Article

Question 1

when are abx given prior to surgery

Answer 1

30min- 1hr

Question 2

when is a fluoroquinolone or vancomycin given before surgery? why?

Answer 2

120 minutes to avoid an adverse reaction associated with rapid infusion.

Question 3

the professional consensus supports using narrow-spectrum, first and second generation cephalosporins. why?

Answer 3

inexpensive, safe to use and bactericidal and have long half lifes

Question 4

if a patient is hypothermic, how many times higher is their rate of infection

Answer 4

3 times higher and stayed in the hospital nearly 1 week longer than normothermic patients.

Question 5

what percent of surgical infections are considered preventable

Answer 5

60%

Question 6

how often is temperature measured

Answer 6

q15 minutes

Question 7

when does the greatest decline in patient temperature occur

Answer 7

during the first hour of surgery

Question 8

how do we keep the patient warm

Answer 8

forced warm air- bair hugger

Question 9

HAI occur at what percent in hospitalized patients

Answer 9

10%

Question 10

what is the failure rate of anesthesia providers not washing their hands

Answer 10

64-93%

Question 11

The CDC and the National Nosocomial Infection System define SSIs by the following clinical criteria

4 things

Answer 11

A purulent exudate draining from a surgical site

A positive culture obtained from a surgical site that
was closed initially

A surgeon’s diagnosis of infection

A surgical site that requires reopening due to at
least one of the following signs or symptoms: tenderness, swelling, redness, or heat

Question 12

what 3 things can CRNA’s do to prevent infection

Answer 12

normothermia
timely abx
handwashing

Question 13

surgical site infections are how common

Answer 13

2nd most common hai

Question 14

how many days since surgery is considered a SSI

Answer 14

30days

Question 15

The infection risk associated with primary hip and knee arthroplasty is approximately 1% and increases to 2% to 5% for arthroplasty revision. Explain why orthopedic infections are a grave concern

Answer 15

infection in the bones and joints is very difficult to treat and is associated with a lifelong recurrence risk of 10% to 20% When multi-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) infect a prosthetic joint, the treatment failure rate is 20% to 40%.
It is costly, and requires a new joint replacement, prolonged abx and rehab.

Question 16

what do volatile and IV anesthetics and opioids do to thermoregulation

Answer 16

mpair thermoregulatory control by decreasing heat production and increasing cu- taneous heat loss through vasodilation

Question 17

how does muscle relaxants impair thermoregulation

Answer 17

Muscle relaxants also compromise thermoregulatory control by preventing shivering

Question 18

name the various adverse outcomes to a patient being hypothermic

Answer 18

increased blood loss (transfusion requirement)

prolonged postoperative recovery times

heightened post op pain

impaired neutrophil function

vasoconstriction leading to hypoxia

INCREASED INCIDENCE OF SSI

Question 19

what precent of colorectal surgeries develop SSI

Answer 19

20%

Question 20

how much longer did patients with hypothermia stay in the hospital

Answer 20

nearly 1 week longer

Question 21

name some various risk factors for developing hypothermia

Answer 21

extremes of age
female
length and type of procedure
general and spinal anesthesia
ambient temp of OR
preexisting condition (BURNS, ENDOCRINE disorder, PREGNANCY, Large open wound)

Question 22

what is deemed the gold standard for measuring temperature

Answer 22

no gold standard exist

Question 23

what is the most reliable method to measure temperature

Answer 23

distal esophagus

Question 24

what is the issue with using rectal temperature

Answer 24

it lags behind temperature measured in the esophagus and pulmonary artery.

fails to rip during MH!!

Question 25

when is the greatest decline in patient temperature

Answer 25

occurs during the first hour of surgery

Question 26

the association of operating room nurses recommends ambient temperature between what two degrees

Answer 26

20-25C

Question 27

failure of hand hygiene is what percent range

Answer 27

64-93%

Question 28

The 2009 WHO Guidelines on Hand Hygiene36 recommend that the healthcare provider engage in hand hygiene in the 4 following situations

Answer 28

1. visibly soiled or after using the toilet
2. exposure to spore forming (cdiff) patogens
3. Before and after touching a patient, if moving from a contaminated body site to another body site during the care of the same patient
4. Before handling medications or preparing food