CNOR flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ASA physical status I

A normal, healthy patient with no systemic disease who is expected to tolerate surgery and anesthesia well; the class is assigned during the preoperative anesthesia evaluation to communicate risk.

Mallampati class IV

Airway assessment in which the soft palate is not visible at all, predicting a difficult laryngeal view and an increased risk of difficult intubation during direct laryngoscopy.

NPO clear liquids interval

Clear liquids may be taken until 2 hours before elective anesthesia; this limits aspiration risk while avoiding unnecessary dehydration and hypoglycemia.

Malignant hyperthermia susceptibility

An inherited ryanodine receptor defect triggered by volatile anesthetics and succinylcholine; a trigger-free anesthetic and immediately available dantrolene are required.

Universal Protocol elements

Preprocedure verification, marking of the operative site, and a time-out performed immediately before the procedure with the full team present and participating.

Prophylactic antibiotic timing

Infuse within 60 minutes before incision, or within 120 minutes for vancomycin and fluoroquinolones; redose at two half-lives or after major blood loss.

Surgical safety checklist phases

Sign in before induction of anesthesia, time out before incision, and sign out before the patient leaves the operating room; each phase verifies identity, site, and key safety items.

Surgical counts timing

Sponges, sharps, and instruments are counted by two people before incision, before cavity closure, at skin closure, and at end of case; discrepancies are resolved before closure.

Dispersive pad placement

Apply the electrosurgical return electrode to dry, hairless, well-perfused muscle near the surgical site, avoiding bony prominences, scars, implants, and areas below the heart.

Tourniquet inflation limit

Limit inflation to about 60 to 90 minutes; if more time is needed, deflate for 10 minutes before reinflation to limit ischemic injury and metabolic acidosis.

Lidocaine maximum dose

For a healthy adult, 4.5 mg/kg without epinephrine and 7 mg/kg with epinephrine; exceeding these doses raises the risk of local anesthetic systemic toxicity.

SBAR handoff

Structured communication using Situation, Background, Assessment, and Recommendation to convey complete, concise information during transfers and clinical escalations.

I-PASS handoff

A handoff mnemonic covering Illness severity, Patient summary, Action list, Situation awareness and contingency planning, and Synthesis of the information by the receiver.

Correcting a record error

Draw a single line through the entry so it remains legible, write the correction, then add initials, date, and time; never obliterate, erase, or use correction fluid.

Verbal order read-back

The receiver writes the order, reads it back completely to the prescriber, and obtains confirmation; the order is documented and countersigned according to policy.

Aldrete discharge score

A score of 8 or higher out of 10 for activity, respiration, circulation, consciousness, and oxygen saturation indicates readiness for discharge from the postanesthesia care unit.

PACU handoff content

Include procedure and anesthesia type, airway and vital signs, allergies, medications, fluids and blood loss, urine output, lines and drains, pain, temperature, and plan.

Transfer monitoring requirements

Transport with continuous pulse oximetry, supplemental oxygen, side rails up, a bag-valve mask immediately available, and an escort trained in airway management.

Spaulding classification

Critical items enter sterile tissue and require sterilization; semicritical items contact mucous membranes and need high-level disinfection; noncritical items contact intact skin only.

Steam sterilization biological indicator

Geobacillus stearothermophilus spores monitor steam sterilization; a positive result means the load is not sterile and requires quarantine, recall, and investigation.

EO biological indicator

Bacillus atrophaeus spores monitor ethylene oxide and dry heat sterilization; a positive result triggers load recall, investigation, and notification of everyone who received items.

Event-related sterility

Sterile items remain sterile indefinitely if the package is intact, dry, and correctly stored; calendar shelf-life dating is not required when event-related principles are used.

Malignant hyperthermia treatment

Stop triggering agents, hyperventilate with 100% oxygen, give dantrolene 2.5 mg/kg IV and repeat as needed, actively cool the patient, and treat hyperkalemia and acidosis.

Anaphylaxis first-line drug

Epinephrine 0.01 mg/kg up to 0.5 mg intramuscularly in the anterolateral thigh, repeated every 5 to 15 minutes as needed, along with fluids and airway support.

Lipid emulsion for LAST

For local anesthetic systemic toxicity, give 20% lipid emulsion at 1.5 mL/kg as a bolus followed by an infusion while securing the airway and supporting circulation.

Venous air embolism position

Place the patient in the left lateral decubitus position with the head down, give 100% oxygen, and aspirate air from a central venous catheter if one is in place.

FTE calculation

One full-time equivalent equals 2080 paid hours per year, or 40 hours weekly; required FTEs equal total workload hours divided by 2080.

Block scheduling utilization

Calculated as used block time divided by allocated block time; low utilization prompts release of the block to the general scheduling pool for other surgeons.

Preference card accuracy

Surgeon-specific lists of supplies and instruments that must be reviewed and updated regularly, because inaccurate cards cause delays, waste, and case cancellations.

Malpractice four elements

Duty to the patient, breach of the standard of care, causation linking the breach to harm, and damages must all be proven for a negligence claim to succeed.

Sentinel event

An unexpected occurrence involving death or serious physical or psychological injury that requires immediate containment, notification, and a root cause analysis.

Just culture

A framework that consoles human error, coaches at-risk behavior, and holds reckless behavior accountable, encouraging staff to report errors and near misses.