ANSWERS

1. List the duties of the veterinary nurse upon admission of a patient for surgery.
   • Ensure that a consent form has been signed and that all details are correct. (Ensure that you have a contact telephone number).
   • Check the reason for admission.
   • Where necessary, identify the surgical site.
   • Explain the procedure to the owner.
   • Ensure that the patient is in good health for routine operations such as neutering or that the symptoms have not worsened since the animal was last seen by the veterinary surgeon.
   • Weigh the patient.
   • Fit an identity tag and label any items brought in with the patient such as collars, leads, baskets, bowls etc.
   • Ensure that preoperative instructions have been carried out (eg. fasting prior to anaesthesia).
   • Ensure that all relevant medical history is collated (radiographs, blood test reports etc).
   • Bathe the patient if feasible to reduce contamination risk. This is especially important in elective orthopaedic procedures).
2. Name 3 common types of skin bacteria.
   • Staphylococcus.
   • Bacillus.
   • Streptococcus.
3. When clipping around a wound, what can be used to prevent hair entering the wound?
   K-Y jelly.
4. List 4 considerations to take into account when clipping up an area prior to surgery.
   • Ensure that the clipper blades are clean and sharp prior to use.
   • Ensure that the area is large enough and in the correct position for the surgeon.
   • Clip neatly.
   • Clip carefully to prevent skin excoriation.
5. How can small loose hairs be removed?
   With a vacuum cleaner.
6. What is the main advantage of clipping whilst the animal is under general anaesthetic?
   This is kinder to the patient if the area is sore; therefore less time is required and restraint is not necessary.
7. State 2 disadvantages of clipping whilst the patient is under anaesthetic.
   • Anaesthesia time is prolonged.
   • Decreased asepsis.
8. List equipment necessary for the cleaning of clippers.
   • Damp cloth impregnated with a disinfectant solution (for the handle).
   • Small bristle brush (to dislodge hairs from the blades).
   • Clipper spray (for disinfection of the blades and the dislodging of hair).
   • Disinfectant solution in which to soak the blades after use (prolonged soaking may cause bluntness).
9. Name 2 surgical scrub solutions that are ideal for surgical site preparation.
   • Chlorhexidine (Hibiscrub).
   • Povidone iodine (Pevidine).
10. What is the name of the forceps used by the scrubbed surgical team to carry out the final stage of skin preparation prior to surgery?
    Rampley sponge-holding forceps.
11. What is meant by "strike through"?
    This occurs when the skin of a patient has been made overly wet during preparation of the surgical site. The moisture seeps through the linen drapes and becomes cold, thus putting the patient at risk from hypothermia, and wet drapes encourage movement of skin bacteria onto and through the drapes.
12. When draping a surgical site, which should be the first drape to be positioned?
    The drape between the veterinary surgeon and the patient.
13. What is meant by "sub-draping"?
    The use of additional towels or drapes to prevent the incision site from contamination. These are applied to each side of the incision and secured with towel clips.
14. What is the name given to a drape that possesses a window for the surgical site?
    A fenestrated drape.
15. Why should chlorhexidine not be used in or around the eye?
    This has been found to be irritant to the surface of the cornea. Instead, a dilute solution of povidone-iodine should be used. NB. Never use alcohol based solutions.
16. When should premedicant drugs be administered?
    15-60 Minutes prior to anaesthetic induction.
17. What is the name of the type of suture used to close the anus and thus prevent faecal contamination during surgery?
    Purse string suture.
18. Under what circumstances might the use of an Esmarch bandage and tourniquet be employed?
    To provide a bloodless operating field during distal limb surgery.
19. When might the use of a throat pack be indicated?
    During oral or nasal surgery to prevent the aspiration of blood, mucus or calculus.
20. State possible reasons for postponing surgery.
    • Awaiting results of preoperative diagnostic tests such as blood tests and radiographs - it may be prudent to wait as the results may influence the anaesthetic risk.
    • Dehydration - if the animal is seriously dehydrated, it may be prudent to administer fluid therapy to rectify this and restore the electrolyte balance beforehand.
    • The presence of other injuries.
    • To allow reduction of swelling.
    • Stabilisation of conditions such as Diabetes Mellitus and Cushings disease.