterile receiving container, slowly pour entire contents of solution container. Avoid splashing.

Back 29

1 to 2 inches

Front 30

"strike through"

Back 30

fluid permeation of the sterile barrier resulting in contamination. Slow pouring prevents splashing of liquids.

Front 31

Edge and outside of bottle (for specimen collection are considered _____.

Back 31

contaminated

Front 32

Who are at risk for developing latex allergy?

Back 32

spina bifida
congenital/urogenital defects
history of catheter use
h/o condom catheters
high latex exposure
history of many surgeries
history of food allergies

Front 33

Keep your gloved hands clasped about ___ inches in front of your body, above waist leel, and below the shoulders until you are ready for the procedure

Back 33

12

Front 34

Latex proteins can enter the body through skin or mucous membranes, _______, or via inhalation

Back 34

intravascularly

Front 35

___ powder made in latex gloves helps them slip on easily over hands is a carrier of ____ proteins. This is one reason vigorous hand hygiene is necessary after glove removal.

Back 35

cornstarch, latex

Front 36

When choosing gloves, be sure they are tight enough that objects can be picked up easily but that they do not stretch so tightly over the fingers that they can easily ___.

Back 36

tear

Front 37

Levels of latex reactions in order of increasing severity

Back 37

irritant dermatitis

type IV hypersensitivity

type 1 allergic reaction

Front 38

Describe Irritant dermatitis (latex reaction)

Back 38

nonallergic response characterized by skin redness itching

Front 39

type IV hypersensitivity

Back 39

a cell-mediated allergic reaction to chemicals used in latex processing. Reaction can be delayed as long as 48 h
includes redness, itching, hives. Localized swelling, red and itchy or runny eyes and nose, and coughing may develop

Front 40

type 1 allergic reaction

Back 40

a try latex allergy can be life threatening. Reactions vary based on type of latex protein and degree of individual sensitivity, including local and systemic. Symptoms include hives, generalized edema, itching, rash, wheezing, bronchospasm, difficulty breathing, laryngeal edema, diarrhea, nausea, hypotension, tachycardia, and respiratory or cardiac arrest