Preoperative Preparation Flashcards

What is the primary goal of preoperative skin preparation?

Answer: Reducing microbial count near the incision site

The primary goal of preoperative skin preparation, often called 'prepping,' is to significantly reduce the number of microorganisms on the patient's skin around the planned incision site. This critical aseptic technique minimizes the risk of surgical site infections (SSIs) by preventing bacteria from entering the surgical wound during the procedure, ensuring patient safety.

Why is the patient NPO before surgery?

Answer: To prevent aspiration during anesthesia

Patients are required to be NPO (Nil per os, meaning 'nothing by mouth') before surgery to prevent pulmonary aspiration. During anesthesia, the body's protective reflexes, such as the gag reflex, are suppressed. If there is food or liquid in the stomach, it can be regurgitated and then aspirated into the lungs, leading to severe respiratory complications like pneumonia.

Which item must be verified before transporting a patient to the OR?

Answer: Surgical site and patient identity

Verifying the surgical site and patient identity is a critical safety measure known as the 'time-out' or Universal Protocol. This step prevents wrong-site, wrong-procedure, or wrong-patient errors, ensuring the correct surgery is performed on the correct individual.

What is the purpose of preoperative shaving?

Answer: To reduce microbial presence near the site

The primary purpose of preoperative hair removal (often clipping rather than shaving) is to reduce the number of microorganisms on the patient's skin. This minimizes the risk of bacteria entering the surgical incision, thereby preventing surgical site infections and promoting better patient outcomes.

Which antiseptic is commonly used in surgical skin prep?

Answer: Povidone-iodine

Povidone-iodine is a widely used antiseptic for surgical skin preparation due to its broad-spectrum antimicrobial activity. It effectively kills bacteria, viruses, and fungi on the skin, significantly reducing the microbial load and lowering the risk of surgical site infections.

Why are jewelry and metal objects removed before surgery?

Answer: To prevent surgical burns and infection

Jewelry and metal objects must be removed before surgery to prevent surgical burns, especially when electrocautery is used, as metal can conduct electricity. Additionally, these items can harbor microorganisms, increasing the risk of infection, and could interfere with surgical procedures or get lost.

What is the role of the surgical checklist?

Answer: To verify key surgical and patient details

The surgical checklist is a vital patient safety tool, often based on the WHO Surgical Safety Checklist. Its role is to systematically verify key details such as patient identity, surgical site marking, allergies, and equipment availability, ensuring all critical steps are completed before, during, and after surgery.

What is the appropriate time for administering prophylactic antibiotics?

Answer: One hour before incision

Administering prophylactic antibiotics within one hour before the surgical incision ensures that a sufficient concentration of the antibiotic is present in the patient's tissues. This optimal timing maximizes the antibiotic's effectiveness in preventing surgical site infections by targeting bacteria at the time of potential exposure.

What is the correct action if the surgical consent form is incomplete?

Answer: Notify the circulating nurse immediately

An incomplete surgical consent form indicates that the patient has not provided full informed consent for the procedure. The circulating nurse is responsible for ensuring all documentation is accurate and complete, and must be notified immediately to address and rectify the issue before surgery can legally and ethically proceed.