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Focus - Chem + professional issues Flashcards

1
Q

List the 4 bond strengths

A

Strongest

Covalent
Ionic
Polar covalent
Van der waals

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2
Q

Calculate C to F and F to C

A
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3
Q

What are the common units of pressure?

A
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4
Q

Which bond has a complete transfer of electrons? Which one equally shares?

A

Ionic - Complete transfer

Covalent - Equal sharing

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5
Q

Common metals, Acids, and bases are examples of which type of bonds? What about water?

A

Ionic

Water - polar covalent

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6
Q

Which type of charges do protons, neutrons, and electrons have?

A

Protons - POSITIVE
Neutrons - NEUTRAL
Electrons - Negative

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7
Q

P total = P1 + P2 + P3 is an example of which law?

A

Daltons - the total pressure exerted is the sum of all partial pressures

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8
Q
A

2.1%

(16/760) * 100

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9
Q
A

760*0.06 = 45.6

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10
Q

Which component of oxygen delivery is most affected by Henry’s law?

A

PaO2

Multiple PaO2 by 0.003 (oxygen’s solubility coefficient) will tell you how much oxygen is dissolved in the blood

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11
Q

Which law is about gas solubility?

A

Henry’s Law

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12
Q

Which law describes the transfer rate of a gas through a tissue medium?

A

Fick’s Law

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13
Q

Anesthetic emergence is prolonged by a hypothermic patient is an example of which law?

A

Henry’s

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14
Q

An over pressurized vaporizer is an example of which law?

A

Henry’s

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15
Q

Increasing FiO2 increases PaO2 is an example of which law?

A

Henry’s

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16
Q

Cardiac output calculation is an example of which law?

A

Fick’s

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17
Q

Placental drug transfer is example of which law?

A

Henry’s

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18
Q

Which law states that the molecular weight determines how fast it can diffuse?

A

Graham’s

Smaller can transfer through a graham cracker faster

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19
Q

Is emergence prolonged in the hypothermic patient?

A

Prolonged

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20
Q

How does increasing pressure affect solubility?

A
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21
Q

How does increasing temperature affect solubility?

A
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22
Q

CO2 is how many more times soluble than O2?

A

20 times

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23
Q

Which law is shown through the 2nd gas effect?

A

Grahams

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24
Q

What is the universal gas law?

A

Pv = nrT

P- pressure
V- volume
n- number of moles
r - constant 0.0821
T- Temperature

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25
Q

Increasing the radius by 1,2,3,4 does what to the flow rate?

A

1 = 1
Doubling = 16x
Tripling = 81x
Quadrupling = 256x

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26
Q

Decreasing temperature does what to viscosity and resistance?

A

Increases

(makes it slower)

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27
Q

What is Q when referring to Ohm’s law?

A

Flow

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28
Q

What is MAP-CVP when referring to Ohm’s law?

A

Pressure gradient

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29
Q

What is SVR and PVR when referring to Ohm’s law?

A

Resistance

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30
Q

What is Delta P when referring to Ohm’s law?

A

Pressure Gradient

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31
Q

What is Cardiac output when referring to Ohm’s law?

A

Flow

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32
Q

When is laminar, transitional, and turbulent flow?

A

Laminar <2000
Transitional 2000-4000
Turbulent >4000

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33
Q

Airflow in the terminal bronchioles is which type of flow?

A

Laminar

Also blood flow in systemic circulation

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34
Q

Airflow in the medium sized bronchioles is which type of flow?

A

Turbulent

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35
Q

Laminar flow is dependent on?

A

Viscosity (Poiseuille’s)

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36
Q

Turbulent flow is dependent on?

A

Density (Graham’s)

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37
Q

Does helium/oxygen mixture help flow that’s already laminar?

A

NO

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38
Q

How does heliox help?

A

Improves flow with high resistance

Ex: Epiglottis, bronchospasm

39
Q

According to Bernoulli’s principle, if fluid velocity is high, is high or low pressure exerted on the walls?

A

High velocity - low pressure on walls

Low velocity - high pressure on walls

40
Q

Examples of the Venturi effect?

A

Jet ventilator
Venturi mask
Nebulizer

41
Q

What is the Coanda effect?

A

Think snake

Flow attaches to the walls

Ex: mitral regurgitation

42
Q

Bernoulli’s
Venturi
Coanda

43
Q

Do large alveoli have a higher or smaller concentration of surfactant? What about small alveoli?

A

Large - smaller concentration

Small - larger concentration

44
Q

Does decreasing radius increase or decrease wall stress?

45
Q

Does decreasing intraventricular pressure increase or decrease wall stress?

46
Q

Does increasing wall thickness increase or decrease wall stress?

47
Q

Does increasing wall stress increase or decrease O2 consumption

A

Anything that increases wall stress also increases O2 consumption

48
Q

Which law describes why LV thickness increases due to systemic hypertension

A

Law of LaPlace

49
Q

What are three ways to limit radiation exposure?

A

Distance
Duration
Shielding

50
Q

Minimum safe distance from radiation source?

51
Q

Maximum radiation exposure for adults? Pregnant?

A

Adult - 5 rem

Pregnant - 0.5 rem

52
Q

What is the critical temperature?

A

The highest temperature where a gas can exist as a liquid

53
Q

What is Avogadro’s number?

A

1 mole of ANY gas is made up of 6.023x10 to the 23rd atoms

54
Q

What is the AANA code of ethics?

A

Principles of conduct and professional integrity that guide-decision making and behavior of CRNAs

55
Q

What are practice standards? Can you deviate from them?

A

Standards that describe the minimum rules and responsibilities of CRNAs

No must be adhered to

56
Q

What are practice guidelines? Must they be adhered to?

A

Statements that assist providers in clinical decision making

they “should” be adhered to

57
Q

What are position statements?

A

Statements that express the AANA on official positions

58
Q

What is nonmaleficence?

A

The provider has an obligation to not inflict hurt or harm

Ex: unnecessary testing

59
Q

What is beneficence?

A

Providers should act for the benefit of others

60
Q

What is justice?

A

Treat everyone the same

61
Q

What are the 6 elements of informed consent?

A
  • Competence
  • Decision making capacity
    -Disclosure of information
    -Understanding of disclosed information
    -Voluntary consent
    -Documentation
62
Q

Define assent

A

including children in the decision-making process

63
Q

Do written materials take the place of a face-to-face conversation?

64
Q

What four things must be proven by the patient in a lawsuit?

A
  1. Duty - the CNRA had duty to the patient
  2. Breach of duty - the CRNA failed their duty
  3. Causation - The CRNA caused patient injury
  4. Damage - Harm was caused to the patient
65
Q

What is Res Ipsa Loquitur?

A

‘the thing speaks for itself’

Burden of proof can shift from the plaintiff to the defendant

Ex; Leaving a lap sponge in the patient

66
Q

What is battery?

A

physical contact

Ex: placing an epidural without consent

67
Q

What is assault? Can it happen to an unconscious patient?

A

Making the person feel that battery is imminent

Can not occur in unconscious patient

Ex: the patient FEELS like you are going to place the catheter without consent

68
Q

Does harm need to be proven with assault or battery charges?

69
Q

What is Vicarious Liability?

A

One person is responsible for another’s actions

Ex: Hospital being held for the actions of the nurse

70
Q

What is the emergency in medical treatment and active labor act? (EMTALA)

A

Must provide services to anyone in the ED

71
Q

What does the affordable care act provide?

A

Mandated that everyone has health insurance

Must provide preventative care

patients cannot be subject to annual or lifetime dollar limits

72
Q

Which schedule drug classification are opioids?

A

2 - along with cocaine, meth, and barbiturates

73
Q

Which schedule drug classification is ketamine, steroids, and codeine?

74
Q

Which schedule drug classification are benzo’s?

75
Q

When a patient experiences serious anesthetic outcomes, what information is appropriate to offer to the patient’s family?

A

Facts while also expressing regret

  • this creates trust and also lowers the risk of a lawsuit
76
Q

What is the first step if being named in a lawsuit?

A

Contact insurance carrier immediately

DO NOT DISCUSS THE CASE

77
Q

What are the most common lawsuits for?

A
  1. Death - 30%
  2. Nerve injury - 22%
  3. Permanent brain damage - 10%
  4. Airway injury - 6%
  5. Awareness - 1%
78
Q

What are usually the causes for a lawsuit regarding death or permanent brain damage?

A
  1. Inadequate ventilation
  2. Esophageal intubation - unrecognized
  3. Difficult intubation
79
Q

What is essential to try to avoid a lawsuit?

A

Establish rapport with the family and patient

80
Q

What 4 things increase the risk of dying within 7 days of surgery?

A
  1. High ASA
  2. Emergency
  3. Major surgery
  4. Old age
81
Q

Which procedures are increasing for malpractice claims?

A

Chronic pain injections - especially cervical

82
Q

What is legal age for consent? What is an emancipated minor?

A

18

Emancipated minor - someone under 18 given rights of an adult by the court

83
Q

How can someone become a emancipated minor?

A
  1. Married
  2. Parent or pregnant
  3. Military
  4. Economically independent
84
Q

Do medical providers have to disclose medical errors that cause no harm?

A

No - but is strongly encouraged under ethics

85
Q

When should exercise and caffeine be avoided before bed?

A

Caffeine at least 4 hours

Workout at least 3 hours

86
Q

What signs and symptoms may develop from MRI?

A

Dizziness, light headedness, nausea

87
Q

What is the recovery time for an addict before coming back to work? How long should they be monitored for?

A

1 year

Probation for 5 years

88
Q

Should you call the police for suspected drug abuse?

A

Only as a last resort

89
Q

The CRNA charts no issues during airway management after they encountered a difficult airway, The CRNA has committed what?

A

Medical malpractice

90
Q

What group sets the highest standards that must be followed?

91
Q

What is an example of an intentional tort?

92
Q

How much higher do anesthesia alarms need to be set over OR noise?

A

At least 20 dB higher

93
Q

What is the peak allowable dB set by OSHA?

Miscellaneous (10 decks)

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