Exam 6: Sutures, Needles, and Instruments

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

When creating a vascular or intestinal anastomosis (connecting two tubular structures together)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 ideal suture material is one that has handling characteristics such as:

Dr.Garrison 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 and also liked the pretty blue color,but it was hard to manage with its memory and slipperiness and normally needed six surgeon's knots to hold.He was using:

Dan Clements 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:

This hemostatic device offers a rapid and secure method of clamping arteries,veins,nerves,and other small structures.They will remain in the patient,are not counted,and are made of a metal that is compatible with MRI.Select the correct hemostatic device that fits this description.

The circulating nurse received the trauma call from the emergency department 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?

Surgical instruments that do not fall under the category of clamps,retractors,or cutting instruments,but are used in most procedures,are typically included within the category of:

During the draping procedure,Dr.Martin Newhouse (the anesthesia provider)asked the scrub person for two towel clamps to secure the top of the drape to the IV poles.The scrub person had two penetrating and two nonpenetrating clamps on her back table.She knew she would need to secure the suction and electrosurgical pencil to the sterile field as soon as draping was finished.How should the scrub person respond to Dr.Newhouse's request for towel clips?

Careful counting (according to established policy),situational awareness,and conscientious and meticulous attention to the field are believed to prevent miscounts and lost items.A recent patient safety statement about preventing retained foreign objects recommends which of these practices?

Tissue reaction characteristics are important in a suture material because:

Linda,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:

Dr.Schuman decided to convert to an open instead of the laparoscopic approach for the colectomy because the patient was morbidly obese and he needed a larger incision.He asked the circulating nurse to bring the largest self-retaining retractor in the sterile storage room.Select the appropriate retractor.

The instrument devices depicted below are designed to ligate,divide,resect suture,and anastomose tissue.They are commonly called:

The primary use for suture is essentially to:

The perioperative nurse and the surgical technologist have a responsibility to maintain a safe environment of care for the surgical patient.A surgical complication concerning surgical counts that poses serious harm for the patient and potential consequences for the involved staff is called:

The safest practice for passing sharps and instruments is to:

These hemostatic devices date back to a period in time when they consisted of a product that was harvested from the ocean.They continue to be used today in every surgical procedure where a considerable amount of bleeding may be encountered and are still made of a natural product,but not from the ocean.Select the appropriate hemostatic device that fits this description.

Dr.Schumann,an older surgeon who was educated in Germany,explains his justification for his suture choice to the new perioperative nurse in the scrub role.He prefers to suture his intestinal anastomosis with a suture that has multiple filaments braided together because it ties well and holds the knot,which tightens when the thread absorbs the tissue fluids.He also needs a strand that is easy to see and only needs to retain its tensile strength for about 1 year,at which time the intestinal junction will be healed,even though this suture is considered nonabsorbable.He will ask the nurse for a 24-inch 4-0:

The surgeon needs a suture material that will not degrade over time,but becomes encapsulated and supports a tissue structure that will continue to be exposed to pressure and stretching forces throughout the patient's life.These physical properties are best described by a suture that: