Sterile Tech Exam 3

Front 1

Routine hygiene for surgical staff should include:

Back 1

*nails short and filed, NO polish
*no cologne/perfume
*Wash hands often
*remove all jewelry/watches

Front 2

Proper attire for surgical personnel should include:

Back 2

*Clean scrubs-use OR only scubs in OR
*Cap
*mask
*gown
* clean shoes 7/or shoe covers
NO jackets or lab coats

Front 3

Circulator is the mediator between ___________ & __________________

Back 3

sterile and non-sterile

Front 4

The duties of the circulator include:

Back 4

*Cleaning and disinfecting the OR
*Set up surgery table
*Collect all necessary surgical supplies
*Drape the back up table
*Assist the Scrub nurse
*Patient prep-clip and surgical scrub
*Assist surgeon with gowning
* Keep OR neat and tidy during Sx
*Open and pass supplies
*Monitor ALL OR staff for sterile techniques** SURGICAL CONSCIENCE ***
*Anticipate Sx teams needs
*can be the anesthetist
*Post op-dispose of sharps, clean instruments, clean OR, restock, Laundry--OR washed seperate from kennel laundry
*wrap and resterilize packs

Front 5

When cleaning the OR everything should be disinfected in the order of from high to low surfaces and at Bel-Rea, the disinfectant of choice for this is _________

Back 5

Roccal

Front 6

Prior to mopping, floors _____________swept.

Back 6

Should not be swept

Front 7

Trash bags should be labeled with __________ because______________ .

Back 7

Patient ID and date to assist with locating lost items should the need arise.

Front 8

What is the order of items from table to patient for setting up the surgery table at Bel-Rea?

Back 8

Table
1) Peripad
2) Circulating water blanket
3) peripad again
4) Grounded cautery plate-grounded w/ultrasound goo
5) large animals need more padding

Front 9

A circulating Water blanket is placed under the patient, set at ________ at Bel-Rea and a towel, blanket or peripad is placed on top of that.

Back 9

104-105 degrees F

Front 10

A warm air blanket known as a __________ may be placed on top of or around patient to allow its warm circulating air to warm patient during surgery as well as post-op.

Back 10

Bair hugger

Front 11

A circulator collecting surgical supplies with get :

Back 11

Surgical packs, miscellaneous instruments, surgeons gloves, suture material, blades
*set up suction if needed--may need plugged in

Front 12

Another item the circulator is responsible for is draping the back up table that holds extra surgical supplies. Draping creates a _____ field.

Back 12

sterile

Front 13

Back up packs at Bel-rea contain:

Back 13

*Back up table drape
*Pt drape cut to size of table
*Surgeons gown and towel
*Indicator strip

__PREMADE PACKS CAN BE PURCHASED and
-Never open till necessary

Front 14

When assisting the scrub nurse, the circulator must tie the gown at _____________ and pass all necessary packs to the scrub nurse, if there is one.

Back 14

Neck and waist--back of gown is never sterile

Front 15

the back of a surgical gown is ___________

Back 15

NEVER sterile

Front 16

The surgical site is clipped with a ____ blade. This should be used to clip at least ______ inches around the incision site.

Back 16

# 40

4 inches

Front 17

Clipping should be done in a room other than the surgery room, and patient should be vacuumed after clipping to remove excess hair and one other way to remove the hair is to use________________-

Back 17

a lint roller

Front 18

When clipping the patient for Sx, it is important be aware of the clippers temperature to avoid burning the patient and the blade of clippers should be held ________ to patient.

Back 18

parallel (flat)

Front 19

What are the landmarks for an OHE Sx prep clip?

Back 19

Cranial: xiphoid process

Caudal: pubis

Around to the edges of the rib cage

*usually express the bladder unless a cystotomy is being performed

Front 20

What are the landmarks for a neuter Sx prep clip?

Back 20

Tip of prepuce to pubis

* scrotom is very sensitive and easy to cut

* can pluck hair away fro scrotum if needed

Front 21

Who is typically thee anesthetist on the surgical team?

Back 21

The circulator

Front 22

What is the typical method of clipping for an orthopedic surgery?

Back 22

Clip limb entire length all the way around.

limb is typically hung for Sx scrub and draping

Front 23

When clipping the patient for Sx, it is important be aware of the clippers temperature to avoid burning the patient and the blade of clippers should be held ________ to patient.

Back 23

parallel (flat)

Front 24

What are the landmarks for an OHE Sx prep clip?

Back 24

Cranial: xiphoid process

Caudal: pubis

Around to the edges of the rib cage

*usually express the bladder unless a cystotomy is being performed

Front 25

What are the landmarks for a neuter Sx prep clip?

Back 25

Tip of prepuce to pubis

* scrotum is very sensitive and easy to cut

* can pluck hair away fro scrotum if needed

Front 26

Who is typically thee anesthetist on the surgical team?

Back 26

The circulator

Front 27

What is the typical method of clipping for an orthopedic surgery?

Back 27

Clip limb entire length all the way around.

limb is typically hung for Sx scrub and draping

Front 28

What are some of the guidelines for performing a Sx scrub?

Back 28

**Always wear exam gloves
*start at incision and bulls eye out
*cover entire clipped area
*Never re-cross the incision site
*Toss gauze after going around hairline

Front 29

What are the Bel-Rea standards for a Sx scrub?

Back 29

1) Use 3 nolvasan soaked antiseptic gauze squares
2) 3 times around in a bulls eye pattern
3) Wipe excess with DRY gauze
4) Spray with alcohol until it pools on patient
5) Position lights over incision site

Front 30

Surgical duties includes assisting surgeon with gowning. Some guidelines for this are:

Back 30

-Tie at neck and waist
-Open and pass any supplies
-Keep OR neat and tidy
-Monitor ALL OR staff for sterile techniques
-Anticipate surgery teams needs and be aware of how surgery progresses.

Front 31

Post surgical duties of the circulator include:

Back 31

*Dispose of all sharps
*Clean instruments properly
*Clean OR
*Restock any used items and rotate stock
*Laundry---OR laundry should be washed separately from kennel laundry.
*Wrap and resterilize packs

Front 32

The scrub nurse is the mediator between

Back 32

STERILE and STERILE fields

Front 33

A scrub nurse must have clean scrubs, surgical cap, mask clean shoes that are specifically for OR or shoes covers and

Back 33

sterile gown and gloves.

Front 34

Pre-surgical duties of scrub nurse include:

Back 34

1) Know start time of each Sx
2) Know patient signalment and PPH
3) Ensure all needed packs are sterilized, with in use date and ready
4) Lay out needed packs as well as gloves, blades, suture material.
5) Remember-HATS on at all times.

5)

Front 35

Before you scrub yourself for Sx, remember:

Back 35

*Put on hat, mask and shoe covers
*Make sure fingernails are short, no polish or fake nails
*No jewelry or watches
*Makeup kept to minimum, especially mascara
* Hair securely fastened under net

Front 36

Scrubbing insures a high level of

Back 36

cleanliness because resident and transient microbes thrive on hands.

Front 37

What are the 2 methods of scrubbing?

Back 37

Timed and Brush stroke method

Front 38

What are the steps for a timed scrub?

Back 38

1) Do a general wash-soapy lather entire length of forearm, just past elbows.
2) Clean under nails with nail pick
3) Rinse
4) Hold hands higher than elbows and away from srcrubs
5) Wash each finger, all 4 sides and then hands. Move onto tops of forearms then bottom.
Dry with sterile towel

Front 39

A general scrub is _______ minutes, and orthopedic procedures scrub should last ________ minutes and this is the preferred method at Bel-Rea.

Back 39

5

10

Front 40

What are the steps for the Brush stroke method for scrubbing?

Back 40

1) General wash
2) Pick under nails
3) Scrub nails and thumb for 50 strokes
4) Scrub each finger 80 strokes, 20 each side
5) Scrub back of hand and palm 20 strokes each
6) Scrub forearms 60 strokes for each third
remember to alternate arms for each part

Front 41

Key things to remember when doing a Sx scrub?

Back 41

*fingers always stay erect--facing ceiling
*hands upright entire time but below shoulders
*Water and foam should run downward toward elbow

Front 42

When rinsing after a Sx scrub, remember:

Back 42

*NEVER drop hands
* Prevent towel from touching scrubs by bending at waist
*Use half of towel to dry an arm and flip to use other side for other arm
*Drop towel to floor W/O dropping hands below table height.

Front 43

A scrub nurse gowns and gloves themselves, this is known as closed gloving and then the ___________will tie neck and waist of gown.

Back 43

circulator

Front 44

Once gown and gloves are donned, scrub nurse may begin accepting ______________

Back 44

sterile packs from circulator

Front 45

The first task for the scrubbed in scrub nurse is to______________

Back 45

Drape the Mayo stand
-drape is generally in the Sx pack
_set out instruments in a fashion that is easy and acceptable for your surgeon
-Load needle drivers and scalpel blade.
-Count sterile gauze.

Front 46

When the surgeon enters, pass them their towel lengthwise while shielding hands, then

Back 46

pass gown while shielding hands, only go up to elbows, circulator will take it from there.

Assist surgeon in gloving

Front 47

Next is to drape the patient that has been prepped by the circulator. With quarter drapes and should be folded

Back 47

with a cuff folded into them( 3 to me, 1 to he/she)

Front 48

Towel clamps, a curved instrument, should be passed

Back 48

with curved side down toward scrub nurses palms.

Front 49

Michelle clips may or may not be used to

Back 49

hold patient drape to quarter drapes. (not used at Bel-Rea)

Front 50

For orthopedic Sx:

Back 50

*leg is hung & prepped by circulator (hanging makes it easier to prep)
* Hanging fatigues muscles, making procedure easier.
* hanging drains excess blood away from incision site which reduces edema.
*may use 4-8 quarter drapes
*may use sterile vet wrap or stockinette to provide a sterile place to grab limb and adjust limb in a sterile manner.
* tape hanging leg is usually cut
* Patient drape may or may not be fenestrated

Front 51

After draping the patient, the scrub nurse will attach suction and cautery, swinging a little excess as possible to__________-

Back 51

the circulator to plug in.

Front 52

cautery and suction may have a special pouch or sticky pad to attach them to patient drape, may also use Edna towel clamps. At Bel-Rea, Dr. Haynes uses _______________

Back 52

Allis tissue forceps

Front 53

Surgical duties for the scrub nurse include:

Back 53

-Passing instruments
-Keep Mayo stand neat and organized
-rinse off excess blood first
-have 4x4 ready at all times to dab at bleeders
-If moving around OR, back to back with sterile persons or items/areas
Pass front to front with non-sterile areas or personnel.

Front 54

Post operative duties for the scrub nurse include:

Back 54

-Separate used from unused and bulky from delicate instruments
-Dispose of all sharps
-Make sure all tissue samples are properly labeled and sent to lab
_help clean

Front 55

What are some sources of contamination from the OR team members?

Back 55

*People shed microbes constantly
*Skin have NF bacteria as well as other pathogens
****BREAKS IN STERILE Technique***

Front 56

How is contamination controlled?

Back 56

*Attire
*Surgical Scrub
*Strong surgical conscious
*Strict adhearance to aseptic technique

Front 57

What are some sources of contamination from the Patient?

Back 57

*Hair & Skin
*Contaminated Sx such as abscess, pyometra, perotinitis
*

Front 58

How do we control contamination from the patient?

Back 58

Good surgical prep-
-Shave w/40 blade, scrub with antiseptic Nolvasan 3x around in bullseye pattern
*Draping

Front 59

What are some sources of contamination form the environment?

Back 59

*Bacteria on surfaces
*A/c or heat vents
*Doors/cabinets

Front 60

What are some ways to control environmental contamination?

Back 60

*Patient draping
*Keep OR door closed (sliding is preferable--swinging away from OR if swinging door)
*Watch for dust bunnies on ledges, tops of doors and cabinets
*

Front 61

What are some sources of contamination from instruments?

Back 61

*Imporperly cleaned/sterilized
*Contaminated due to type of surgery

Front 62

What are some ways to control contamination from the instruments?

Back 62

*sanitizeddisinfect
*Use proper sterilaiztion methods
**wrap surgical packs correctly
*use proper techniques to avoid contamination

Front 63

Bleach, sodium hypoclorinate is

Back 63

Bacteriocidal, virucidal and slightly sporocidal w/ sufficient quantities.

Front 64

Bleach is not very effective against ___________and is inactivated by ____________.

Back 64

fungus

organic matter--feces, urine, blood

Front 65

Bleach, if used as an disinfectant, should be used after _____________ because___________ .

Back 65

cleaning up

bleach is inactivated by organic matter

Front 66

Cons of bleach use are:

Back 66

*Corrosive, especially to instruments
*Stains clothes
*Irritating to mucous membranes
*Must be diluted
*Don't use Clorox II--non-chlorine bleach---its just peroxide

Front 67

Roccal, the disinfectant of choice at Bel-rea, is _______ and one advantage is _____.

Back 67

Bateriocidal, virucidal, fungicidal

-Won't corrode metal

Front 68

Some cons of Roccal are:

Back 68

*Toxic to fish
*Irritating to mucous membranes
*Must dilute
*$$$expensive

Front 69

Chlorhexadene is

Back 69

Bactericidal
Virucidal
Fungicidal
Slightly sporocidal

Front 70

Some advantages of Chlorhexadine are:

Back 70

*doesn't stain
*Has RESIDUAL effect up to 24 hours
*Less expensive than Roccal
**Effective in presence of organic material***

Front 71

Chlorhexadine is also used as an antiseptic as well as disinfectant and is the antiseptic of choice at Bel-Rea. The Brand names are___

Back 71

Nolvasan and Hibidens

Front 72

Chlorhexadene comes as a scrub or a solution and is effective in the presence of________

Back 72

organic matter and one major advantage is its RESIDUAL EFFECTS on skin

Front 73

COns of Chlorhexadene are:

Back 73

*May be ototoxic & irritating to eyes
*Does not kill Spores
*effectivness decreases when using with saline or hard water

Front 74

When used as a surgical scrub antiseptic

Back 74

Chlorhexadene is NOT diluted and is full strength on the soaked gauze.

Front 75

70% isopropyl Alcohol is:

Back 75

bacteriocidal-dries skin and decrease the skin temp which also decreases number of microbes

Front 76

Alcohol is used as a final step in patient scrub and should actually ________ on patient.

Back 76

pool

Front 77

Cons of using Alcohol as an antiseptic are:

Back 77

*Flammable---cautery will ignite it!!
*Don't use in open wounds
*Not effective for use unless area is saturated.
*Inactivated by organic matter

Front 78

3% Hydrogen perioxide is

Back 78

Bacteriocidal only--bubbles in presence of Staphlococcus

Front 79

Cons of using Hydrogen perioxide are:

Back 79

Is cytotoxic---do not use on wounds

-stains fur

-Can be used to remove dried blood

Front 80

Iodine is _____ and brand names are__________

Back 80

Bacteriocidal, Virucidal, Fungicidal, Slightly sporcidal

Providine, Betadine

Front 81

What are some cons of using iodine as an antiseptic?

Back 81

*Stains skin and clothes
*Corrosive to metal
*Irritates tissues
*Alcohol may decrease effectiveness
*Inactivated by organic debris

Front 82

Avagard is made up of a combination of:

Back 82

61% alcohol and 1% Chlorhexadine