Operating Room Nursing Flashcards

Question 1

What does the term perioperative mean in surgical nursing?

Accepted Answer

Perioperative refers to the entire surgical experience, which is commonly divided into three phases: preoperative, intraoperative, and postoperative. The term covers care before the patient enters the operating room, care during the procedure, and recovery-related care afterward. Nurses in each phase document, communicate, and protect safety.

Question 2

When does the intraoperative phase of perioperative care begin?

Accepted Answer

The intraoperative phase begins when the patient is transferred into the operating room and ends when the patient is transferred to the postanesthesia care unit or another recovery area. During this time, the team performs the procedure and monitors the patient. Nurses document events, counts, and safety checks as they occur.

Question 3

What happens during the postoperative phase of perioperative care?

Accepted Answer

The postoperative phase begins when the patient leaves the operating room and continues until the patient reaches a stable recovery point or is discharged. Nurses focus on monitoring, documenting, and handing off care to receiving staff. Discharge teaching and follow-up instructions are also part of this phase.

Question 4

What does PACU stand for, and what is its function?

Accepted Answer

PACU stands for postanesthesia care unit, a specialized area where patients are monitored as they emerge from anesthesia. Nurses there assess airway, breathing, circulation, pain, and level of consciousness. Staff use standardized recovery scoring tools to decide when a patient can be discharged or moved to another unit.

Question 5

What does the abbreviation NPO mean on a preoperative order?

Accepted Answer

NPO is an abbreviation meaning nothing by mouth. It appears on preoperative orders to indicate that the patient should take no food or fluids by mouth for the period defined by facility policy, so nurses must verify and document the timing carefully.

Question 6

What is ambulatory surgery, and how does it differ from inpatient surgery?

Accepted Answer

Ambulatory surgery is a procedure performed on a same-day basis, with the patient going home after recovery rather than being admitted to a hospital bed overnight. Inpatient surgery usually involves admission and a longer hospital stay. Ambulatory care places greater emphasis on discharge teaching and planning for home support.

Question 7

What is the main purpose of a preoperative assessment?

Accepted Answer

The main purpose of a preoperative assessment is to collect health history, review current medications and allergies, and identify risks that the team should plan for before surgery. The information guides scheduling, consent discussions, and safety planning. Nurses document findings accurately so that every team member can access them.

Question 8

What does the term elective surgery mean in scheduling?

Accepted Answer

Elective surgery is a procedure that is planned in advance and can be scheduled at a convenient time, because it is not needed immediately to prevent serious harm. Emergency surgery, by contrast, must be performed promptly. Scheduling staff and nurses use the category to set priorities and prepare the team.

Question 9

What is the difference between medical asepsis and surgical asepsis?

Accepted Answer

Medical asepsis aims to reduce the number and spread of microorganisms, as in routine hand hygiene and patient isolation. Surgical asepsis, by contrast, aims to keep a sterile field free of all microorganisms during invasive procedures. Operating room practice relies on surgical asepsis, which requires sterile gowns, gloves, instruments, and strict traffic control.

Question 10

What does the term sterile field mean in the operating room?

Accepted Answer

A sterile field is a defined area that is free of microorganisms and used for surgical procedures. It includes the sterile instruments, the surgical site, and sterile personnel and surfaces that remain within the boundaries set by the team. Anything that contacts a nonsterile surface is considered contaminated.

Question 11

What is the role of the scrub nurse?

Accepted Answer

The scrub nurse is the member of the team who works inside the sterile field. This nurse prepares instruments, sponges, and sutures before the case, arranges them on the back table, and passes items to the surgeon using aseptic technique. The scrub nurse also keeps an accurate count of sponges, needles, and instruments.

Question 12

What part of a sterile gown is considered sterile?

Accepted Answer

The front of the gown from the chest down to the level of the sterile field, and the sleeves from above the elbow to the cuffs, are considered sterile. The back, the shoulders, and the area below the sterile field are considered nonsterile.

Question 13

What is the purpose of surgical hand antisepsis before a procedure?

Accepted Answer

Surgical hand antisepsis is a thorough handwashing and antiseptic cleansing step performed before gowning and gloving, and it reduces microorganisms on the skin of the hands and forearms. Its purpose is to lower the chance that skin flora move into the sterile field during the case. Teams follow facility protocols for duration and technique.

Question 14

What should a team do when a sterile item or sterile glove becomes contaminated?

Accepted Answer

The team should treat a contaminated sterile item or glove as nonsterile and remove it from the sterile field. The person responsible replaces it using aseptic technique, and the team notifies the surgeon and circulating nurse. The event is documented according to facility policy.

Question 15

What is the purpose of a sterilization indicator in a load?

Accepted Answer

A sterilization indicator is a test device placed in a load to show that the sterilizer reached the conditions needed for sterilization. Chemical indicators change color to show exposure to the process, while biological indicators contain test spores that are incubated after processing to confirm kill.

Question 16

What is the basic rule for opening a sterile package on the sterile field?

Accepted Answer

Open the sterile package by peeling the wrapper away from your body, so that the contents land on the sterile field without touching nonsterile surfaces. Hold the package by its edges, and never reach over an open sterile item to add or remove anything.

Question 17

What is the main role of the circulating nurse during surgery?

Accepted Answer

The circulating nurse is the unsterile team member who coordinates the operation from outside the sterile field. This nurse verifies records, obtains supplies and equipment, communicates with the surgeon and anesthesia staff, maintains the sterile environment, and documents events as they occur. The circulator advocates for the patient throughout the case.

Question 18

Why do operating room teams use a surgical time out before an incision?

Accepted Answer

Teams use a surgical time out to confirm the patient identity, procedure, surgical site, and special equipment needs before the first incision. This structured pause helps prevent wrong-patient, wrong-site, and wrong-procedure events. Every team member participates, and anyone may raise a concern.

Question 19

Who is responsible for anesthesia care during surgery?

Accepted Answer

Anesthesia care is provided by a qualified anesthesia professional, such as an anesthesiologist or a certified registered nurse anesthetist, working under facility rules. This clinician manages the patient's airway, breathing, and level of consciousness throughout the procedure and communicates with the surgical team about physiologic changes.

Question 20

What is a structured handoff in surgical care?

Accepted Answer

A structured handoff is a standardized verbal and written transfer of patient information between team members or between care settings. Common content includes identity, procedure, relevant history, events during surgery, and planned postoperative needs. Many facilities use a consistent format, so information is not omitted.

Question 21

What is the surgeon's role within the operating room team?

Accepted Answer

The surgeon leads the procedure, makes operative decisions, and directs the sterile team on the exposure, dissection, repair, and closure. The surgeon is responsible for the operative plan and for communicating findings to the team. Many surgeons also contribute to the surgical time out and the discussion of the postoperative plan.

Question 22

What is closed-loop communication and why is it used?

Accepted Answer

Closed-loop communication is a process in which the sender gives an instruction, the receiver repeats it back, and the sender confirms that it is correct. It is used to reduce errors, especially when team members are busy or working quickly.

Question 23

What is the purpose of encouraging every team member to speak up?

Accepted Answer

Encouraging every team member to speak up allows anyone to raise a safety concern without fear of reprisal, regardless of job title. The purpose is to catch errors early, since a junior team member may notice a problem that a senior person has missed. Leaders support this culture by listening and responding respectfully.

Question 24

What is the purpose of a debriefing after a surgical case?

Accepted Answer

A debriefing is a short, structured discussion held after a case, in which team members review what went well, what could improve, and any events that occurred. Its purpose is learning and quality improvement, not blame. The discussion supports future safety and helps the team adjust workflow for the next case.

Question 25

What is an instrument count and why is it performed?

Accepted Answer

An instrument count is a verified tally of sponges, sharps, and instruments that the team completes at set points, including before closure. It is performed so that no retained item is left in the patient. Discrepancies must be resolved and documented before the case ends. Counts are usually done aloud by two team members.

Question 26

What information should an intraoperative nursing record contain?

Accepted Answer

An intraoperative nursing record documents the patient identity, procedure, team members, times of key events, positioning, skin preparation, counts, specimens, equipment, and any deviations from the plan. Entries must be accurate, timely, and signed or identified by the author. Corrections follow facility policy and never obscure the original entry.

Question 27

What does the nurse verify about the surgical consent form?

Accepted Answer

The nurse verifies that a signed consent form is present, that it matches the planned procedure and surgical site, and that the patient or legal representative signed it before any sedation was given. Any questions or changes must be resolved with the surgeon before the procedure begins.

Question 28

Why must surgical specimens be labeled at the bedside?

Accepted Answer

Specimens must be labeled at the bedside so that identity is verified at the point of collection, before the container leaves the patient's area. Bedside labeling reduces the risk of mislabeling and misidentification. Labels should include patient identifiers, the site, and the time of collection, and should be recorded in the chart.

Question 29

What is a retained surgical item, and why is it treated as a serious safety event?

Accepted Answer

A retained surgical item is any object, such as a sponge, needle, or instrument, that is unintentionally left in a patient after a procedure. It is treated as a serious safety event because it can cause harm and may require another procedure to remove it. Reporting and analysis help teams identify system weaknesses.

Question 30

What does the term chain of custody mean for surgical specimens?

Accepted Answer

Chain of custody is the documented record of who handled a specimen, when, and in what condition, from collection through laboratory analysis. Each transfer is recorded with signatures or electronic identifiers so that the specimen can be traced at any point. Gaps in the record can compromise results and patient care.

Question 31

Why do surgical teams record implant identifiers in the chart?

Accepted Answer

Teams record implant identifiers, such as manufacturer, model, lot, and serial numbers, so that a device can be traced if a recall or safety notice is issued. This traceability protects patients and supports regulatory reporting and follow-up. The information is recorded in the operative record.

Question 32

What does it mean for documentation to be contemporaneous?

Accepted Answer

Contemporaneous documentation is recorded at or very near the time the event occurs, so that the entry reflects what actually happened. Late entries are acceptable only when clearly labeled with the time they were written. Delayed recall can introduce errors, so teams are encouraged to document as events happen.

Question 33

What is the purpose of quality improvement in perioperative nursing?

Accepted Answer

Quality improvement is a systematic approach to finding and reducing gaps between current care and the desired standard. In perioperative nursing, teams measure processes such as checklist completion or infection prevention practices, analyze results, change workflows, and measure again. The goal is safer, more consistent patient care.

Question 34

What is the purpose of an incident report after an operating room event?

Accepted Answer

An incident report is a formal record that describes an unplanned event, near miss, or unsafe condition so that the organization can learn from it. Reports focus on system factors such as equipment design, staffing, or communication rather than assigning individual blame. Reporting promptly, factually, and without speculation supports improvement.

Question 35

What is the purpose of a root cause analysis after an adverse surgical event?

Accepted Answer

A root cause analysis is a structured review that looks beneath an adverse event to find the underlying system causes, rather than stopping at the person closest to it. The team maps the sequence of events, identifies contributing factors, and proposes corrective actions with measurable outcomes. The review should be nonpunitive.

Question 36

What is surveillance in surgical site infection monitoring?

Accepted Answer

Surveillance is the ongoing, systematic collection and analysis of data about a health problem so that action can be taken. In surgical settings, facilities track surgical site infection rates and share findings with staff so that prevention practices can be reviewed. Surveillance identifies trends but does not by itself improve care.

Question 37

What is a par level in supply management?

Accepted Answer

A par level is the predetermined minimum or target quantity of an item that should be kept on hand, so that supplies are available when needed without overstocking. Operating room staff monitor par levels for instruments, implants, and disposable items, and they reorder when quantities fall below the set threshold.

Question 38

What is a surgeon preference card and how is it used?

Accepted Answer

A surgeon preference card is a standardized list of the instruments, supplies, equipment, and positioning items a particular surgeon usually needs for a specific procedure. Teams use it to prepare the room efficiently and to reduce missed items. Preference cards should be reviewed periodically, because surgeons' practices change and unused items add cost.

Question 39

What is the purpose of a sterile processing department?

Accepted Answer

A sterile processing department cleans, inspects, assembles, packages, and sterilizes reusable instruments and equipment for use in procedural areas. It also tracks each load and maintains records that link sterilization batches to specific items. Its work protects patients from infection and supports the sterile field across the facility.

Question 40

What is a near miss in the operating room?

Accepted Answer

A near miss is an event that could have caused harm but was intercepted before reaching the patient, such as a wrong instrument caught during a count. Near misses are learning opportunities because they reveal weaknesses without causing injury. Teams should report and review them as carefully as events that cause harm.

Operating Room Nursing Flashcards

1Perioperative Terms and Phases

2Sterile Technique and Asepsis

3Team Roles and Communication

4Records, Counts, and Documentation

5Quality and Safety Systems

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