ATI Fundamentals For Nursing Chapter 10 - Medical and Surgical Asepsis

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1

Which area of the hands requires special attention before you begin a surgical hand scrub?

The area under each fingernailThe back of the handsThe area between each fingerThe palm of each hand

The area under each fingernail

The area under the fingernails, called the subungual area, harbors micro-organisms. You must clean it thoroughly during the first scrub of the day and whenever visibly soiled.

2

When opening a sterile pack, which of the following actions would compromise the sterility of the instruments and supplies inside the pack?

Opening the sterile pack just prior to the procedureAllowing movement of team members around the fieldKeeping sterile items away from the edge of the tableHolding the sterile pack below waist or table level

Holding the sterile pack below waist or table level

The top of the table or sterile field is the only area that is considered sterile. Anything below waist or table level is considered nonsterile.

3

The goal of surgical asepsis is to:

minimize exposure to the patient's blood during an invasive procedure.create and maintain a micro-organism-free environment.reduce the presence of pathogenic organisms in the environment.kill all micro-organisms on all instruments involved in a procedure.

create and maintain a micro-organism-free environment.

Surgical asepsis consists of methods and practices directed toward keeping an area or object free of all micro-organisms.

4

During surgical hand washing, the hands are kept above the elbows to:

keep them from coming into contact with a contaminated object.facilitate the application of sufficient friction to the hands.encourage water and soap to flow away from the clean hands.provide good visualization of the hands as they are scrubbed.

encourage water and soap to flow away from the clean hands.

The water and soap runs by gravity from the fingertips to the elbows, thus directing the contaminated substances away from the clean hands and preventing recontamination.

5

A nurse donning sterile gloves knows that the proper technique for gloving the dominant hand prevents contact between the contaminated hand and the non contaminated glove because...

gloving the dominant hand first allows for better control over the process.the inner edge of the cuff will lie against the skin and thus will not be sterile.slipping the fingers beneath the cuff maintains the gloves' sterility.the hand has been surgically scrubbed and is considered noncontaminated.

the inner edge of the cuff will lie against the skin and thus will not be sterile.

Direct contact with the skin makes the inner edge of the cuff nonsterile.

6

When donning sterile gloves using the open-glove method, it is important to remember to:

grasp only the inside of the glove with your ungloved hand.ask another team member to assist with donning gloves.grasp only the underside of the cuff with your ungloved hand.choose a pair of gloves at least one size smaller than usual.

grasp only the inside of the glove with your ungloved hand.

The inside of the glove is considered nonsterile and will be placed against the skin of the hand, which is also considered nonsterile. When donning gloves using the open-gloving method, you would use a skin-to-skin and glove-to-glove technique.

7

While waiting for a sterile procedure to begin, how do you position your hands and arms?

With your hands clasped together in the back of your body at waist levelFolded across your chest with your hands on your shouldersAt the sides of your body with your hands pointing downwardWith your hands clasped together in front of your body above waist level

With your hands clasped together in front of your body above waist level

Holding your hands and arms in this manner keeps them from coming into contact with nonsterile items.

8

When opening a sterile pack, what is the proper sequence for opening the sterile pack?

1. open the flap furthest from your body
2. open the side flaps
3. open the flap closest to your body

1. open the flap furthest from your body
2. open the side flaps
3. open the flap closest to your body

You would open the flap furthest from your body first, followed by the side flaps, and finally, the flap closest to your body. Any other order would risk your gown coming into contact with the sterile wrap or your arm reaching over the sterile field, both of which would result in contamination.

9

A nurse preparing a sterile field knows that the field has been contaminated when, select all that apply

a contaminated instrument touches the outer edge of the sterile field.a liquid is poured into a sterile container from a distance of 4 inches.the nurse turns to address the patient's question concerning the procedure.a cotton ball dampened with sterile normal saline is placed on the field.the procedure is postponed for 30 minutes to accommodate the patient.a sterile instrument is dropped onto the near side of the sterile field.

the nurse turns to address the patient's question concerning the procedure.

a cotton ball dampened with sterile normal saline is placed on the field.

the procedure is postponed for 30 minutes to accommodate the patient.

Principles of surgical asepsis state that a sterile field becomes contaminated by capillary action when it comes into contact with moisture.

A 1-inch (2.5-centimeter) border around a sterile field is considered contaminated.

The near side of the field is an appropriate location for introducing items onto the field without reaching over the field itself.

Principles of surgical asepsis state that a sterile field becomes contaminated when it is out of visual range.

Principles of surgical asepsis state that a sterile field becomes contaminated when it is exposed to air for prolonged periods.

The recommended pouring distance is between 4 and 6 inches.

10

Prior to entering the surgical-scrub area, which of the following personal protective equipment (PPE) items do the team members don?

GownMaskProtective eyewearHair coverShoe covers

MaskProtective eyewearHair coverShoe covers

A gown used for a sterile procedure is considered sterile and is not donned until the surgical hand scrub has been completed and the hands have been dried.

Protective eyewear is worn to protect mucous membranes from splashes or sprays of blood and body fluids.

Hair is covered to keep hair and dander from contaminating the sterile field.

A mask is worn to protect mucous membranes from splashes or sprays of blood and body fluids.

Shoe covers are worn to facilitate sanitation whenever splashes or spills are anticipated.

11

A nurse preparing to flush and change the dressing on a patient central venous catheter and should understand that the primary purpose for them wanting this intervention using surgical asepsis is to

assess the skin's integrity around the catheter site.provide a clean, dry environment for the catheter.control the introduction of micro-organisms at the catheter site.promote the catheter's patency.

control the introduction of micro-organisms at the catheter site

The primary goal of surgical asepsis is to implement methods and practices directed toward keeping an area or object free of all micro-organisms.