CO2 Absorbers: Principles Exam 2
What is the average maximum CO2 produced by an adult? a) 12-18 L/hr b) 14-16 L/hr c) 12-14 L/HR D) 10-12 L/HR
A
What is the composition of Baralyme? a) 80% CaOH & 20% BaOH b) 20% CaOH & 80% BaOH c) None of the Above
A
What is the reduction of a chemical compound to one less complex, as by splitting off one or more groups called? a) Degradation b) Recycling c) Reduction d) Degeneration
A
Which of the following is the *most* common Absorbent used in Anesthesia? a) Soda Lime/Sodasorb b) Medisorb c) Drägersorb 800 Plus d) Amsorb Plus e) Litholyme
A
At what percentage is Sevoflurane in oxygen very flammable? a) 5% b) 10% c) 11% d) 15%
C
How do CRNA's minimize the production of Compound A? a) Do not use Baralyme b) Do not use flows less than 1-2 L/minute for greater than 2 MAC hours with sevoflurane c) A & B
C
How is Compound A made? a) Degradation of Halothane to a vinyl ether b) Degradation of Isoflurane to a vinyl ether c) Degradation of Sevoflurane to a vinyl ether d) Degradation of Enflurane to a vinyl ether
C
In the presence of total re-breathing, how many hours should the top canister of a double canister system last? a) 4-8 hrs b) 10-12 hrs c) 8-10 hrs d) 12-14 hrs
C
What are 2 advantages of a Re-Breathing system? a) Conserves heat and humidity b) Conserves Anesthetic Gases c) A & B
C
T or F: Absorb CO2 from exhaled gases to allow patient to re-breath gases.
True
T or F: Absorbent can absorb and later release anesthetic agents potentially affecting induction and emergence.
True
T or F: Color change not a reliable indicator of absorber exhaustion.
True
T or F: Interactions between Sevoflurane and absorbents have lead to canister fires.
True
The CRNA must don __________________ when changing out canisters due to increased. risk of airway irritation from alkaline dust which can result in bronchospasm. a) hat b) goggles c) gloves d) mask
D
Which of the following statements correctly describes how CO2 Absorbers work? a) A chemical reaction where a base neutralizes an acid b) Neutralization reaction of CO2 c) The base used is a hydroxide of an alkali or alkaline earth metal that neutralizes the carbonic acid d) All of the Above
D
What increases the degradation of Sevoflurane to a vinyl ether resulting in Compound A? a) Low Fresh Gas Flows < 2L/min b) Baralyme c) High concentrations of Sevoflurane d) Longer duration of anesthesia with Sevoflurane administration e) Higher absorbant temperatures f) Drying out of the absorbent g) All of the Above
G
Name one disadvantage of a re-breathing system.
Hyper-carbia if no method of CO2 removal
A Blend of large and small granules has proven to be the most effective. Smaller provides ________ surface area and larger provides optimal absorbent granules that __________ resistant to gas flow.
More Decrease
When changing out canisters, the CRNA should always don what items: a) gloves b) mask c) goggles d) hat e) gown
A-B
Which of the following are the 2 correct compositions for Soda Lime? a) 94% calcium hydroxide (CaOH) b) 4% sodium hydroxide (NaOH) c) 4% calcium hydroxide (CaOH) d) 94% sodium hydroxide (NaOH)
A-B
What is located on the inspiratory limb of the breathing circuit prevents _____________ ____________ from getting to the patient.
Alkaline dust
What should the CRNA always remember to do prior to inserting a new canister?
Always, Always remove the wrapper from the canister.
Dried-out absorbent can degrade volatile anesthetics into what substance? a) Carbon Dioxide b) Carbon Monoxide c) Compound A d) Compund C
B
Soda Lime is capable of absorbing ____________ liters of CO2 per 100 grams of absorbent. a) 13-26 L b) 23-26 L c) 26-36 L
B
What water content is the proper amount in CO2 Absorbers? a) 4-10% b) 14-20% c) 24-30%
B
T or F: If changing a dual canister, it is okay for the CRNA to do so during a case.
False, do not change during a case.
Degradation of Volatile Anesthetics by CO2 Absorbent product what 2 substances? a) Carbon Dioxide b) Carbon Monoxide c) Compound A d) Compound C
B-C
Alkaline dust from absorbers, if inspired, have the potential to cause the CRNA and/ or patient what complication? a) Head-ache b) Eye irritation c) Bronchospasm
C
To prevent fires on the OR, after returning from having the weekend off, the CRNA should do what to anesthesia absorber?
Change the canister
What are the flammable byproducts of Sevoflurane? a) CO b) Methanol c) Formaldehyde d) All of the Above
D- *CO*ME *FOR* *ME*
Order these volatiles from *most* to *least* degradation to CO2. Desflurane Halothane Enflurane Isoflurane Sevoflurane
D-E-I-S=H
How can the CRNA prevent fires in the OR? a) Turn off O2 between cases b) Turn off your anesthesia machine at the end of the day c) If an anesthesia machine has not been used in a while, replace the absorbent before use. d) Monitor the temperature of CO2 canisters e) All of the Above
E
What are the end products of a CO2 Absorber? a) Bicarbonate b) H2O c) Carbonate d) A & B e) B & C
E
Which of the following produce higher levels of carbon monoxide? a) Higher temperatures in the absorber b) Higher anesthetic concentrations c) Longer cases d) Use of baralyme rather than soda lime e) All of the Above
E
Which of the following statements regarding Color Indicators for CO2 Absorbents are true: a) pH dependent indicator dyes b) provide a visual cue of absorber exhaustion c) use Ethyl violet most commonly d) color change not a reliable indicator of absorber exhaustion e) All of the Above
E
T or F: Smaller granules decrease resistance to flow and larger granules provide more surface area.
False, *smaller* granules provide *more surface area* and *larger* granules *decrease* the *resistance* to flow.
What are the clinical signs of CO2 Absorber Exhaustion? a) Increase in HR b) Increase in BP c) Respiratory Acidosis d) Increased bleeding at surgical site e) Increased end-tidal CO2 f) Flushed skin g) Diaphoresis h) Arrhythmias i) Hyperpnea j) Just kidding, they are all clinical signs
J
A blend of _____________ and ______________ granules has proven to be the most effective.
Large Small
Irregular surface size of CO2 granules provides __________________ surface area for absorption.
Maximum
What component is essential for CO2 conversion to H2CO3?
specific water