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CNOR > 1 > Flashcards

1 Flashcards

1
Q

How far away from a sterile field should un-sterile staff stay?

A

at least 1 foot

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2
Q

Length of aeration time depends on what 4 factors?

A
  1. type of wrapper
  2. composition of the items
  3. temperature reached during aeration
  4. concentration of EO and flow rate
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3
Q

Convection heat

A
  • air currents passing over skin

* keep PT covered

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4
Q

Radiation Heat

A
  • when heat transfers from body surface to room atmosphere

* Increase room temp

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5
Q

What nursing action will overcome conduction heat loss?

A

Use warming blanket on PT

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6
Q

Evaporation Heat

A
  • When skin becomes wet

* avoid excessive draping

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7
Q

Glove perforation usually occurs when?

A

40 minutes into case

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8
Q

SNIs occur most often when…

A

suturing of fascia or muscle with curved sharp needle

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9
Q

WAGs

A
  • Exposure levels measured every 6 mos
  • Maintained at less than 25ppm for nitrous oxide
  • 2 ppm for halogenated agents
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10
Q

Most common cause of SSIs

A

Gram-Positive Cocci

* staphylococcal, enterococcal, pseudomonal and streptococcal

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11
Q

Where is staphylococci found?

A

skin, nose, urethra and vagina

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12
Q

Where is enterococci found?

A

GI flora and female genitalia tract

*can cause SSI, bacterial endocarditis, septicemia and UTIs

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13
Q

Pseudomonads

A
  • most common: Pseudomonas aeruginosa
  • moist environments
  • skin and intestines
  • preventative measure: cleaning and strict aseptic tech
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14
Q

Where is streptococci found?

A

Upper respiratory flora, genitourinary and GI tract

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15
Q

How is Hep B spread?

A
  • blood or body fluids

* incubation 6 wks- 4 mos

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16
Q

How is Hep A spread?

A
  • fecal-oral route

* hand hygiene important

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17
Q

How is Hep C spread?

A
  • direct exposure to blood

* incubation 7 weeks

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18
Q

Where is spinal block med injected?

A

into subarachnoid space

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19
Q

Pre-op PT has anemia. What potential side effects does this PT face?

A

hypoxia and hypotentsion

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20
Q

When considering the thermoregulation of the infant ped PT, the peri-op nurse should remember that….

A

Infants under 3 mos do not shiver when cold

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21
Q

St. Johns Wort

A
  • Prolongs sedation

* interferes with calcium channel blockers, warfarin and some abx

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22
Q

PT with bulimia nervosa. Notify anesthesia bc PT may have….

A
  • inadequate kidney function
  • unstable vitals
  • electrolyte imbalances
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23
Q

Low-level disinfectants

A

kills most vegetative bacteria and some viruses and fungi

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24
Q

Intermediate level disinfectant

A

May kill tubercle bacilli, vegetative bacteria and most viruses and fungi but not bacteria spores

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25
Q

High level disinfectant

A

kills all microorganisms except high numbers of bacterial spores

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26
Q

Disinfection

A

The process that kills all microorganisms with the exception of high numbers of bacterial spores

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27
Q

Hydrogen Peroxide Vapor Sterilization

A

*Vapor is sterilant
* byproduct: water vapor and oxygen
* no aeration
BI–B. atropheus

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28
Q

Low Temp Hydrogen Peroxide Gas Plasma Sterilization

A

plasma is 4th state of matter

  • Hydrogen peroxide vapor is charged with radio frequency and turns to plasma
  • byproducts: water and oxygen
  • replacing EO
  • no aeration needed
  • cold form
  • STERRAD
  • cycle time= 75 mins
  • used for heat sensitive and moisture sensitive items
  • dry sterilization
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29
Q

Percentage of OR needlesticks associated with carelessness

A

74%

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30
Q

Most common presenting sign of MH

A

unexplained ventricular dysrhythmia ( tachy or PVCs)

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31
Q

Which type of law encompasses malpractice and negligence?

A

Tort Law “personal injury law”

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32
Q

Concerning metal instruments, what type of sterilization is performed for 3 mins at 132C at 27lbs of pressure?

A

Immediate Use Steam Sterilization

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33
Q

You have prepared the sterile back table and the mayo stand. You receive word that surgery will be delayed due to an unanticipated emergency. You should….

A

Cover the table and stand with sterile drapes and leave them in their current position

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34
Q

Percent of all HAIs from S. aureus occuring in surgical PTs

A

35%

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35
Q

7 Rights of Med Administration

A

Right:

  1. PT
  2. drug
  3. dose
  4. reason
  5. time
  6. route
  7. documentation
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36
Q

How often should water in the ultrasonic cleaner be changed?

A

at least once per shift

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37
Q

An individual who disperses significantly increased numbers of viable contaminated particles

A

Shedder

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38
Q

Which mask protects from aerosolized carcinogens?

A

A mask which can filter particles as small as 0.1mm

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39
Q

What is the difference between sterilization and High-Level Disinfection?

A

Sterilization kills all microorganisms including endospores while High-level disinfection kill microorganisms only

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40
Q

How do you know chemical indicator tape has been subjected to a successful sterilization cycle?

A

Tape starts out tan then turns dk brown or black

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41
Q

2 common ABXs for surgical prophylaxis

A

Rocephin and Keflex

42
Q

Vascular surgeon schedules “cold leg” for surgery. Which procedures is the surgeon expected to perform?

A

Embolectomy and possible Revascularization Grafting

43
Q

Assault

A

Threat to do harm

44
Q

Kasai Procedure

A

The construction of a bile drainage system by use of an intestinal conduit

45
Q

The 5 Rights of Delegation

A

The Right:

  1. task
  2. circumstance
  3. person
  4. communication and direction
  5. supervision and evaluation
46
Q

Peracetic Acid

A
  • STERIS I
  • for items that can be immersed
  • corrosive to instruments and people
  • temp 120-130
  • micron filtered tap water rinse
  • for point of care use only - will be wet
47
Q

Battery

A

Ex: Operating without consent

48
Q

Tort

A

wrong committed against someone

49
Q

Negligence

A

Failure to use reasonable care

50
Q

ABX given pre-op that can potentiate neuromuscular blocking agents

A

Clindamycin

51
Q

ABX usage and/or admin for C-Sections

A

Administer intraop after umbilical cord clamped

52
Q

Primary ICF anion

A

Phosphate

53
Q

Osmosis

A

Movement of fluid through a selective semipermeable membrane from a soln that has a lower solute conc to one that has a higher conc

54
Q

isotonic

A

A soln that has same osmolality as blood plasma

  • NS, LR
  • prevent shift from IC compartments
55
Q

Neonate heart murmurs

A
  • Patent Foramen Ovale: closes in 3-12 mos
  • Patent Ductus Arteriosis: up to 2 mos to close
  • Undetected anomaly
  • innocent flow murmur
56
Q

Why are infants prone to dehydration?

A
  • Renal function is immature
  • ability of kidneys to concentrate urine is limited
  • complete renal maturation at @ 2 yrs
57
Q

Myelomeningocele

A
  • form of spina bifida
  • always associated with Chiari type II malformations
  • Meninges, spinal cord and nerve roots protrude
58
Q

Omphalocele

A
  • intestines out through umbilical cord
  • error in digestive tract development
  • may be associated with other major congenital defects
59
Q

Dry heat spore testing

A

Bacillus atropheus

60
Q

Cloaca

A

single opening for the urethra, rectum and vagina

61
Q

talipes

A

Deformities of the foot

62
Q

Talipes Varsus

A

Clubfoot

most common

63
Q

Talipes Equinovarus

A

idiopathic true club foot deformity

64
Q

Milwaukee Brace

A

brace for scoliosis

65
Q

What gives the patient the right to chose not to be treated for an emergent event precipitated in response to normal anesthesia during surgery?

A

Self Determination Act

66
Q

Most common childhood chronic condition

A

Secretory Otitis Media

67
Q

Most common source of pathogens in the OR

A

Surgical staff ( S. aureus 25%)

68
Q

When using bipolar delivery of electrical current remember….

A

One side of the bipolar forceps returns the current back to generator

69
Q

Do not scrub longer than how many minutes?

A

5 mins

70
Q

Who are qualified to perform and document H&Ps

A
  • Physician
  • NP
  • PA
  • RNFA
71
Q

4 domains of the Perioperative Patient Focused Model

A
  1. Behavioral Responses
  2. Patient Safety
  3. Physiological Responses
  4. Health Systems
72
Q

Nursing Process

A 
Assessment
Nursing dx
Outcomes identified
Planning
Implementation
Evaluation
73
Q

Spaulding Class “Critical”

A
  • Will enter sterile tissue or the vascular system
  • should be sterile
  • Ex: caths, instruments, needles, etc
74
Q

Spaulding Class “Non-critical”

A
  • will come in contact with skin
  • intermediate or low level cleaning
  • linens, tourniquets
75
Q

“Rule of Ten” and cleft palates

A

Pt is:
10 weeks old
10 lbs
hemoglobin = 10

76
Q

LMA

A
  1. provides an airway
  2. forms a seal with trachea
  3. used in place of ET tube
  4. does not protect against regurg and aspiration
77
Q

Where should gloved hand be placed when “buzzing the forceps”?

A

Covering as much of the forcep as possible.

current is delivered below hand

78
Q

Precordial thump can be used as a rapid measure to correct

A

V fib

79
Q

Durant position/maneuver

A
  • Left lateral with steep Trendelenberg
  • air embolus enters right atrium during surgery
  • anesthesia aspirates air bubble
80
Q

Why do infants have an increased sensitivity to sedatives, opioids and hypnotics?

A
  • immature blood-brain barrier

* decreased protein-binding

81
Q

What is LR good for intraoperatively?

A

Fluid replacement to help correct intraoperative third-space losses

82
Q

inherent resistence

A

The bacteria can avoid absorption of the ABX by coating itself with asn impervious biofilm

83
Q

Bacteria demonstrate their resistance to ABX through…

A
  1. inherent resistance

2. Acquired resistance

84
Q

Vertical Evolution

A

Bacteria can mutate spontaneously, transmitting a chromosome to one of its own population

85
Q

Horizontal Evolution

A

A bacteria which already has an ABX resistant gene shares that gene with a member of a different bacgterial population

86
Q

Instruments used on PT with Creutzfeld-Jakob disease should be…

A
  1. Steam sterilized for 60 mins at 132C or 272F

2. after being soaked in bleach for 1 hour at room temp

87
Q

Superficial Incisional SSI

A
  • within 30 days
  • only involves skin or subq
  • must have one of the following:
    1. purulent drainage
    2. pain
    3. tenderness
    4. localized swelling
    5. redness/heat
    6. surgeon deliberately opens
    7. surgeon dx
88
Q

Complementing Action

A

using nonverbal communication to support or augment verbal communication

89
Q

85% of the microbial contaminants located in an open surgical site originate from…

A

Room Air

90
Q

Treatment of DIC

A 
blood
plasma
dextran
blood thinners
replacement clotting factors
91
Q

Ozone sterilization used for all types of devices except…

A

sealed glass ampules
implants
flexible scopes

92
Q

3 Factors necessary to achieve steam sterilization

A
  1. time
  2. temp
  3. saturated steam
93
Q

Primary Hyperthyroidism is associated with…

A

Hypercalcemia

94
Q

You are caring for a PT with breast CA who is scheduled for a lumpectomy followed by radiation therapy. When do you administer ABX?

A

Preop, intraop and post op

95
Q

Central Venous catheters are threaded into…

A

Right Atrium

96
Q

Ginseng may cause…

A
  1. hypertension

2. bleeding

97
Q

What is ectropion?

A

The eyelid is everted to expose conjunctival surface

98
Q

Geriatric PTs need extra care with what aspects of the environment?

A
  1. hypothermia
  2. potential for emboli
  3. monitoring fluid loss/blood loss
  4. positioning to avoid injury
99
Q

entropion

A

When eyelid margin is inverted causing eye lashes to abrade the cornea

100
Q

Stye

A

infection of eyelash follicle

CNOR (1 decks)

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