AORN Electrosurgical Safety 2

Question 1

What distinguishes bipolar electrosurgery from monopolar electrosurgery?

Accepted Answer

In bipolar electrosurgery, current travels only between the two tips of the instrument, eliminating need for a dispersive electrode

Answer

Bipolar uses higher voltage to achieve faster tissue cutting

Answer

Bipolar electrosurgery uses a separate dispersive electrode on each limb

Answer

Bipolar mode generates a continuous waveform while monopolar uses interrupted pulses

Question 2

What is 'capacitive coupling' in the context of laparoscopic electrosurgery?

Accepted Answer

Generation of an electrical charge in a nearby conductor without direct contact via an insulated active electrode

Answer

Transfer of electrical energy through direct contact between two conductive instruments

Answer

Shorting of the active electrode against the trocar sleeve

Answer

Failure of the return electrode to maintain adequate skin contact

Question 3

What is 'direct coupling' in laparoscopic electrosurgery, and why is it dangerous?

Accepted Answer

The active electrode accidentally makes contact with another metal instrument, conducting current to unintended tissue

Answer

The ESU is directly connected to the return electrode, bypassing safety circuits

Answer

Current travels directly through the trocar without tissue contact

Answer

Two monopolar instruments are used simultaneously, doubling the electrical output

Question 4

According to AORN standards, what is the recommended power setting principle for electrosurgical units?

Accepted Answer

Use the lowest effective power setting that achieves the desired tissue effect

Answer

Use the highest setting to minimize activation time

Answer

Set power to a standard facility preset regardless of tissue type

Answer

Increase power by 10% increments until hemostasis is achieved

Question 5

Before applying the dispersive electrode, what patient assessment should the perioperative nurse perform?

Accepted Answer

Assess the patient's allergy history and inspect the intended placement site for hair, scar tissue, bony prominences, or compromised skin integrity

Answer

Measure the patient's body temperature to ensure adequate perfusion

Answer

Verify that the patient has not eaten within 8 hours prior to surgery

Answer

Check the patient's blood pressure and heart rate for hemodynamic stability

Question 6

What does the Return Electrode Monitoring (REM) system do during electrosurgical procedures?

Accepted Answer

Detects changes in impedance at the dispersive electrode and alarms when contact is inadequate

Answer

Monitors the frequency output of the ESU generator continuously

Answer

Records the total energy delivered during the surgical case

Answer

Prevents the ESU from activating unless the dispersive electrode is applied

Question 7

Why should pooling of prep solutions under the patient be prevented before electrosurgery is used?

Accepted Answer

Pooled flammable or caustic solution can ignite or cause chemical burns when exposed to ESU activation

Answer

Pooled solution increases electrical resistance and reduces cutting efficiency

Answer

Pooled solution conducts current away from the surgical site, reducing effectiveness

Answer

Pooled solution prevents proper adhesion of the dispersive electrode