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Anesthesia Practice > Exam 1-checked > Flashcards

Exam 1-checked Flashcards

1
Q

HAIs

A

Healthcare associated infections

  • 80% are UTI and 35% are CAUTI
  • 15% bloodstream infections
  • ventilator pneumonia
  • 70% of these infections are resistant to 1 or more antibiotics
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1
Q

Anesthetists’ hazards

A
  • Chemical vapors
  • Ionizing radiation
  • Infections
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2
Q

Federal safety group responsible for making the rules:

A

NIOSH

National Institute for Occupational Safety and Health

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3
Q

Group that enforces the safety rules

A

OSHA

Occupational safety and health administration

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4
Q

Trace gas hazard: females and cancer (3) types

Males: no statistical change

A

cervical

lymphoma

leukemia

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5
Q

True or false:

Overall mortality rates for anesthesia personnel is less than general population and other medical specialists

A

True

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6
Q

Methylmethacrylate

A

glue in ortho rooms

exposure for factory workers < 8 hours

  • asthma
  • skin
  • genitourinary
  • allergy sensitizer

100ppm, 280 max

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7
Q

Halothane risk

A

hepatitis

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8
Q

True or false: More than 70% of healthcare workers reported by the FDA were allergic to latex

A

True

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9
Q

True or false: Sensitivity can be reversed

A

False

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10
Q

Spina bifida

A

73% of patients have developed latex allergy due to multiple surgeries from foley catheters

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11
Q

Radiation hazards

A
  • Angiography
  • Fluro
  • Radiation therapy
  • PACU
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12
Q

Proper radiation precautions

A

Stand 6 ft away from Xray machine

lead apron with collar

dosimeters

maintain distance E= 1/d^2

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13
Q

Laser hazards

A
  • thermal burns
  • eye injury
  • electrical hazards
  • fire and explosion from O2
  • laser plume contains viral DNA and toxic chemicals like HPV, HIV, Hep B
  • plume contain formaldehyde, benzene, CO
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14
Q

The mutagenic affect of thermal destruction of 1 gram of tissue is equivalent to that of:

Protection:

A

3-6 cigarettes for laser and electrocautery smoke

Special glasses and mask

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15
Q

Work hazards

A

10-16 hour shifts not uncommon

disruption of circadian rhythms

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16
Q

% error in anesthesia management attributed to fatigue

A

64%

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17
Q

Transmission of infection requires: SPNVP

A

Some people never value pennies.

S: Source

P: Pathogen

N: Numbers

V: Vector

P: Port of entry

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18
Q

Respiratory transmission: aerosol

A

TRIM

  • TB
  • Rhinovirus
  • Influenza
  • Measles
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19
Q

Respiratory transmission: self-inoculation

A

includes direct oral, nasal, or conjunctival exposure

  • Rhinovirus
  • Respiratory Synctival Virus
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20
Q

Flu

A

sheds in 5 days

increased in December

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21
Q

Measles

(Macopap Kop 3C PED)

A

aka Rubeola

highly infective 90% of households

  • Maculopapular rash
  • Koplicks spots
  • Fevers and 3 C’s (cough, choryza, conjunctiva)
  • diarrhea
  • pneumonia
  • encephalitis
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22
Q

Mumps (epidemic parotitis) is spread by aerosol or droplets?

A

Droplets

Painful swelling of salivary and parotid glands

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23
Q

Symptoms of mumps is severe in children. True or false

A

False

Most often children 5-9 are affected

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24
Q

Respiratory Synctial Virus

aka PARAMYXOVIRIDAE

A

Most important cause of serious lower respiratory disease in young.

60% of infants

100% 2-3 YO

Viable on surface for 6 hours!

Infected individual sheds in 7days

Recurrent asthma symptoms for up to 6 months

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25
Q

Immunity is permanent is RSV. True or false

A

False

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26
Q

Rhinovirus

A

Most common viral common cold.

Self inoculation and/or aerosol particles

Responsible for 50% of cases of cold

Over 110 types

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27
Q

Herpes Virus

Varicella-zoster

A

chickenpox and shingles

communicability 1-2 days before and last 5-6 days after

healthcare workers over 36 had antibodies

7.5% of younger population was susceptible

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28
Q

Herpes Simplex

A
  • Encephalitis: 70% mortality without treatment
  • Ocular blindness
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29
Q

Cytomegalovirus(CMV)

A
  • usually occurs during childhood
  • 40-90% adults have antibodies
  • transmitted by DIRECT CONTACT, not aerosolized
  • Low morbidity
  • Serious in pregnant or immunocompromised patients!
  • No greater risk of infection than personnel with no patient contact.

STANDARD PRECAUTIONS OK

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30
Q

Hepatitis A

A

Eating bad oysters

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31
Q

Hepatitis B and C

A

Greatest risk of transmission to personnel

blood bourne contact

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32
Q

Hep B

stats high or low?

transmission?

precautions?

A

5% develop chronic hepatitis develops into cirrhosis and ESLD

Seroconversion is 30% but infection usually resolves

  • sexual contact/shared needles/perinatally
  • standard precautions
33
Q

Hep C

A

Leading cause of chronic liver disease

seroconversion 1.8%

34
Q

HIV

A
  1. 3 % percutaneous exposure
  2. 1 % mucous membrane exposure

Increased risk associated with:

  • visible blood
  • deep injury
  • needle intravascularly
  • terminal illness death within 2 months
  • only 57 cases in the pasted 25 years
35
Q

Tuberculosis

A

Mycobacterium TB transmitted through bacilli 1-5 microns

36
Q

TB immune response to limit spread is _____ to _____ weeks

A

2 to 10 weeks

37
Q

If a patient has TB and is having an elective surgery, it should be delayed until the patient is no longer infectious, or ____ negative ____ _____ ____ tests and performed at the _______ of the day.

A

3 negative sputum acid fast

end

38
Q

High efficiency filter filters ____.___% particles > 0.___ microns

A

99.97% particles > 0.3 microns

39
Q

Patient with TB should be transported

A

wearing a mask

OR door closed with minimal traffic

should be done with least number of patients in OR at end of day

USE BACTERIAL FILTER between anesthesia circuit

40
Q

Standard Precautions: bloodbourne infection route:

A

percutaneous, mucosal, non-intact skin exposure

41
Q

Standard precautions: infectious fluids

Urine is sterile!

A

Blood, blood products

CSF

Amniotic

Pleural

Pericardial

Peritoneal

Synovial

Inflammatory exudates (pus)

42
Q

Hand washing

A

Minimum 15 seconds!

43
Q

Personal protection devices

A

Gloves

Mask

EYE PROTECTION

Gowns

44
Q

Patients with multidrug resistant microorganisms

Alcohol is effective. True or False?

PPE?

A

MRSA

Vancomycin resistant enterococci (VRE)

C. diff

False–hand wash

gown, gloves, more obsessive standard precautions

Mask is not necessary

45
Q

Droplet precautions

It’s when to wear a mask…

A

Mumps

Measles

Strep

Meningitis

46
Q

Do not make contact with patients unless immune with these patients:

A

Varicella

Measles

Varicella zoster

47
Q

Postexposure Management

A

Wound management

Exposure reporting

Evaluation of transmission risk

serologic testing of health care worker

consideration of post exposure prophalaxis (PEP)

48
Q

Cleaning

A

remove foreign material

like cleaning the floor

49
Q

Antiseptic

A

Use on living tissue

50
Q

Disinfectant

A

use on non-living items like bleach

51
Q

sterile

A

completely free of microorganisms

52
Q

sterilization

A

process that results in probability of microorganism survival on an item < 1:1,000,000

53
Q

High level disinfection

A

Kills fungi, viruses, and vegetative bacteria except endospores

54
Q

Intermediate level

A

Kills fungi, non small or nonlipid viruses and bacteria except endospores

55
Q

low level disinfection

non baby baby wipes

A

kills fungi, some viruses (lipid/medium sized), and bacteria EXCEPT TB and endospores

56
Q

any item that comes in contact with the patient intact skin must be wiped down with a low level disinfectant

A

OR table

Arm boards

BP cuffs

ECG cable

Pulse oximeter

Stethoscope

57
Q

High level disinfectant needs to be used on

A

mucous membrane contact

laryngoscope

bronchoscope

58
Q

Simple cleaning

A

soap and water

59
Q

antiseptic cleaning

A

has antimicrobial activity that can be applied to living tissue like alcohol and iodine

60
Q

chlorine

A

widely used disinfectant used on tables, floors, surfaces, and equipment

1: 100-1000 effective against HIV
1: 10 for blood spills
1: 5-1:10 effective against hepatitis

61
Q

hydrogen peroxide (25-37%)

A

effective surface cleaner safe for rubber and plastic

62
Q

Sterilization: StRaPCh

A

Steam

Radiation

Plasma

Chemical: Gas, Liquid

63
Q

Autoclaving

A

quick, cheap, effective with no residues

Kills everything with Pressure, temperature

64
Q

15 min autoclaving at temp?

10 min?

3.5 min?

A

121 degrees Celcius

126 degrees C

134 degrees C

65
Q

Autoclaving sterilization confirmed by ____________inside wrapped metal trays

A

indicator strip

66
Q

Metal instruments and laryngoscope blades sterilized by

A

autoclaving

67
Q

For preservative free medications

A
  • Check label
  • use aseptic technique
  • DISCARD after use
68
Q

Propofol newer formulation with EDTA has a ___ hour shelf life.

A

12

69
Q

Bupivicain is ____ dose

A

single

70
Q

Immuno-suppressed patient

A

skin prep with disinfectant

wear sterile gloves, mask, cap

avoid contamination

maintain good sterility

71
Q

High risk latex allergy groups

A

Healthcare people

multiple surguries (spina bifida)

occupational exposure (hairdressers)

History of hay fever, rhinitis, asthma, eczema

foods: avocado, kiwi, banana, chestnuts, stone fruit

72
Q

Latex allergy cases performed at ______ of day

A

beginning

73
Q

Contains latex

A

BP cuff

bed mattress and bumpers

Latex port on IV bag…not the tab coverted port

Place “latex allergy” sign on door of OR

74
Q

Betadine Allergy

A

Contrast dye

Shellfish

75
Q

IV catheter infection prevention

A

Subclavian vein carries a lower risk

Catheter site dressing: transparent, semipermeable polyurethane

76
Q

When inserting a central line or performing neuroaxial anesthesia (spinal or epidural)

A

Wear a surgical mask

77
Q

Patient airborne infection isolation room

A

AIIR

78
Q

Airbourne guidelines

A
  • Place patient in AIIR room
  • signage outside room
  • N95 respirator
  • Pt wears standard mask to prevent droplets into environment
  • OR rooms are positive pressure; choose one most remote or has negative pressure chamber that can be installed at door
  • End of day surgery
  • communicate precaution to personnel
79
Q

Contact precautions

A
  • Gown and glove when entering room
  • remove gown and gloves when exiting
  • separate 3 feet between patients

Anesthesia Practice (6 decks)

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