Hemostasis and Tissue Management Flashcards

During a laparoscopic procedure, the surgeon asks the CRNFA to adjust the monopolar ESU settings. Which finding on the ESU display indicates that the dispersive pad alarm is activated?

Answer: The contact quality monitor indicator shows poor pad contact

Modern ESUs with contact quality monitoring display a poor contact warning when the dispersive pad has inadequate skin contact, preventing unsafe current return.

Proper tissue handling during dissection requires that the CRNFA use instruments that minimize which primary cause of delayed wound healing?

Answer: Tissue crush injury and devitalization from traumatic handling

Crush injury from traumatic forceps and excessive tissue manipulation devitalizes tissue, impairing blood supply and increasing infection and dehiscence risk.

When passing a sharp instrument to the surgeon on the sterile field, the CRNFA should use which safety technique?

Answer: Place the instrument in a neutral zone (kidney basin) for the surgeon to pick up

The neutral zone (hands-free) technique places sharps in a designated zone for the surgeon to retrieve, preventing direct hand-to-hand transfer and reducing needlestick injuries.

Suture ligation (stick tie) is preferred over a free tie for vessel hemostasis when the vessel:

Answer: Is large or in a location where a free tie could slip off before it is secured

A suture ligation (stick tie) anchors the suture through the tissue around the vessel, preventing slippage that could occur with a free tie on a large or deep vessel.

Which bipolar energy device is capable of sealing vessels up to 7 mm in diameter reliably?

Answer: LigaSure vessel sealing system

The LigaSure system uses a combination of bipolar electrical energy and pressure to fuse vessel walls, reliably sealing vessels up to 7 mm without clips or sutures.

Which patient position change should the CRNFA anticipate to prevent venous air embolism when opening the internal jugular vein during a neck dissection?

Answer: Trendelenburg (head down) position

Trendelenburg positioning increases central venous pressure in neck veins, reducing the risk of air entrainment if the internal jugular vein is inadvertently opened.