Exam 7: Sutures, sharps, and Instruments

The scrub person was precepting a surgical technology student on her first orthopedic case,a tibial intramedullary (IM)rodding.The scrub person explained to the surgical technology student the importance of keeping the instruments free of blood and bioburden during the procedure and demonstrated the best practice and how to:

A veteran perioperative nurse remembers a time when all suture needles had eyes,and she even had her own needle rack.She hand threaded all sutures according to the surgeon's preference.The newer sutures were originally called "atraumatic" sutures because they did not double back through a needle eye and cause tissue trauma during pulling or suturing through the tissue.Today,we call this manufacturing process of connecting the suture thread to the needle:

The primary use for suture is essentially to:

When creating a vascular anastomosis,the surgeon will typically suture one-half of the anastomosis with one-half of the suture and the other half of the anastomosis with the other half of the suture.This technique minimizes the drag and wear on the suture material and needle.The correct name for this type of suture and needle is:

The circulating nurse received the trauma call from the emergency department (ED)and called sterile supply to assemble the instruments for an abdominal trauma case with possible aortic rupture.When the cart arrived,she saw the vascular set; however,the most important instrument set was missing.What important instrument set was needed for this procedure besides the vascular set?

Careful counting (according to established policy),situational awareness,and conscientious and meticulous attention to the field are believed to prevent miscounts and lost items.AORN's Guideline for Prevention of Retained Surgical Items recommends that counts should be performed:

Perioperative team members are accountable for all of the soft goods,instruments and miscellaneous items used in surgical procedures.In the event of a count discrepancy what is the first action to be taken?

There are many different types of suturing techniques (stitches)in wound closure and tissue approximation.Which type of stitches are used to reinforce the primary suture line with heavy,strong suture material in an obese patient with high tension on the wound closure?

A male patient had a vasectomy in his urologist's office.The small incision was closed with sutures that are synthetic and will "dissolve and fall out" after 2 to 3 weeks.As the procedure ended,he heard the doctor ask the nurse for 5-0:

Wound tissue healing is enhanced by the use of stapling instruments that mechanically apply internal staples for ligation and division,resection,and anastomoses.What feature of the mechanical process reduces tissue manipulation,edema,and inflammation?

Sharps injuries increase the risk of exposure to bloodborne pathogens in the OR.Control methods should be based on a hierarchy of impact and include elimination of the risk,using safety-engineered devices,work practice controls,and proper personal protective equipment (PPE).The most effective strategy would be:

All perioperative team members are responsible for the prevention of retained surgical items (RSIs).Unintentionally retained surgical items are felt to be completely preventable "never events." Variables associated with increased RSI risk include:

A neutral zone is a predetermined location on the surgical field where sharps are placed for retrieval by the surgeon.Which of the following is a best practice for the use of the neutral zone?

Nonabsorbable sutures are strands of material that effectively resists enzymatic digestion in living animal tissue.The USP categorizes nonabsorbable surgical suture into classes.A suture composed of monofilament or multifilament metal wire would be a:

Flat neurosurgical patties are flat sponges composed of soft compressed cotton or rayon with an embedded radiopaque element and string attached.They are often used in neurosurgical procedures.While used for hemostasis and exposure,what other use would be important in surgery?

This hemostatic device offers a rapid and secure method of clamping arteries,veins,nerves,and other small structures.It may be made of one of several metals,such as stainless steel,tantalum,or titanium.Select the correct hemostatic device that fits this description.

A surgeon was teaching the new residents as he closed the muscle and fascia layer following an open cholecystectomy.He stated that he liked the tensile strength of this monofilamented synthetic suture,but it was hard to manage with its memory and slipperiness and normally needed six surgeon's knots to hold.He was using:

The ideal suture material is one that has handling characteristics such as:

Surgical adhesives may be divided into two categories,cyanoacrylates and fibrin tissue adhesives.These adhesives are sometimes grouped together and considered the same product,but the inherent properties of each result in separate indications.Select the true statement/s about cyanoacrylic tissue adhesives.

Where do more than half of needlestick injuries involving suture needles occur?