Tech120 Domain 20 Surgical Nursing

Modified dorsal position is head lower than tail used in abdominal surgery. Rolling side to side is a hazard in any position and securing with equipment is necessary.

With those short legs, there is not much vessel access so a 0.75 inch (2 cm) is a good choice for the dachshund.

A retractor is used to hold open tissues to allow better viewing of the surgical field, or hold tissues out of the way. Forceps, ligatures, and electrocautery can all be used to control bleeding.

In second intention healing, there is suppuration between the wound edges and healing is allowed to continue as an open wound until it can be cleaned properly or is determined to be a clean wound. This method allows multiple cleanings to occur and minimizes the chance for pockets of infection to occur if the wound (i.e. skin or tissue) is closed too early. First intention healing is side-by-side as the wound edges are held together with sutures, staples or glue.

Although the sterile region is considered to be from just below the shoulders to the waist or table level, on the gown sleeves the armpit region is considered non-sterile (as is below the waist).

An ovariohysterectomy is removal of the ovaries and uterus preventing pregnancy as well as the need for a caesarean section. Pyometra is pus within the uterus (usually from a pregnancy resorption gone bad), but without a uterus, no pyometra!

Disinfectants are only used on inanimate objects, not on animate objects. They may be microbicidal, virucidal, sporicidal, or fungicidal. This makes option B the correct choice.

Cyst/o for the urinary bladder; -otomy= cutting into. Edward might have bladder stones or perhaps a biopsy of the bladder wall was needed.

Ethylene oxide is used for gas sterilization.

Retractors, by definition, retract or keep incisions and wounds open so the surgeon can have access to the area of concentration. A Gelpi retractor is self-retaining with blades that turn down at the tips and are bowed towards each other. They are used for retracting muscle bellies most commonly. (They are too small for holding the abdominal wall open). They are not indicated for friable or fragile tissue due to the sharp points. Ref:Sonsthagen, T. F. (2006). Veterinary Instruments & Equipment: A Pocket Guide 2nd edition. Elsevier-Mosby.

Pink and some may say red, but it is really pink. Brick red is NOT a good color, ever! Brick red can be a sign of heat stroke. White is also not the correct color for a healthy granulation bed. Black is death = necrotic, aka the tissue is not vital and is prone to develop infection, harbor gangrene, etc. and should be debrided immediately.

A wound is defined as any insult, either purposeful (such as surgery) or incidental (such as trauma), that disrupts the normal integrity of the tissue.

Patients should be assessed and monitored pre-operatively, intra-operatively and post-operatively. As long as the animal is in hospital, it should be monitored for vital signs as well as behavior, appetite, bathroom habits, and incision status. There are many causes of a prolonged recovery from anesthesia. These fall into two categories: *Anesthesia related: an occurrence of either excessive depth of anesthesia, or breeds that are hypersensitive to some anesthetics such as sight hounds; and *Patient related factors: hypothermia, hypotension, hypoglycemia, shock, liver, or kidney disease. Slow recovery can be aided by physical stimulation, ventilation, fluid therapy, reversal agents, and warming.

Everyone in the surgical suite needs to track what is sterile and contaminated. Excessive talking is not optimal as it can distract the surgeon, make it difficult to assess changes in the patient and may lengthen anesthesia time. Excessive movement stirs up airborne dust and microorganisms.

The jugular vein is on the trunk and therefore not peripheral.

Hypovolemic shock is the result of blood, plasma, or fluid loss.

Use of antibiotics and other stuff is not beneficial because the goal of lavage is LOTS and LOTS of washing as the mechanical action of debridement is the key factor in lavage. Additives are wasted; literally, money down the drain.

The 90-90 flexion sling is a way of immobilizing a hind leg; it serves a similar goal as an Ehmer sling.

Dorsal position is spine down on the table exposing the abdomen for surgery. This position is also known as dorsal recumbency.

Hypercapnia is excessive carbon dioxide in the blood. Hyperoxia is increased oxygen, hypocapnia is decreased carbon dioxide and hypoxia is low levels of oxygen in the blood.

In a sterile environment, one should pass a sterile person back to back: non-sterile to non-sterile area. Arms are never crossed, one should remain facing the sterile field as much as possible, and hands never go beneath the waist.

Povidone-iodine needs 5 minutes of contact time. The site should then be rinsed with water or swabbed with alcohol. Repeat 3 times. Never retrace a scrub stroke.

This is a Backhaus Towel Forceps used for holding drapes in place. Ref: Sonsthagen, T. F. (2006). Veterinary Instruments & Equipment: A Pocket Guide 2nd edition. Elsevier-Mosby.

This is a Baumgartner needle holder used primarily for holding needles during medical procedures.

Retractors are hand held or self-restraining. Scalpels are used for creating incisions. Forceps are for clamping off vessels and handling tissue. A rongeur is used to cut/snip small bits of dense tissue such as bone or cartilage.

The linea alba is where the aponeurosis of the abdominal muscles join. It is mostly connective tissue without much vascularization so it is used as a caudal midline abdominal incision that will have minimal bleeding due to the avascularization.