Surgical Nursing: Surgical Procedures and Equipment

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Author:
nitacherry
ID:
287927
Filename:
Surgical Nursing: Surgical Procedures and Equipment
Updated:
2014-11-12 22:35:21
Tags:
Nursing Procedures Equipment
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Description:
Procedures, Equipment, Common Sx
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  1. Common Surgical Procedures *7
    • 1. Asepsis
    • - avoid nosocomial inf
    • 2. Patient Assessment
    • - stable for anesthesia
    • - bloodwork pre-op (kidney/liver)
    • 3. Patient Needs
    • - specific procedure (pre-intra-post)
    • 4. Prep
    • - tools
    • - surgical fields
    • 5. Communication
    • 6. Recovery Plan
    • - pain
    • - mobility
    • - ō edu
    • 7. Prepare for the unexpected!
  2. Technician's Role Sx *7
    • 1. Prep patient sx
    • 2. Surgical nurse
    • 3. Anesthetist
    • 4. Care/Sterilization of instruments
    • 5. Clean/Stalked surgical suite
    • 6. Scrub to assist DVM
    • 7. ō comm
  3. Pre-Sx Prep *7
    • 1. ō comm
    • 2. Consent form/Treatment plan
    • 3. Med. Rec.
    • - check pre-op bl wk
    • 4. Review pre-op evaluation & anesthesia protocols
    • 5. Patient assessment
    • - TPR (Temp, Pulse, Resp Rate)
    • 6. NPO
    • 7. Emergency drugs prep
  4. * Think ahead : Surgical Proc *3
    • - staff comm
    • - stock/exp dates
    • - access to items that MAY be needed *pre-op
  5. * IV Catheter during Sx
    • - Life Line!
    • - Every patient having a procedure!
    • - Admin of Emergency Drugs
    • - Fluids
    • - Bl Press
  6. * Butterfly Catheter for Sx
    • Contraindicated during Sx:
    • - needle in vein
    • - poss perforation of vessel
  7. * Surgery Packs
    • - Customized: specific instruments
    • - holding, clamping, retracting
  8. Hemostatic Forceps
    • * stops bleeding by crushing bl vessels
    • - diff sizes
    • - straight/curved
    • * transverse grooves to grasp tissue
  9. Hemostatic Forceps *8
    • 1. Allis Tissue
    • 2. Crile
    • 3. Ferguson Angiotribe
    • 4. Halstead Mosquito
    • 5. Hartman Mosquito
    • 6. Kelly
    • 7. Rochester Carmalt
    • 8. Rochester-Pean
  10. Kelly Forceps
    • * occlude sm to med size vessels
    • - larger in sz
    • - grooves go halfway up
  11. Halstead Mosquito Forceps
    • * clamp sm vessels to be occluded, crushed or held firmly in place
    • - grooves go entire length
  12. Hartman Mosquito Forceps
    • * clamp/occlude sm cap or vessels that have been or will be cut
    • - grooves go entire length
  13. Crile Forceps
    • * occlude sm to med sz bl vessels
    • - sm uterine horns
    • - grooves entire length
  14. Rochester Carmalt Forceps
    • * clamp large tissue bundles that contain bl vess
    • * placed perpendicular to bl vess = occludes & prevents bl flow
    • - perpendicular, long grooves
    • - grooves criss cross @ tip
    • - spay pack*
  15. Use of Rochester Carmalt Forceps Vs Other Hemostats
    * other hemostats are not used bc their transverse grooves can allow bl to continue flowing
  16. Rochester-Pean Forceps
    • * clamp bl vess
    • * control large tissue bundles
    • *transverse gr
  17. Ferguson Angiotribe Forceps
    • * crush powerfully
    • * creates fold in tissue
    • * spay packs :: uterine horns & spermatic cords
    • - thick
  18. Allis Tissue Forceps
    • * hold w/ max power
    • * causes tissue trauma :: tissue removal
    • no grooves :: only teeth*teeth lock @ tip

  19. Thumb Forceps *3
    • 1. Adson Tissue Forceps
    • 2. Brown-Adson Tissue Forceps
    • 3. Rat-Tooth Tissue Forceps
  20. Thumb Forceps
    • * hold & easily release tissue w/ single finger motion
    • * spring action
    • * jaws are opposed by compressing the two metal handles together
    • -diff jaw surfaces
  21. Adson Tissue Forceps
    • * pu, hold, maneuver delicate tissue
    • * min damage not used for large tissue
  22. Brown-Adson Tissue Forceps
    • * pu, hold, maneuver delicate tissue
    • * + teeth
    • - grabs more tissue not as delicate- more freq in packs
  23. Rat-Tooth Tissue Forceps
    • * grasp sk & other dense tissue to place sutures
    • - may cause extensive damage to delicate tissue
    • - multiple teeth only @ tip
  24. Intestinal Forceps *2
    • 1. Babcock
    • 2. Doyen
  25. Babcock Intestinal Forceps
    • * grasp delicate tissue w/o crushing or traumatizing no teeth/no grooves
    • - intestine/uterus
  26. Doyen Intestinal Forceps
    • * occlude/hold intestine grabs w/o crushing
    • - grooves top to bottom
    • ej. used to extract foreign body & sew intestine back together
  27. Towel Forceps *4 *TF *TC
    • 1. Backhause
    • 2. Jones
    • 3. Lona
    • 4. Roeder
  28. Backhause Towel Forceps
    • * secures drapes to patients sk small puncture
    • pointy tips
  29. Roeder Towel Clamp
    • * fixes drapes into the sk of anesthetized patient punctures sk
    • ball stop = prevents deep tissue penetration
  30. Jones Towel Forceps
    • * secure towels & surgical draping during proc
    • small  
    • delicate tissue = ocular sx
  31. Lorna Towel Clamp
    • * secure drapes to patient
    • * secure items to surgical field
    • w/o puncturing skin or instruments
    • broad/flat edges pinches the sk
  32. Needle Holder *2
    • 1. Olsen-Hegar
    • 2. Mayo-Hegar
  33. Olsen-Hegar Needle Holder
    • * drive suture through tissue that req suturing
    • * assist in tying knots and cutting sutures
    • scissor blades behind jaws
    • criss-cross tip = good traction
    • locking apparatus
    • tungsten carbide tip replaceable
    • ej. precaution continuous suturing
  34. Mayo-Hegar Needle Holder
    • * drive suture through tissue that req suturing
    • * assist in tying sutures
    • does not have scissor = cannot cut sutures
    • tip replaceable insert
  35. Scissors *6
    • 1. Lister Bandage
    • 2. Littauer Suture
    • 3. Mayo
    • 4. Metzenbaum
    • 5. Operating
    • 6. Spencer Delicate Suture
  36. Mayo Scissors
    • * blunt dissection
    • * cut through bulky connective tissue
    • straight/curved
    • big/fat/thick/heavy blades
  37. Metzenbaum Scissors
    • * blunt-dissect or cut soft tissue
    • long/thin blades
    • not for cutting sutures = will dull blade
    • may be used for pushing/moving tissue
  38. Lister Bandage Scissors
    • * remove bandage & other dressing
    • one blade ends in blunt Δ = designed to push sk out of the way as the tine is slipped under the bandage material prevents accidental cutting of sk
  39. Spencer Delicate Suture Scissors
    • * remove suture from incision line
    • one tine ends in shaped curve = designed to slip under suture tie for easy cutting * half moon crescent shape
  40. Littauer Suture Scissors
    • * half moon crescent shape tine
    • * thicker/wider blades
    • not for wire sutures
  41. Compare Spencer Delicate Suture Scissors Vs Littauer Suture Scissors
    • Spencer - more narrow
    • Littauer - thicker/wider
  42. Operating Scissors
    • * cut suture material & other inanimate obj
    • named based on blades *tine differences
    • ej. sharp/blunt :: sh/bl straight/curved
  43. Retractor *5
    • 1. Army-Navy
    • 2. Balfour
    • 3. Gelpi
    • 4. Senn Rake
    • 5. Weitlaner
  44. Senn Rake Retractor
    • Used to hold open a wound/incision so the surgeon can view underlying tissue handheld
    • Beware Force exerted
  45. Army-Navy Retractor
    • Used to hold open a wound/incision so the surgeon can view underlying tissue handheld
    • smooth blades
    • no teeth or prongs
  46. Weitlaner Retractor
    • Used to maintain muscle retraction during orthopedic sx self retaining r.
    • 3/4 prongs
  47. Gelpi Retractor
    • Used to maintain wound exposure
    •    - orthopedic
    •    - neurosurgery
    • self retaining r.
    • 2 prongs
  48. Balfour Retractor
    • Used to hold the abdomen wall open self retaining r.
    •    - opens in 3 diff dir
    •    - adjusts side to side/up & down
  49. Bone Curette
    • Used to scrape out cancellous bone from the medullary cavity
    •    - Bone Grafts
    • Used to scrape Osteochondrosis Dessicans lesions OCD
    • Bone fracture repair
  50. Periosteal Elevator
    • Used to pry periosteum or muscle from bone surface
    •    - blade-like @ one/both ends
    •    - sharp/blunt edges
    • *Dentistry
    • *Orthopedic
  51. Ruskin Rongeur
    • Used to remove or break up small chunks of bone, cartilage or fibrous tissue
    •    *biting pieces -> remove for biopsy
    •    *sharp cuffed tips -> trough
    •    *single/double(mech stronger/larger)
  52. Bone Mallet & Osteotome
    • hammer: used to set pins or strike osteotomes or any other matter that requires pounding during sx.
    • chisel: used to cut through/shape bone
  53. Suction Tips *3
    • 1. Frasier
    • 2. Poole
    • 3. Yankauer
  54. Yankauer Suction Tip
    • Used to suction fluids out of surg. field esophagus
    • *rough suction good for bleeding
    • *large volume
    • *suction through tip curved tip
  55. Frasier Suction Tip
    • Used to suction fluid out of surgical field
    • *orthopedic cruciate sx
    • *delicate/small areas
  56. Poole Suction Tip
    • Primarily used in the abdomen or thoracic cavity
    • *outer sleeve w/ small holes that prevents tissue from getting trapped in the tip
    • *covers ample space
  57. Snook's Ovariohysterectomy Hook
    • Spay Hook: used to retrieve the uterine horn from sm anim
    • *flat hook @ the end
    • *allows surgeon to make an incision smaller than one big enough for finger
  58. Trephine
    • Used to:
    • - perform biopsies
    • - drill sm holes in skull/sinus
    • *Removal of bone for biopsy
  59. Scalpel Handles
    • Used to incise & transect
    • *maneuver blade
    • *comfortable grip
  60. Scalpel Handle #3
    Used in sm anim sx
  61. Scalpel Handle #4 & #8
    Used in lg anim sx
  62. Beaver Blade
    Used in ocular sx
  63. Scalpel Blades *sm anim
    • *fit #3 Handle
    • #10 : general blade used in proc
    • #11 : sever ligaments
    • #12 : lance an abscess
    • #15 : small/precise/curved incisions
  64. Scalpel Blades *lg anim
    • *fit #4 & #8 Handle
    • #20 & #23 : general blade
  65. Mayo Stand, Kidney Dish, Suction Bowl
    • *instrument tray
    • *adjustable
  66. Surgical Wraps
    • Used for wrapping instrument packsGreen/Blue
    • *square cloth
    • **double wrapped if being opened in sx
  67. Drapes
    • Freq included in sx pack
    • *sterile
    • *Larger=Better
    • *Extra
  68. Indicator Strips/Tape
    • *indicate whether the pack has been sterilised
    • T : Outside -> black stripes when autoclaved
    • IS : Center of pack
    • - have diff heat sensitivities
    • - date*

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