The following 4 questions pertain to this case study:

Exhibits

Which task is appropriate for the nurse to delegate to experienced certified nurse assistant (CNA)?

Choice A: Hypotonic

A hypotonic solution has a lower concentration of solutes compared to the fluid inside the cells. When cells are placed in a hypotonic solution, water enters the cells, causing them to swell and potentially burst. This is because the osmotic pressure drives water into the cells to balance the solute concentration. Hypotonic solutions are not used to describe a state where extracellular and intracellular fluids have the same osmolality.

Choice B: Oncotic Pressure

Oncotic pressure, also known as colloid osmotic pressure, is the form of osmotic pressure exerted by proteins, primarily albumin, in the blood plasma. It plays a crucial role in maintaining fluid balance between the blood vessels and the surrounding tissues by pulling water into the circulatory system. Oncotic pressure is not related to the concept of equal osmolality between extracellular and intracellular fluids.

Choice C: Isotonic

An isotonic solution has the same concentration of solutes as the fluid inside the cells. When extracellular fluid is isotonic to intracellular fluid, there is no net movement of water into or out of the cells, maintaining cell stability. This balance is crucial for normal cellular function and is the term used to describe equal osmolality between extracellular and intracellular fluids.

Choice D: Hypertonic

A hypertonic solution has a higher concentration of solutes compared to the fluid inside the cells. When cells are placed in a hypertonic solution, water leaves the cells, causing them to shrink or crenate. This occurs because the osmotic pressure drives water out of the cells to balance the solute concentration. Hypertonic solutions are not used to describe a state where extracellular and intracellular fluids have the same osmolality.

Choice A: All materials that enter the sterile field must be sterile

This is a correct principle of aseptic technique. Ensuring that all materials entering the sterile field are sterile is fundamental to preventing contamination and infection during surgical procedures. Any non-sterile item introduced into the sterile field can introduce pathogens, compromising patient safety.

Choice B: The surgical team working in the operative field must wear sterile gowns and gloves

This is another correct principle. Members of the surgical team who work directly in the operative field must wear sterile gowns and gloves to create a barrier against microorganisms. This practice helps maintain the sterility of the surgical environment and protects both the patient and the healthcare providers.

Choice C: The sterile package is contaminated once it has been opened

This statement is incorrect. A sterile package is not necessarily contaminated once it has been opened, provided it is opened correctly and the contents are handled using aseptic techniques. Proper opening and handling ensure that the sterility of the contents is maintained.

Choice D: The circulating nurse must wear sterile gowns and gloves

This statement is incorrect. The circulating nurse does not need to wear sterile gowns and gloves because they do not work directly in the sterile field. Instead, they assist by providing necessary supplies and support from outside the sterile area.

Choice E: Tables are sterile only at tabletop level. Items extending beneath this level are contaminated

This is a correct principle. In the operating room, the sterility of tables is maintained only at the tabletop level. Any items that extend below this level are considered contaminated and should not be used in the sterile field.

Choice F: A wide margin of safety is maintained between sterile and unsterile fields

This is also a correct principle. Maintaining a wide margin of safety between sterile and unsterile fields helps prevent accidental contamination. This practice ensures that sterile areas remain uncontaminated by non-sterile items or personnel.