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CNOR > Safe Use Of Equipment > Flashcards

Safe Use Of Equipment Flashcards

1
Q

What risk of electrocautery should the perioperative nurse scrubbed into the laparoscopic procedure be aware?

A

Direct coupling

when the active electrode is activated near another metal device inserted into an adjacent trocar port. The current travels through the metal device and cauterizes tissue that comes in contact with it. The scrubbed team is careful that the electrocautery does not contact other metal devices.

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2
Q

How far should evacuation device be from the source of smoke plume?

A

2 inches

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3
Q

Radiation exposure: primary radiation 

A

directly from source

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4
Q

Methyl methacrylate

A

-bone cement
-Highly volatile
-Closed bowl for mixing with a scavenger system
-let anesthesia know when placing cement into the canal (may cause hypotension)
-Dry time for cement affected by room temp

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5
Q

What action decreases radiation exposure during fluoroscopy procedures?

A

Positioning the patient as close to the image intensifier as possible 

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6
Q

Magnetic resonance imaging (MRI)

A

Relies on radio frequency waves to reproduce cross-sectional images of the body without exposing the patient to ionizing radiation 

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7
Q

What movement of a powered instrument is used to drill holes were insert screws, wires, and pins?

A

Rotating

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8
Q

Reciprocating movements of a powered instrument are used for

A

Cutting or removing bone
Uses an in and out action 

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9
Q

Flammable antiseptic solutions

A

Below the flashpoint of 100°F

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10
Q

Combustible antiseptic solutions

A

Flashpoint above 100°F 

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11
Q

Oscillating movements of a powered instruments are used for

A

Cutting or removing bone
Uses a side to side cutting action

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12
Q

Contraindications to the use of a pneumatic tourniquet

A

-Venous thromboembolism
-Impaired circulation or peripheral vascular compromise
-Previous revascularization of the extremity
-Extremities with dialysis access
-Acidosis
-Sickle cell anemia
-Extremity infection

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13
Q

Compared to those warmed with a warm water circulating device, patients who are warmed with forced air show

A

A higher occurrence of adverse outcomes 

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14
Q

Radiation exposure: leakage radiation

A

from x-ray machine covering

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15
Q

Radiation exposure: scatter radiation

A

reflects off the patient, top of the table, protective shielding

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16
Q

Most common patient injury

A

Burn at dispersive electrode (grounding pad)

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17
Q

Best place for dispersive electrode

A

Large muscle mass close to the surgery site
Example: quadriceps (thigh muscle), deltoid (shoulder muscle)

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18
Q

Endoscopic considerations: direct coupling

A

Active electrode touches another instrument
Bovie to metal instrument

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19
Q

Endoscopic considerations: capacitive coupling

A

Electrical current passes through intact insulation to conductive material
Bovie to metal instrument but Surgeon feels buzz

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20
Q

Electrosurgical safety with ICD and pacemakers

A

Used bipolar if possible
Keep the pacemaker out of the path of the device
Turn ICD off or use magnet

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21
Q

What kind of energy should only be used with any nerve stimulator?

A

Bipolar energy
Example: cochlear implant

22
Q

Argon electrosurgical unit

A

Prevent gas emboli, avoid direct contact with tissue

23
Q

Safe medical devices act of 1990

A

In the case of an incident, send the equipment, supplies and packages to biomed

24
Q

Water mist fire extinguisher

A

A extinguisher
For when ASHES will be left behind
Not good on liquid fires 

25
Q

CO2 fire extinguisher

A

BC extinguisher
For when ashes won’t be left behind
Not good for paper drapes 

26
Q

R. A. C. E. 

A

Rescue
Alarm
Contain
Extinguish

27
Q

P. A. S. S

A

Pull
Aim
Squeeze
Sweep

28
Q

Fire safety

A

National fire protection agency (NFPA)
-Materials saturated in flammable liquids must be thrown away at least 6 feet from the patient ex: Chloraprep
-external O2 (NC) off for one minute prior to use in head and neck procedures
-All personnel should be able to identify and shut off medical gases under direction 

29
Q

Greatest risk at 6 feet to occupational exposure to radiology are

A

Head
Neck
Hands

30
Q

Laser safety specialist (optional)

A

-Assistant to the laser safety officer
-Roll recommended if multiple laser might be operating at the same time

31
Q

Laser user

A

Physician or PA with the education, credentials, and privileges to operate a specific laser 

32
Q

Laser operator

A

Required for every laser case
Annual competency
Cannot be the circulator 

33
Q

Laser nominal hazard zone

A

In room where operating
Warning signs should be specific to the laser being used
Appropriate eye protection 

34
Q

Laser resistant ETT

A

Balloon inflated with methylene blue tinted saline
-ventilate with room air (21% O2) if possible or low concentration O2 (30% or less)

35
Q

Pneumatic tourniquet cuff size requirements

A

Cuff greater than half of the diameter of the extremity
Cuff should allow bladder overlap of 3 to 6 inches

36
Q

Pneumatic tourniquet position

A

At the point of maximum circumference
-Tubing on lateral aspect of extremity
-Tubing should be labeled

37
Q

Most common injury with pneumatic tourniquet? 

A

Nerve damage of obturator nerve closest to surface of groin
-from excessive pressure/uneven padding
-or Excessive inflation time
-Can result in permanent motor/sensory deficits

38
Q

Esmarch exsanguination contraindicated in patients with

A

Risk of thrombus
Infection
Dislocated fractures
Malignancy (tumor)
-exsanguinated by elevation

39
Q

How many minutes prior should Prophylactic anabiotic’s ideally be infused before inflation of pneumatic tourniquet?

A

20 minutes

40
Q

Patient with pneumatic tourniquet should be monitored for

A

Increasing core temperature
Pediatric patients for acidosis, especially if >75 minutes

41
Q

When extended tourniquet time is needed

A

Can deflate and allow reperfusion for a minimum of 10 to 15 minutes and then re-inflate

42
Q

Limb occlusion pressure

A

-Determines pressure settings of pneumatic tourniquet
-Done in doctors office when scheduling surgery
-Use a Doppler to locate an artery distal to cuff
Slowly increase pressure until pulse stops

43
Q

Tourniquet pressure=

A

LOP + (40, 60 or 80)
40 mm/Hg greater for LOP <130
60 mm/Hg greater for LOP 131-190
80 mm/Hg greater for LOP >190
Pediatric pressure set at 50 mm/Hg greater than LOP

44
Q

At minimum the tourniquet pressure is based on

A

Systolic pressure and limb circumference

45
Q

Pneumatic tourniquet complication with rapid deflation

A

Rush of metabolic waste and meds
Lactic acid being produced by distal tissue to tourniquet
S/s: ringing ears, numb tingling lip/fingers, loss of consciousness, seizures, arrhythmias 

46
Q

Pneumatic tourniquet temperature complications

A

Hyperthermia after inflation, hypothermia after deflation
-Temperature increases when tourniquet is up
-Temperature decreases when tourniquet is down

47
Q

What anesthesia medication is contraindicated with pneumatic tourniquet use?

A

Isoflurane
Increased ICP
-It brings down blood brain barrier
-Allowing organs to engorge

48
Q

Other pneumatic tourniquet complications

A

-Emboli within one minute of deflation
-Overpressurization – pain at tourniquets site, nerve damage
-Excessive time - ischemic injury, nerve damage
-Under pressurization – bleeding, venous congestion

49
Q

Adequate eye protection for staff members and patients during laser procedures is determined by the

A

Optical density and laser wave length marked on the eyewear

50
Q

Skin burns from the electrosurgical unit are most likely due to

A

High current on a small area of contact

51
Q

Phacoemulsification

A

The process of cataract removal in which the cataract is broken up by ultrasonic vibration, and then aspirated

CNOR (14 decks)

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