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final exam principles of nurse anesthesia > mini study guide (OR Safety) > Flashcards

mini study guide (OR Safety) Flashcards

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1
Q

give the equation for electricity that follows Ohm’s Law?

A

voltage= current x impedance

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2
Q

voltage is known as the?

A

driving pressure

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3
Q

current is also known as?

A

flow

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4
Q

impedance is also known as?

A

resistance

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5
Q

the electrocautery delivers a high frequency current that is ____ to ____ hertz

A

500,000 to 1 million hertz

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6
Q

the electrocautery is used to?

A

cut, coagulate, dissect, or destroy tissue

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7
Q

the higher the frequency on the electrocautery, they will have a _____ tissue penetration and does not affect _____ cells. thus what is not a risk?

A

low
excitable
Vfib

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8
Q

monopolar electrocautery requires a?

A

grounding pad

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9
Q

a grounding pad is placed on a patient to allow?

A

for the exit point of a return current

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10
Q

a grounding pad is also called a?

A

functional return electrode

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11
Q

A functional return electrode serves as the exit point by providing?

A

a large, low impedance surface area for the electrical current to exit the body and return to the power generator

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12
Q

if a return electrode fails, what does this place the patient at risk for?

A

burns

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13
Q

if the return electrode malfunctions the electrical current will?

A

find another pathway to exit the patient, such as the EKG electrodes, temperature probe, or metal components of the surgical table.

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14
Q

the smaller the area that the electricity exits the body other than the functional return electrode, the greater the?

A

intensity of the burn

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15
Q

To prevent burns at the return pad site, the entire surface of the return electrode should be?

A

in direct contact with the patient’s skin

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16
Q

the functional return electrode should never be placed where?

A

over bony prominences ro metal implants

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17
Q

what happens if the gel on the functional return electrode dries out?

A

the electrical current won’t have a direct path to the return electrode and will find another way to exit the body

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18
Q

the electrocautery can emit ____ and cause a fire

A

sparks

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19
Q

the bipolar electrocautery has two electrodes known as?

A

active and return electrode

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20
Q

the bipolar electrocautery does not have a ?

A

return pad

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21
Q

what is a critical aspect of using an electrocautery on a patient with a pacemaker or an ICD?

A

the current must not pass across the pacemaker.

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22
Q

to recieve a shock, a person must become a part of and complete an?

A

electrical circuit

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23
Q

for current to flow, there has to be a voltage difference across an ______.

A

impedance.

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24
Q

therefore, if a closed circuit exists, then exposure to a live electricity source provides an electromotive force (voltage) that pushes the current through an impedance. The impedance can be?

A

you or the patient

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25
Q

an electrical current that enters the body will exit the body along the path?

A

of least resistance

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26
Q

name three consequences of electrical injury?

A

cardiac arrhythmias
nerve injury
thermal injury

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27
Q

with electrical injury resulting in nerve injury you could have _____ paralysis and muscle contractions

A

diaphragmatic

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28
Q

with thermal injury from an electrical injury the damage to the ______ may be more extensive than the damage you observe on the skin

A

internal organs

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29
Q

define macroshock?

A

a comparatively larger amount of current that is applied to the external surface of the body.

30
Q

why must larger amounts of current be applied to the external surface of the body?

A

because the impedance of the skin offers a high resistance

31
Q

1 mA of macroshock results in?

A

threshold for touch perception of electrical shock

32
Q

5 mA of macroshock results in?

A

maximum current for a harmless electrical shock

33
Q

10-20 mA of macroshock results in?

A

“let go” current occurs before sustained contraction

34
Q

50 mA of macroshock results in?

A

loss of consciousness

35
Q

100 mA of macroshock results in?

A

ventricular fibrillation

36
Q

define microshock?

A

a comparatively smaller amount of current that is applied directly to the myocardium

37
Q

with microshock, the high resistance of the skin is bypassed, so it takes a significantly ____ amount of current to induce ventricular fibrillation.

A

smaller

38
Q

10 uA of microshock results in?

A

maximum allowable current leak in the OR

39
Q

100 uA of microshock results in?

A

ventricular fibrillation

40
Q

what unit are used in microshock?

A

uA

41
Q

what unit of measurement are used in macroshock?

A

mA

42
Q

What type of devices provide a direct conductive pathway to the heart, so it should make sense that they increase the patient’s susceptibility to microshock.

A

central line
PA catheter
pacing wires

43
Q

How does the electrical system in the OR reduce the risk of electrical shock in what two ways?

A

OR power supply is NOT grounded

the equipment is grounded

44
Q

for an electrical shock to occur in the OR there must be ___ faults in the system, which are?

A

2 faults
first, the OR power supply becomes grounded
second, the equipment is not grounded.

45
Q

the line isolation monitor serves what purpose?

A

to assess the integrity of the undergrounded power system in the OR

46
Q

the line isolation monitor, tells you when the OR becomes grounded and how much?

A

current could potentially flow through you or a patient if a second fault occurs

47
Q

if the line isolation monitor alarm sounds what should you do?

A

the last piece of equipment that was plugged in should be unplugged

48
Q

the line isolation monitor will alarm when?

A

when 2-5 mA of leak current is detected

49
Q

all electrical devices leak a small amount of?

A

current

50
Q

if the sum of the leak of currents from devices in the OR exceeds 2-5 mA, the LIM alarm will sound, however, there is no risk of electrical shock in this situation, and what corrective action is required?

A

none

51
Q

does the LIM by itself protect you or the patient from macro or micro shock?

A

no

52
Q

what is the primary purpose of the LIM?

A

to alert the OR staff of the first fault, meaning the OR has become grounded

53
Q

CRNAs are at greater risk for exposure to ____ radiation

A

ionizing

54
Q

where are potential areas for ionizing radiation exposure for the CRNA?

A

CT, CCL, EP lab, IR, NM, RAD therapy, anywhere fluoroscopy is used

55
Q

ionizing radiation can remove electrons from atoms, this causes ______.

A

free radicals

56
Q

free radicals can be damaging on the ____ level

which includes risk of tissue injury, chromosomal damage or malignancy

A

cellular

57
Q

most exposure of ionizing radiation is the result of ___ ____ , not direct exposure

A

scattering x-rays

58
Q

how do we quantify exposure to ionizing radiation?

A

roentgen (R)

59
Q

the roentgen equivalent in man (REM) is a unit dose equivalent, this relates the?

A

human tissue absorption to the effective biological damage of the radiation

60
Q

the yearly maximum radiation exposure is ___ rem

A

5 rem

61
Q

the yearly maximum exposure for the fetus of a pregnant worker is ___ rem or ___ rem/month

A

0.5
or
0.05 rem/month

62
Q

in the non-pregnant person, the ___ and ____ are the most susceptible to injury from radiation on the body.

A

eye and thyroid

63
Q

in the pregnant person, who is most suseptible to injury the mother or the fetus?

A

the fetus

64
Q

how can you protect yourself from radiation? 3 ways

A

distance
duration
shielding

65
Q

the minimum safe distance is ___ feet from the radiation source.

A

6 feet

66
Q

the amount of exposure is _____ proportional to the square of the distance of the source

A

inversely

67
Q

six feet of air confers the same protection from radiation as ___ inches of concrete or ___ mm of lead

A

9 inches of concrete

2.5 mm of lead

68
Q

a lead apron is usually ___ mm thick

A

0.25 to 0.5 mm

69
Q

what is the measuring device for radiation exposure?

A

dosimeter

70
Q

where should a pregnant provider where her second dosimeter?

A

under her apron

71
Q

where should a provider wear a dosimeter?

A

on the shirt collar near the thyroid gland.

final exam principles of nurse anesthesia (12 decks)

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