Surgical Technology for the Surgical Technologist: A Positive Care Approach: Surg Tech Chapter 4 Q&A Flashcards


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1

What are special populations?

They present with physical and psychological unique challenges like stress, body temperature, and loss of intravascular fluids

2

A patient is considered a ..... if she is between birth and the age of 12

Pediatric

3

What do they class a patient first 28 days of life outside the womb

A neonate

4

A child less than 6 months old cannot .......

Shiver

5

Because a child less than 6 months old cannot shiver what are the repercussions?

They are at risk for hyperthermia, bradycardia, and acidosis

6

At what age are tears produced

2-3 months of age

7

What genitalia changes by 1 year of age in a male

Testes descend

8

What overwhelming feeling do most pediatric patients feel

Anxiety, due to separation from parents.
Can lead to a feeling of abandonment

9

What is the role of the circulating surgical tech when a pediatric patient is on the table

They should stand nearby to assist the anesthesia provider by holding the mask on the face of the child, holing their hands or arms and making sure the room is kept very quiet

10

What critical parame4ters should be monitored for a pediatric patient

Temperature, urine output, cardiac function, and oxygenation

11

What is the primary means of monitoring temperature in the OR

Skin temperature

12

What is the most effective way of maintaining temperature in the OR

Keeping extremities wrapped and covered

13

Due to contamination what is the route least used in the groin region

Saphenous vein

14

What is the standard for monitoring oxygenation for all age groups

Measure the arterial blood gases (ABG's)

15

What are the two most common sorts of shock seen in all age groups

Septic shock and hypovolemic shock

16

What is septic shock

A life-threatening illness characterized by hypotension, impaired organ function and/or failure, and metabolic abnormalities

17

What is hypovolemic shock

A state of decreased blood volume; more specifically, decrease in volume of blood plasma. It is thus the intravascular component of volume contraction, but, as it also is the most essential one, hypovolemia and volume contraction are sometimes used synonymously

18

In neonates Hypovolemic shock results in

Decrease venous return that lowers cardia output that leads to tissue perfusion and lactic acidosis

19

In infants what is the most common cause of hypovolemic shock

Dehydration

20

Septic shock is normally caused by ......

Gram-negative bacteria
This can result from peritonitis, intestinal perforation, UTI's, and Upper respiratory Infection (URI)

21

What are the reasons for insensible water loss, mainly in the OR

Water loss through the skin and lungs caused by overhead radiant heaters and phototherapy

22

What is the initial sign of postoperative infection

Fever

23

What are the most common sites of preoperative infections

Lungs, surgical wound, urinary tract, and vascular access sites

24

Three important side effect differences in children vs adults for antibiotics

Sulfonamides, Chloramphenicol, and Tetracycline

25

What is kernicterus

Excess of bilirubin in the blood

26

Children vs adults-Sulfonamides

Bactum or Septa, are associated with increased incidents of kernicterus in neonates. This should not be given to newborns

27

Children vs adults-Chloramphenicol

A synthetic form of antibiotic that is associated with the cause of "gray" syndrome, infants skin turns grey from drug toxicity

28

Children vs adults-Tetracycline

Causes staining and hypoplasia of the enamel of the developing teeth, therefore should not be administered to children

29

What is the number one cause of death in 1-15 year olds

Accidents

30

What is the best treatment for a child having breathing problems

Intubate immediately by placing an uncuffed endotracheal tube

31

What is Pneumothorax

Accumulation of air in the pleural cavity

32

Why must bleeding be brought under control

To prevent hypovolemia

33

What is the most common bone fracture

The clavicle - usually a result of a shoulder dystocia (in labor and delivery this is normally because the shoulders of the baby are stuck behind the pubic bone, or they are too big for delivery)

34

What is the term for a patient whose body weight is 100 pounds greater than ideal body weight

Obese

35

In obese patients what issues do anesthetic personnel face

Higher doses of anesthetic agents are required due to their large uptake of adipose tissue. Recovery time is increased, and poor blood supply slows the elimination of these agents

36

Obese patients are prone to.....

Increased incidences of postoperative wound infections

37

Patients who are obese are high risk for......

Coronary artery disease due to hypertension and diabetes

38

In obese patients what aids in ventilation?

Placing the patient in reverse Trendelenburg's position to expand total lung volume

39

What is reverse Trendelenburg's position

A body position in which the trunk and head are elevated above the pelvis and lower extremities

40

Three most common complications after gastric bypass or gastroplasty

Abdominal catastrophes, internal hernia, and acute gastric distention

41

What is an Abdominal catastrophes

A torsion/twist of the abdominal contents

42

What is an internal hernia

Protrusion of an internal organ into a retroperitoneal fossa or a foramen (congenital or acquired) in the abdominal cavity

43

What is an acute gastric distention

Bloating of the stomach when air is pumped into it

44

What often indicates peritonitis

Acute respiratory failure

45

What is often found in patients that are obese, resulting in the gall bladder being removed

Gall stones

46

What affects the normal metabolic and physiological processes of a patient with diabetes

Anesthesia

47

What is the most common preoperative complication with a diabetic patient

Increase rate of infection

48

What should be postponed in the first trimester, if possible

Surgical procedures

49

Why should surgical procedures be postponed in the first trimester

Increased chances of spontaneous abortion, if need be they should be performed in the second trimester when the fetus is more stable

50

What can stimulate pre term labor

Vasopressors and neostigmine (reversed muscle relaxation)

51

What decreases the uterine tone and aids in preventing uterine contractions

Halogenated agents

52

What should be placed under a pregnant patient when placing them in the supine position

A small rolled sheet or pad under the right hip to slightly laterally shift the uterus to the left

53

What position should be used on a pregnant patient in a supine position

Trendelenburg position with the OR table tilted 30 degrees to the left to aid with venous return, in turn taking the weight of the vena cava

54

Name some autoimmune diseases

Multiple Sclerosis, lupus erythematosus, and rheumatoid arthritis

55

What opportunistic diseases have been seen more frequently since the arrival of AIDS

Kaposi's sarcoma, severe psoriasis rash of the body
Pneumocystis carinil pneumonia (PCN)

56

What is a common complication when a patient has Kaposi's sarcoma

Multiple internal and external lesions

57

How will IV placement be difficult doe to Kaposi's lesions

Candidiasis Skin patches may cover large areas of normal skin, veins may be used up due to repeated sticks previously

58

In a study of AID's patients requiring abdominal surgery what are the four clinical syndromes that require clinical intervention

1. Peritonitis secondary to cytomegalovirus infection
2. Non-Hodgkin's lymphoma of the GI track resulting in an obstruction or bleeding
3. Kaposi's sarcoma lesions in the GI tract
4. Mycobacterial infection of the retro peritoneum or spleen

59

In an isolation patient wearing of protective attire is mandated by the .......

OSHA blood borne pathogens final rule

60

In an isolation patient who addresses the wearing of a respirator

CDC

61

In an isolation patient who should be notified of precautions to reduce the risk of transmission of

All personnel including pre op room, anesthesia, PACU personnel, and pre op holding

62

In geriatric patients what special considerations are taken into account

Preoperative assessment and planning in scheduled elective surgeries.

63

What is associated with geriatric patients and emergency surgeries

Higher mortality rates

64

What does the "Golden hour" mean

It refers to reaching the trauma victim and providing treatment within the first hour following injury, this is critical to the patients outcome

65

Level I trauma center

Can meet all needs required for treating trauma patients, including qualified personnel and on a 24hr basis

66

Level II trauma center

Can treat seriously injured or ill patients, but does not have all the resources available at a Level I facility

67

Level III trauma center

Most often a community or rural hospital in an area that does not have a Level I or II facility. Patients are stabilized and transported to a Level I or II hospital

68

What are three important factors when considering the resulting injury from various forces

1. Velocity of the injuring force
2. Flexibility of the tissue
3. Shape of the injuring force

69

What is the number one organ injured in an MVA

Spleen

70

In preservation of evidence what clothing considerations should be made

Remove clothing by cutting along the seams and around a bullet or stab wound holes. Shape of the hole can provide vital evidence.

71

In preservation of evidence what considerations should be made for bullets

They should be carefully handled as lead will easily scratch. They SHOULD not be handled with metal forceps or clamps. Surg tech places it on a clean gauze and hands of to the circulator for placing in an evidence cup

72

What is a central venous catheter

A catheter placed into a large vein in the neck(internal jugular vein), chest (subclavian vein or axillary vein) or groin (femoral vein

73

What is enterocolitis

An inflammation of the digestive tract, involving enteritis of the small intestine and colitis of the colon.

74

What is intra-arterial measurement

Monitors the blood pressure real-time

75

What is Kinematics

Motion of points, bodies (objects) and systems of bodies (groups of objects)

76

What is a splenectomy

A surgical operation involving removal of the spleen

77

What is a splenomegaly

An enlargement of the spleen

78

What is torticollis

Dystonic condition defined by an abnormal, asymmetrical head or neck position