Surgical Nursing
Surgical nursing items ask you to protect the sterile field, prepare the patient without adding contamination, and recognize when an instrument or pack is not sterile. The exam favors sequence questions, sterilization parameters, and recovery-room judgment.
Core rules
- Clip hair outside the surgical suite; vacuum loose hair; then perform a surgical scrub at the incision site and move outward. Let the prep dry before draping.
- Sterile gowns and gloves are contaminated by contact with nonsterile surfaces; keep hands above waist and within the sterile field.
- Steam autoclave commonly uses 121°C (250°F) at 15 psi for 15–20 minutes, or 132°C (270°F) at 27 psi for about 4 minutes; follow the pack manufacturer's cycle.
- Count instruments and sponges before closure and at the end; document counts.
- Recovery: monitor temperature, respiration, perfusion, and pain; do not leave an anesthetized patient unattended.
Worked example
A pack is wrapped, taped, and autoclaved. Before use you notice the autoclave tape is unchanged and the indicator strip inside is not darkened. Reasoning: the tape and internal indicator are process monitors, not proof of sterility, but an unchanged indicator means the cycle did not reach parameters. Do not use the pack; rewrap with new indicators and resterilize, then document the load.
Traps
- Scrubbing from the clean incision outward is correct; scrubbing back toward the incision contaminates it.
- Alcohol near electrocautery is a fire risk; allow prep to dry and remove pooled alcohol.
- A sterile glove touching the drape's outer edge is contaminated.
- Skipping instrument counts after an emergency C-section.