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Surg Tech Chapter 4 Q&A

front 1

What are special populations?

back 1

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

front 2

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

back 2

Pediatric

front 3

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

back 3

A neonate

front 4

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

back 4

Shiver

front 5

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

back 5

They are at risk for hyperthermia, bradycardia, and acidosis

front 6

At what age are tears produced

back 6

2-3 months of age

front 7

What genitalia changes by 1 year of age in a male

back 7

Testes descend

front 8

What overwhelming feeling do most pediatric patients feel

back 8

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

front 9

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

back 9

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

front 10

What critical parame4ters should be monitored for a pediatric patient

back 10

Temperature, urine output, cardiac function, and oxygenation

front 11

What is the primary means of monitoring temperature in the OR

back 11

Skin temperature

front 12

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

back 12

Keeping extremities wrapped and covered

front 13

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

back 13

Saphenous vein

front 14

What is the standard for monitoring oxygenation for all age groups

back 14

Measure the arterial blood gases (ABG's)

front 15

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

back 15

Septic shock and hypovolemic shock

front 16

What is septic shock

back 16

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

front 17

What is hypovolemic shock

back 17

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

front 18

In neonates Hypovolemic shock results in

back 18

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

front 19

In infants what is the most common cause of hypovolemic shock

back 19

Dehydration

front 20

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

back 20

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

front 21

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

back 21

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

front 22

What is the initial sign of postoperative infection

back 22

Fever

front 23

What are the most common sites of preoperative infections

back 23

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

front 24

Three important side effect differences in children vs adults for antibiotics

back 24

Sulfonamides, Chloramphenicol, and Tetracycline

front 25

What is kernicterus

back 25

Excess of bilirubin in the blood

front 26

Children vs adults-Sulfonamides

back 26

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

front 27

Children vs adults-Chloramphenicol

back 27

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

front 28

Children vs adults-Tetracycline

back 28

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

front 29

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

back 29

Accidents

front 30

What is the best treatment for a child having breathing problems

back 30

Intubate immediately by placing an uncuffed endotracheal tube

front 31

What is Pneumothorax

back 31

Accumulation of air in the pleural cavity

front 32

Why must bleeding be brought under control

back 32

To prevent hypovolemia

front 33

What is the most common bone fracture

back 33

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)

front 34

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

back 34

Obese

front 35

In obese patients what issues do anesthetic personnel face

back 35

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

front 36

Obese patients are prone to.....

back 36

Increased incidences of postoperative wound infections

front 37

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

back 37

Coronary artery disease due to hypertension and diabetes

front 38

In obese patients what aids in ventilation?

back 38

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

front 39

What is reverse Trendelenburg's position

back 39

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

front 40

Three most common complications after gastric bypass or gastroplasty

back 40

Abdominal catastrophes, internal hernia, and acute gastric distention

front 41

What is an Abdominal catastrophes

back 41

A torsion/twist of the abdominal contents

front 42

What is an internal hernia

back 42

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

front 43

What is an acute gastric distention

back 43

Bloating of the stomach when air is pumped into it

front 44

What often indicates peritonitis

back 44

Acute respiratory failure

front 45

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

back 45

Gall stones

front 46

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

back 46

Anesthesia

front 47

What is the most common preoperative complication with a diabetic patient

back 47

Increase rate of infection

front 48

What should be postponed in the first trimester, if possible

back 48

Surgical procedures

front 49

Why should surgical procedures be postponed in the first trimester

back 49

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

front 50

What can stimulate pre term labor

back 50

Vasopressors and neostigmine (reversed muscle relaxation)

front 51

What decreases the uterine tone and aids in preventing uterine contractions

back 51

Halogenated agents

front 52

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

back 52

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

front 53

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

back 53

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

front 54

Name some autoimmune diseases

back 54

Multiple Sclerosis, lupus erythematosus, and rheumatoid arthritis

front 55

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

back 55

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

front 56

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

back 56

Multiple internal and external lesions

front 57

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

back 57

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

front 58

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

back 58

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

front 59

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

back 59

OSHA blood borne pathogens final rule

front 60

In an isolation patient who addresses the wearing of a respirator

back 60

CDC

front 61

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

back 61

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

front 62

In geriatric patients what special considerations are taken into account

back 62

Preoperative assessment and planning in scheduled elective surgeries.

front 63

What is associated with geriatric patients and emergency surgeries

back 63

Higher mortality rates

front 64

What does the "Golden hour" mean

back 64

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

front 65

Level I trauma center

back 65

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

front 66

Level II trauma center

back 66

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

front 67

Level III trauma center

back 67

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

front 68

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

back 68

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

front 69

What is the number one organ injured in an MVA

back 69

Spleen

front 70

In preservation of evidence what clothing considerations should be made

back 70

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

front 71

In preservation of evidence what considerations should be made for bullets

back 71

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

front 72

What is a central venous catheter

back 72

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

front 73

What is enterocolitis

back 73

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

front 74

What is intra-arterial measurement

back 74

Monitors the blood pressure real-time

front 75

What is Kinematics

back 75

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

front 76

What is a splenectomy

back 76

A surgical operation involving removal of the spleen

front 77

What is a splenomegaly

back 77

An enlargement of the spleen

front 78

What is torticollis

back 78

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