CNOR 2024 (2) Zander
_ _ _ _ before you _ _ _ _ - correct answer-Rescue patient
Alarm
Contain
Extinguish
Pull
Aim
Squeeze
Sweep
* Other term for jack knife position: *
- how to position to aid in ventilation: - correct answer-Kraskes
- use transverse hip roll
** If question on exam about burn patients, it's most likely going to be about: - correct
answer-> Hypothermia (no skin = cold)
> Fluid Electrolyte Imbalance
** If there's a question on the exam about increased ICP, what are they asking about? ** -
correct answer-Fluid balance
" Too much and ICP will further increase,
Too little and BP will decrease and decrease perfusion
to the brain"
** It is the nurses own responsibility to ensure that her competency is maintained** - correct
answer-
** Know for Braden Scale: ** - correct answer-> What it is: An assessment tool for skin
breakdown
> Lower the score, the higher the risk of skin breakdown.
24 = Perfect score
18 or less = at risk
** What does closed loop cautery mean? - correct answer-** The current goes back to the
machine
** What kind of hernia would you expect to find in Hesslebachs Triangle? ** - correct
answer-> Direct Inguinal Hernia INSIDE the triangle
,> Indirect Inguinal Hernia OUTSIDE the triangle (usually in scrotum)
** Why is the esmark used before tourniquet inflation? - correct answer-To prevent
'tourniquet pain' post op
**ON Exam: You're counting EVERYTHING, ALL the time ** - correct answer-
**What can happen with temperature and a pneumatic tourniquet? - correct
answer-**Tourniquet up --> Hyperthermia
- cooling vasc system is cut off
**Tourniquet down --> Hypothermia
- blood drops down into icy cold leg
- First temp in PACU is important
**What can you wear in
Unrestricted:
Semi-Restricted:
Restricted: - correct answer-Unrestricted: Street Clothes
- Lounge
- Locker room
- Pre-op & PACU
Semi- Restricted: Cover Hair + Scrubs
- OR Nurses station
- OR hallways
- SPD
- Sterile Storage
- Only necessary personnel (students count)
Restricted: Mask Up
- Sterile Supplies are open (OR)
- Possibly antechamber and Central Core
(per hospital)
- Only necessary personnel (students count)
All instrument trays should be standardized. If special instruments are used by a surgeon,
those items should be peel packed. - correct answer-mmhmm
All preps are either ineffective when wet or ineffective and flammable when wet... - correct
answer-Dry before draping.
An alcoholic has anesthesia/surgery....anesthesia concerns? - correct answer-> Liver
disease --> Not clotting ---> Bleeding
,> Working around the throat (NG tube, ET) --> Esoph varices
> Pancreatitis
> Malnutrition ( Check albumin levels...needed to heal)
> **Withdrawal**
- Alcohol withdrawal looks like amphetamine/speed
- Tremors, palpitations, clammy, N/V
Autologous Transfusions
Directed Donor Transfusions
Autotransfusion - correct answer-Autologous: Patient does pre donation of blood, then
receives iron afterwards.
Eliminates risks of BBPathogen
DDonor Transfusions: Friends and family donate
No significant decrease in risk
Autotransfusion: Quickest form of blood replacement.
-blood salvage
-spins down and pumps to pkg and reinfuses PRBCs
Besides the obvious ICK, why is it so important to prevent insects/flies and vermin from
being in health care settings? - correct answer-- they carry pathogens with antibiotic
resistance
Best post op position for Peds: - correct answer-Lateral
Semiprone/Lateral recumbant for T&A - On side leaning fwd.
- May need safety restraints to maintain tubes and drains.
Best practice for intubation with person with airborne illness? - correct answer-- Intubate
outside of the OR in an isolation room.
- Place bacterial filter on ET tube.
(then can move through hospital without fear of exposure because it's a close circuit)
Best way to deliver O2 to COPD patient during moderate sedation? - correct answer-Oxygen
low concentration 30% or less
Nasal cannula 2L MAX
Venturi Mask (not as safe)
, Bio how often with EO? - correct answer-Each load (loads take too long to aerate)
Blood Types: - correct answer-ABO type determined by antigens on the surface of the RBC
* UNIVERSAL DONOR: O- * (no Rh, no antigens, no reactions)
Universal Recipient: AB+
BMI values: - correct answer-Overweight BMI > 25
Obese BMI > 30
Morbidly O BMI > 40
Burns Day 1&2 issues vs Day 3 issues: - correct answer-Day 1 & 2:
- Fluid DEFICIT (fluid leaves intravascular and goes interstitial)
- Dehydration - Needs IV fluids
- K+K+K+K+K+K+K+K+K+K+K+K+
Day 3:
- Interstitial moves to Intravascular
- Now you can take to OR for debridement
- LOW k+, electrolytes, hgb (because diluted)
Colors and meanings for mass casualty disaster patients - correct answer-RED: Life
Threatening. Goes to OR 1st. Life saving intervention required to survive.
YELLOW: Serious but not life threatening. Goes to OR 2nd. Delaying treatment won't affect
outcome.
GREEN: Walking wounded. Not life threatening.
BLACK: Not expected to survive. Comfort Care.
Compartment Syndrome monitoring:
Treatment: - correct answer-Edema/hematoma
Monitor for:
-Pulse
-Cap Refill
Monitor under the drapes in case it worsens and blood flow is occluded during repair of other
trauma.
-Mark Pulses.
Treatment:
-Fasciotomy
Cut, Pack wet to dry, apply a wound vac, and let it heal 2nd intention (bottom up)
Concern of CHF patients in surgery? - correct answer-Fluid Volume OVERLOAD.
_ _ _ _ before you _ _ _ _ - correct answer-Rescue patient
Alarm
Contain
Extinguish
Pull
Aim
Squeeze
Sweep
* Other term for jack knife position: *
- how to position to aid in ventilation: - correct answer-Kraskes
- use transverse hip roll
** If question on exam about burn patients, it's most likely going to be about: - correct
answer-> Hypothermia (no skin = cold)
> Fluid Electrolyte Imbalance
** If there's a question on the exam about increased ICP, what are they asking about? ** -
correct answer-Fluid balance
" Too much and ICP will further increase,
Too little and BP will decrease and decrease perfusion
to the brain"
** It is the nurses own responsibility to ensure that her competency is maintained** - correct
answer-
** Know for Braden Scale: ** - correct answer-> What it is: An assessment tool for skin
breakdown
> Lower the score, the higher the risk of skin breakdown.
24 = Perfect score
18 or less = at risk
** What does closed loop cautery mean? - correct answer-** The current goes back to the
machine
** What kind of hernia would you expect to find in Hesslebachs Triangle? ** - correct
answer-> Direct Inguinal Hernia INSIDE the triangle
,> Indirect Inguinal Hernia OUTSIDE the triangle (usually in scrotum)
** Why is the esmark used before tourniquet inflation? - correct answer-To prevent
'tourniquet pain' post op
**ON Exam: You're counting EVERYTHING, ALL the time ** - correct answer-
**What can happen with temperature and a pneumatic tourniquet? - correct
answer-**Tourniquet up --> Hyperthermia
- cooling vasc system is cut off
**Tourniquet down --> Hypothermia
- blood drops down into icy cold leg
- First temp in PACU is important
**What can you wear in
Unrestricted:
Semi-Restricted:
Restricted: - correct answer-Unrestricted: Street Clothes
- Lounge
- Locker room
- Pre-op & PACU
Semi- Restricted: Cover Hair + Scrubs
- OR Nurses station
- OR hallways
- SPD
- Sterile Storage
- Only necessary personnel (students count)
Restricted: Mask Up
- Sterile Supplies are open (OR)
- Possibly antechamber and Central Core
(per hospital)
- Only necessary personnel (students count)
All instrument trays should be standardized. If special instruments are used by a surgeon,
those items should be peel packed. - correct answer-mmhmm
All preps are either ineffective when wet or ineffective and flammable when wet... - correct
answer-Dry before draping.
An alcoholic has anesthesia/surgery....anesthesia concerns? - correct answer-> Liver
disease --> Not clotting ---> Bleeding
,> Working around the throat (NG tube, ET) --> Esoph varices
> Pancreatitis
> Malnutrition ( Check albumin levels...needed to heal)
> **Withdrawal**
- Alcohol withdrawal looks like amphetamine/speed
- Tremors, palpitations, clammy, N/V
Autologous Transfusions
Directed Donor Transfusions
Autotransfusion - correct answer-Autologous: Patient does pre donation of blood, then
receives iron afterwards.
Eliminates risks of BBPathogen
DDonor Transfusions: Friends and family donate
No significant decrease in risk
Autotransfusion: Quickest form of blood replacement.
-blood salvage
-spins down and pumps to pkg and reinfuses PRBCs
Besides the obvious ICK, why is it so important to prevent insects/flies and vermin from
being in health care settings? - correct answer-- they carry pathogens with antibiotic
resistance
Best post op position for Peds: - correct answer-Lateral
Semiprone/Lateral recumbant for T&A - On side leaning fwd.
- May need safety restraints to maintain tubes and drains.
Best practice for intubation with person with airborne illness? - correct answer-- Intubate
outside of the OR in an isolation room.
- Place bacterial filter on ET tube.
(then can move through hospital without fear of exposure because it's a close circuit)
Best way to deliver O2 to COPD patient during moderate sedation? - correct answer-Oxygen
low concentration 30% or less
Nasal cannula 2L MAX
Venturi Mask (not as safe)
, Bio how often with EO? - correct answer-Each load (loads take too long to aerate)
Blood Types: - correct answer-ABO type determined by antigens on the surface of the RBC
* UNIVERSAL DONOR: O- * (no Rh, no antigens, no reactions)
Universal Recipient: AB+
BMI values: - correct answer-Overweight BMI > 25
Obese BMI > 30
Morbidly O BMI > 40
Burns Day 1&2 issues vs Day 3 issues: - correct answer-Day 1 & 2:
- Fluid DEFICIT (fluid leaves intravascular and goes interstitial)
- Dehydration - Needs IV fluids
- K+K+K+K+K+K+K+K+K+K+K+K+
Day 3:
- Interstitial moves to Intravascular
- Now you can take to OR for debridement
- LOW k+, electrolytes, hgb (because diluted)
Colors and meanings for mass casualty disaster patients - correct answer-RED: Life
Threatening. Goes to OR 1st. Life saving intervention required to survive.
YELLOW: Serious but not life threatening. Goes to OR 2nd. Delaying treatment won't affect
outcome.
GREEN: Walking wounded. Not life threatening.
BLACK: Not expected to survive. Comfort Care.
Compartment Syndrome monitoring:
Treatment: - correct answer-Edema/hematoma
Monitor for:
-Pulse
-Cap Refill
Monitor under the drapes in case it worsens and blood flow is occluded during repair of other
trauma.
-Mark Pulses.
Treatment:
-Fasciotomy
Cut, Pack wet to dry, apply a wound vac, and let it heal 2nd intention (bottom up)
Concern of CHF patients in surgery? - correct answer-Fluid Volume OVERLOAD.
