Intro to Anes Test3

Question 1

What prep solution is superior to providone-iodine in reducing skin flora?

Answer 1

0.5% Clorhexidine + 70% alcohol skin prep

Question 2

Why should you never use 0.5% Clorhexidine + 70% alcohol skin prep for lumbar puncture?

Answer 2

• May be related to previous animal studies
• Higher concentration
• Neurotoxicity

Question 3

Should you wear masks during Neuraxial blocks? why or why not?

Answer 3

Yes, there are documented meningitis outbreaks in parturients when masks are not worn

Question 4

Is an Arterial Line insertion a sterile procedure?

Answer 4

No, use aseptic technique, but you should still prep and drape with sterile gloves, sterile field, and sterile catheter.

Question 5

How should you choose a central line insertion site?

Answer 5

• In order of less likely to get an infection

- Subclavian > neck > femoral

Question 6

Is a central line insertion a sterile technique?

Answer 6

Yes, use full sterile barrier technique: including gown, gloves, cap and mask

Question 7

Central Line Dressing should be ____?

Answer 7

Clear, transparent, and adhesive

Question 8

What should be done before accessing a central line?

Answer 8

• Hand hygiene

- Scrub the hub

Question 9

How to prevent spreading infection via Laryngoscope blades?

Answer 9

• Keep stored laryngoscope blades covered
• Keep material for materials for next case in clean place, confined and covered
• Blades must be disinfected/sterilized, stored in a way that prevents recontamination, and not stored in an open drawer.

Question 10

What happens when “Single Use” items are reused?

Answer 10

It imposes liability on the individual and institution for proper function.

Question 11

Why are Bronchoschopes difficult to disinfect?

Answer 11

Because of their design, fiberoptic materials, channels

Question 12

Which bacteria is most prevalent in Bronchoscope infections

Answer 12

Pseudomonas outbreaks

Question 13

How are Bronchoscopes cleaned in between uses

Answer 13

High level disinfection

Question 14

Double gloving decreases the risk of what?

Answer 14

Needle stick injury

Question 15

What is a formite

Answer 15

An inanimate object that is contaminated with pathogens and can be a source of spreading pathogens

Question 16

Ventilator Associated Pneumonia Care Bundle

Answer 16

1) Use Non-invasive ventilation if possible
2) Extubate ASAP
3) In-line subglottic suction, sheathed suction catheters
4) Cuff 20 cm H20
5) Avoid naso-endotracheal route
6) Avoid H2 blockers, PPIs 2° to ↑ aerodigestive bacteria

Question 17

Epidural Catheters should be removed within what time frame to decrease risk?

Answer 17

48 hours

Question 18

Difference between Critical items, Semi-critical items and Non-critical items.

Answer 18

1) Critical items - Contact sterile body tissues and needs to be sterilized.
2) Semi-critical items - Contacts mucous membrane and needs high-level disinfection (i.e. laryngoscope blades)
3) Non-critical items - contacts skin and must be cleaned

Question 19

How do you calculate flow, when talking about the size of IV and tubing?

Answer 19

Pousille’s Law: Q = πR^4p/8nl

Question 20

How do you troubleshoot pain on injection when dealing with IVs.

Answer 20

• It could be from a misplaced of infiltrated IV
  1) Flush IV and look for swelling
  2) Don’t use cold fluids
  3) Inject lidocaine around the vein

Question 21

Difference between Infiltration and Extravasation?

Answer 21

1) Infiltration - when the catheter is outside the vein and medication is administered extravascularly but no damage happens.
2) Extravasation - when the catheter is outside the vein and medication is administered extravascularly but har or damage happens.

Question 22

Which medicines cause the worst damage from extavasation?

Answer 22

Chemo

Question 23

Examples of medicines that are painful but no cytotoxic if infiltrated?

Answer 23

1) Aminophyllines, amiodarone, calcium solutions, digoxin
2) Mannitol, nitroglycerin, propylene glycol (etomidate, phenytoin, phenobarbital),
3) Tetracyclines, TPN, vancomycin, vasopressin

Question 24

Complication that can be caused from an Oropharyngeal airway?

Answer 24

1) Macroglossia

2) Lingual nerve palsy

Question 25

How is an Oropharyngeal airway sized?

Answer 25

Sized from lips to earlobe

Question 26

When using a Nasopharyngeal airway, what precautions should the CRNA use?

Answer 26

1) use lidocaine jelly (will helpprevent nose bleeds)

2) Bevel faces septum to avoid turbinates

Question 27

Complications of using Nasopharyngeal airways?

Answer 27

Epistaxis and aspiration of blood

Question 28

Types of Laryngoscope blades

Answer 28

1) Curved = Macintosh (Designed to engage vallecula and move tongue base and epiglottis forward)
2) Straight = Miller (Designed to scoop under epiglottis and lift it anteriorly)