AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers, Exams of Medicine

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AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers Adhesion - correct answer Abnormal attachment between two surfaces Anastomosis - correct answer an opening created by surgically joining two structures, such as blood vessels or bowel segments Approximated - correct answer closed, with the wound's edges touching each other Autologous - correct answer From patient, either stored or cell saver autotransfusion Hemostasis - correct answer stopping the loss of blood compress - correct answer (v.) to press together; to reduce in size or volume; hemostat - correct answer Surgical instrument used to hold or grasp items synthetic - correct answer not naturally produced; made by artificial processes AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers tissue reaction - correct answer The response of tissues to altered conditions, such as swelling, inflammation, redness, heat, or drainage Homologous - correct answer donated from another; requires type and cross-match Rh (Rhesus) factor - correct answer antigenic substance found in the erythrocytes in most people hemolysis - correct answer specific type of reaction that occurs with Rh mismatch Collagen - correct answer structural protein found in the skin and connective tissue First intention healing - correct answer Type of healing that occurs with primary union that is typical of an incision opened under ideal conditions; healing occurs from side to side, dead space has been eliminated, and the wound edges are accurately approximated AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers Hematoma - correct answer a solid swelling of clotted blood within the tissues. Dehiscence - correct answer partial or total separation of wound layers friable - correct answer easily torn Evisceration - correct answer protrusion of viscera through an incision gangrene - correct answer death of tissue associated with loss of blood supply Granuloma - correct answer a mass of granulation tissue, typically produced in response to infection, inflammation, or the presence of a foreign substance. ischemia - correct answer an inadequate blood supply to an organ or part of the body, especially the heart muscles. AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers keloid - correct answer Thick scar resulting from excessive growth of fibrous tissue Seroma - correct answer A mass or swelling caused by the localized accumulation of serum within a tissue or organ. inflammation - correct answer a localized response to an injury or to the destruction of tissues packing - correct answer filling an open wound or cavity with a material such as gauze Elasticity - correct answer The ability of a material to bounce back after being disturbed inert - correct answer lacking the ability or strength to move Monofilament suture - correct answer relatively inert and do not readily harbor bacteria AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers Capillarity - correct answer capability to harbor bacteria and retain tissue fluids pliability - correct answer receptive to change; adaptable. memory - correct answer the ability to store and retrieve information over time Ligated - correct answer tie up or otherwise close off (an artery or vessel). Swaged - correct answer suture needle with the suture material attached French-eyed needle - correct answer A type of needle in which the suture must be threaded by pulling the strand into a V-shaped area just above the eye primary suture line - correct answer main suture that approximates the wound edges for first intention healing to occur AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers presence of dead space - correct answer close all dead spaces or leave open for healing by second intention or delayed primary closure drain wound appropriately presence of coagulated blood - correct answer irrigate wound drain wound appropriately presence of excessive suture - correct answer use proper suturing technique use monofilament suture presence of undrained serum - correct answer drain wound appropriately leave wound open presence of foreign material - correct answer remove gross material irrigate wound, if possible, with use of antibiotic solution AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers thrombus - correct answer blood clot formed Drains - correct answer Used to eliminate dead space and hematoma formation ADP (adenosine diphosphate) - correct answer Released along with epinephrine, causing platelets to clump and forming a small initial thrombus vasoconstriction - correct answer initial response when a blood vessel is cut or injured fibrin - correct answer formed from the reaction thrombin with fibrinogen to form a matrix that leads to a more solid clot sequential compression device - correct answer Prevents venous stasis and deep vein thrombosis endothelial cells - correct answer Interacts with platelets and clotting factors after trauma or certain vessel diseases AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers Coagulation - correct answer bodily process to control blood loss resulting in hemostasis thrombin - correct answer formed from the reaction of prothrombin with thromboplastin pledgets - correct answer Provides pressure as a buttress over small holes to prevent bleeding silver nitrate (hemostasis) - correct answer chemical ligating clips (hemostasis) - correct answer mechanical cryotherapy (hemostasis) - correct answer thermal suture (hemostasis) - correct answer mechanical electrosurgery (hemostasis) - correct answer thermal epinephrine (hemostasis) - correct answer chemical stick tie (hemostasis) - correct answer mechanical AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers When cutting suture for the surgeon who is using monofilament suture, leave a tail of approximately how long - correct answer 1/4th inch what is the purpose of leaving the tail - correct answer enhance knots security/unraveling what type of material are ligating clips made of - correct answer nonreactive metal, titanium or stainless steel, or plastic material, permanent or absorbable what are patties (cottonoids) used primarily for - correct answer neurosurgery what is a pledget made of - correct answer felt and teflon describe the purpose of a pledget - correct answer to maintain hemostasis or as a filter over delicate tissue requiring suction describe how the pledget is used - correct answer buttresses over the suture line (slip on the pledget over the suture, then sew patient) AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers what is bone wax made of - correct answer Ethylene oxide and propylene oxide describe the purpose of bone wax - correct answer To stop bleeding from a cut bone what is suction used for during surgery - correct answer it is used to keep the surgical site visible, to see where the bleeding is coming from what is the purpose of a drain - correct answer to measure and observe the amount of bleeding post surgery describe the purpose of sequential stockings - correct answer to prevent blood clots, they send the blood back up to the heart to prevent it from pooling in the feet and legs describe the purpose of the tourniquet - correct answer to stop the flow of blood through a vein or artery, typically by compressing a limb with a cord or tight bandage AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers What is the most commonly used thermal device? - correct answer bovie or ESU what time of energy does the laser use - correct answer intense concentrated beam of light what is the benefit of using the laser - correct answer more precise and uses less energy what is the advantage of using argon plasma coagulation - correct answer - Argon gas and monopolar electrical energy with no contact (white light beam) - Provides rapid hemostasis - Produces less charring of tissue then ESU what type of energy does the harmonic scalpel use - correct answer the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue what are the advantages of the harmonic scalpel - correct answer The Harmonic Scalpel's biggest advantage is the reduced bleeding and recovery time for the patient. Other advantages include the ability for a surgeon to make more precise cuts, and an overall reduction of lateral AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers How is blood recovered when there is no cell saver machine? - correct answer Blood may be collected in a salvage collection bag containing an anticoagulant & reinfused through a blood filter; blood can be suctioned into a sterile blood collection canister, emptied & contents washed in a red cell washer and reinfused What are the identification requirements when a blood product from the blood bank is administered to the patient? - correct answer Information for blood group, RH type & unit number must match the tag on the blood bag, the patient's armband, & patient's chart, physician's order and expiration date on the blood bag describe typical signs and symptoms of a transfusion reaction - correct answer The most common signs and symptoms include fever, chills, urticaria (hives), and itching. what signs and symptoms might you see with a patient under general anesthesia - correct answer Nausea. Vomiting. Dry mouth. Sore throat. Shivering. AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers Sleepiness. Mild hoarseness. what actions are taken if a transfusion reaction is suspected - correct answer 1. STOP THE TRANSFUSION 2. Keep IV open with normal saline 3. Check all blood components, labels, forms, patient identification for errors 4. Notify patient's physician as appropriate 5. Treat reaction 6. Notify Blood Bank submit specimens for work-up (blood bag, patient blood draw, urine sample) submit transfusion reaction report forms A B AB O - correct answer four main blood type groups autologous - correct answer from patient, either stored or cell savor transfusion AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers hemolysis - correct answer specific type of reaction that occurs with Rh mismatch homologous - correct answer donated from another; requires type and cross match Rh factor - correct answer antigen found in RBC's of most people transfusion reaction - correct answer Occurs when mismatched blood is given (mild to anaphylactic shock) type AB - correct answer universal recipient Type O - correct answer universal donor When is the wound classification recorded on the intra- operative record? - correct answer end of the procedure after dressing is applied True or false? when reviewing the chart the wound classification tells the degree of microbial contamination AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers Examples of a class 3 wound. - correct answer - Emergency bowel resection; feces noted during anastomosis Examples of a class 4 surgical wound. - correct answer Laparoscopicassisted vaginal hysterectomy; purulent left ovary. Examples of a class 1 surgical wound. - correct answer Hernia repair; mesh used Examples of a class 3 surgical wound. - correct answer - Open reduction internal fixation <4 hours open fracture Examples of a class 4 wound. - correct answer -Incision and drainage of groin; STAT gram stain indicates gramnegative rods Examples of a class 3 surgical wound. - correct answer - Gunshot wound to the abdomen; bowel resection and liver laceration repaired. AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers abrasion - correct answer scrape laceration - correct answer cut or tear contusion - correct answer bruise chronic wound - correct answer persists for an extended period puncture - correct answer penetrating wound clean wound - correct answer Incision made, sutured, heals by first intention. complicated wound - correct answer Tissue is lost or destroyed, or a foreign body remains in the wound. contaminated wound - correct answer Dirty object damages skin thermal wound - correct answer occurs by heat or cold AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers closed wound - correct answer The skin remains intact, but underlying tissues suffer damage what is released from the damaged cells that causes the inflammatory response - correct answer histamine normal healing of the wound occurs from - correct answer side to side across the wound, not from the inside out describe the five signs of the inflammatory process - correct answer pain heat redness swelling loss of function primary intention phase 1 - correct answer lag phase or inflammatory response phase 3-5 days primary intention phase 2 - correct answer proliferation phase AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers infection - correct answer microbial contamination occurs sinus tract - correct answer Tract between two surfaces open at one end suture complication - correct answer splitting of suture material 3-0 and 4-0 sutures are most commonly used for subcuticular skin closure T/F? - correct answer True 6-0 and 7-0 sutures are typically used for closure of very large vessels T/F? - correct answer False 8-0 and 11-0 sutures are typically used for microsurgery such as ophthalmic T/F? - correct answer True The Brown and Sharpe (B&S) sizing is used for stainless steel wire gauzes T/F? - correct answer True Nonabsorbable suture should be used when continued support is not needed T/F? - correct answer False AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers Silk suture is common for ligating blood vessels T/F? - correct answer True GI tissue is weak but heals quickly, and absorbable suture should be used for inner layers T/F? - correct answer True Due to capillarity, monofilament rather than multifilament sutures should be used in the presence of infection T/F? - correct answer True Multifilament suture may be more pliable, allowing knots to hold more easily T/F? - correct answer True Absorbable sutures inhibit tissue reactions such as hydrolysis or digestion T/F? - correct answer False place the USP sizes in order from smallest to largest. Smallest starting at 1. - correct answer 1. 11-0 2. 8-0 3. 6-0 4. 4-0 AST Chapter 11 Hemostasis, Wound Healing, and Wound Closure Questions And Answers 5. 3-0 6. 2-0 7. 0 8. 1 9. 2 10. 5