Pearson Edexcel International
A+ Graded Paper
CNOR 2025 Zander Notes-Comprehensive
Study Resources– 100% Verified Q&A for
Success
Questions and Mark scheme
Version: Final
,What is Dry Heat sterilization used for: - ✔✔Powder & Oils
-Also burrs (dentist), needles (tattoo), glass
Dry Heat Sterilization settings:
Temp
Time
Material: - ✔✔Temp: 360-400
Time: 50-60 min
HIGH AND DRY
Material: Must use special packaging for dry heat only.
NO TAPE
What has to be documented and traceable for EACH item sterilized? - ✔✔LOT Control #
Load/Cycle #
Date
Time
Instrument Tracking System: - ✔✔-Items should be traceable from the method to the patient.
-CDC requires infection rates on certain things (Totals, Colons)
-This may require Infectious Disease to look at commonalities
What kind of spore testing for EO & Dry Heat - ✔✔BA / Bacillus Atropheus
DRY EOBA
What type of sterilization requires Bacillus Atropheus spore tests - ✔✔Dry Heat & EO
DRY EOBA
What type of sterilization requires Geo Stearo - ✔✔Anything NOT DRY NOT EO
-PreVac/Dynamic, Gravity, Plasma, Ozone, Paracetic Acid,
What happens in DIC?
What causes it? - ✔✔Inflammatory response causes clotting, and then hemorrhage.
Clotting --> BLEEDING
- Caused by tissue factor getting into the system. Eventually there isn't anymore TF available, so the pt
hemorrhages.
What are 2 causes of DIC? - ✔✔1- Systemic Response
> Trauma (large injuries or multiple injuries, leaving a wound open with a wound vac, trauma)
> Sepsis
> OB - Amniotic fluid
2- Procoagulant is released into the blood stream
(Bone tumor)
,Complications of DIC - ✔✔- SEVERE bleeding (nose, old wounds, IV site, surgery site)
- Stroke
- Kidney and liver damage and overload (dialysis for life)
- Organs and spinal cord don't get enough blood flow
> paraplegic
What are 4 ways to correct DIC? - ✔✔- Fix the cause. Sew up the holes, and stop TF from entering the vascular
system.
- FFP & Cryoprecipitates (infuse clot factors)
- Volume/blood replacement after hemorrhage
- Heparin can be given early on
> Draw serial PTTs qh or q2h. Watch for trends/shorter clot times. PTT 37...35...32...
What are common procedures that can result in a venous air embolism? - ✔✔- Neuro in sitting position
- Hysteroscopy
- TURP
Why are venous air embolisms common in neuro procedures? - ✔✔- Pt is in sitting position
- Pressure in RA is lower than atmospheric pressure
- So dura veins don't collapse, and air enters vasc system if surgeon misses it.
Why are venous air embolisms common in hysterscopes and TURPs? - ✔✔They are vascular, hollow organs
with fluid under pressure being pumped into them.
If air under pressure is in the circuit it can be pushed into the vasc system.
What is at risk during a hysteroscopy? - ✔✔Venous Air Embolism
* Also important to support the instruments in the cervix...more common to have an air embolism with cervical
tear from unsupported instruments (?)
What are common causes of an arterial air embolism (2)? - ✔✔- Cardiac bypass
- Dialysis
(Both are pushing air IN)
What are signs of an air embolism (4) - ✔✔> Rapid onset Pulmonary Edema (alveoli can't exchange O2)
> CO2 DROPS
> SpO2 drops
> BP drops
...head damage...no O2
Differences between treating venous air embolism vs arterial? - ✔✔Venous = Durants maneuver (Left Lateral,
HOB up a little)
, Arterial= Deep Trendelenburg (head DOWN)
What position for a venous air embolism? - ✔✔**Venous Air Embolism = Durant's Maneuver
LEFT Lateral - HOB up
Aspirate RA with a cath via echo-
What are some precautions to prevent a venous air embolism? (3) - ✔✔- Neuro: Occlude entry points. Have
sloppy wet sponges and an irrigation syringe on the field.
> Irrigate --> Detect --> Occlude Vessel
- Bone Wax in open bone.
- D/C Nitrous Oxide (makes tiny bubbles one big bubble)
What should not be used in the case of a venous air embolism? - ✔✔Nitrous Oxide (makes tiny bubbles one
BIG bubble)
What should be done if arterial air embolism is detected (ex: during cardiac bypass, or dialysis) - ✔✔-Deep
Trendelenburg
-Aspirate air from the circuit.
A AWAY.
Want to keep the air away from the heart
Common cause of cardiac arrest in surgery: - ✔✔Blood loss --> Hypovolemic shock
What should the RN do in the case of cardiac arrest? - ✔✔1. CALL FOR HELP
2. Get the defibrillator
3. Start documenting
>Meds (time and dose)
>Rhythms
>CPR start and stop time
4. Take orders from 1 doctor and know who is running the code
Mnemonic for cardiac emergencies: - ✔✔OMI
Oxygen
Monitors
IV fluids
In the case of an emergent inadequate HR or BP, what would be steps to anticipate: - ✔✔- CPR
- Defibrillator
- Epinephrine (for the BP)
- Amiodarone (heart food, for contractility)
An inadequate HR/BP indicates a ventricular rhythm issue (not perfusing)
In the case of a cardiac emergency with an adequate HR, what would be steps to anticipate? - ✔✔Medications...
A+ Graded Paper
CNOR 2025 Zander Notes-Comprehensive
Study Resources– 100% Verified Q&A for
Success
Questions and Mark scheme
Version: Final
,What is Dry Heat sterilization used for: - ✔✔Powder & Oils
-Also burrs (dentist), needles (tattoo), glass
Dry Heat Sterilization settings:
Temp
Time
Material: - ✔✔Temp: 360-400
Time: 50-60 min
HIGH AND DRY
Material: Must use special packaging for dry heat only.
NO TAPE
What has to be documented and traceable for EACH item sterilized? - ✔✔LOT Control #
Load/Cycle #
Date
Time
Instrument Tracking System: - ✔✔-Items should be traceable from the method to the patient.
-CDC requires infection rates on certain things (Totals, Colons)
-This may require Infectious Disease to look at commonalities
What kind of spore testing for EO & Dry Heat - ✔✔BA / Bacillus Atropheus
DRY EOBA
What type of sterilization requires Bacillus Atropheus spore tests - ✔✔Dry Heat & EO
DRY EOBA
What type of sterilization requires Geo Stearo - ✔✔Anything NOT DRY NOT EO
-PreVac/Dynamic, Gravity, Plasma, Ozone, Paracetic Acid,
What happens in DIC?
What causes it? - ✔✔Inflammatory response causes clotting, and then hemorrhage.
Clotting --> BLEEDING
- Caused by tissue factor getting into the system. Eventually there isn't anymore TF available, so the pt
hemorrhages.
What are 2 causes of DIC? - ✔✔1- Systemic Response
> Trauma (large injuries or multiple injuries, leaving a wound open with a wound vac, trauma)
> Sepsis
> OB - Amniotic fluid
2- Procoagulant is released into the blood stream
(Bone tumor)
,Complications of DIC - ✔✔- SEVERE bleeding (nose, old wounds, IV site, surgery site)
- Stroke
- Kidney and liver damage and overload (dialysis for life)
- Organs and spinal cord don't get enough blood flow
> paraplegic
What are 4 ways to correct DIC? - ✔✔- Fix the cause. Sew up the holes, and stop TF from entering the vascular
system.
- FFP & Cryoprecipitates (infuse clot factors)
- Volume/blood replacement after hemorrhage
- Heparin can be given early on
> Draw serial PTTs qh or q2h. Watch for trends/shorter clot times. PTT 37...35...32...
What are common procedures that can result in a venous air embolism? - ✔✔- Neuro in sitting position
- Hysteroscopy
- TURP
Why are venous air embolisms common in neuro procedures? - ✔✔- Pt is in sitting position
- Pressure in RA is lower than atmospheric pressure
- So dura veins don't collapse, and air enters vasc system if surgeon misses it.
Why are venous air embolisms common in hysterscopes and TURPs? - ✔✔They are vascular, hollow organs
with fluid under pressure being pumped into them.
If air under pressure is in the circuit it can be pushed into the vasc system.
What is at risk during a hysteroscopy? - ✔✔Venous Air Embolism
* Also important to support the instruments in the cervix...more common to have an air embolism with cervical
tear from unsupported instruments (?)
What are common causes of an arterial air embolism (2)? - ✔✔- Cardiac bypass
- Dialysis
(Both are pushing air IN)
What are signs of an air embolism (4) - ✔✔> Rapid onset Pulmonary Edema (alveoli can't exchange O2)
> CO2 DROPS
> SpO2 drops
> BP drops
...head damage...no O2
Differences between treating venous air embolism vs arterial? - ✔✔Venous = Durants maneuver (Left Lateral,
HOB up a little)
, Arterial= Deep Trendelenburg (head DOWN)
What position for a venous air embolism? - ✔✔**Venous Air Embolism = Durant's Maneuver
LEFT Lateral - HOB up
Aspirate RA with a cath via echo-
What are some precautions to prevent a venous air embolism? (3) - ✔✔- Neuro: Occlude entry points. Have
sloppy wet sponges and an irrigation syringe on the field.
> Irrigate --> Detect --> Occlude Vessel
- Bone Wax in open bone.
- D/C Nitrous Oxide (makes tiny bubbles one big bubble)
What should not be used in the case of a venous air embolism? - ✔✔Nitrous Oxide (makes tiny bubbles one
BIG bubble)
What should be done if arterial air embolism is detected (ex: during cardiac bypass, or dialysis) - ✔✔-Deep
Trendelenburg
-Aspirate air from the circuit.
A AWAY.
Want to keep the air away from the heart
Common cause of cardiac arrest in surgery: - ✔✔Blood loss --> Hypovolemic shock
What should the RN do in the case of cardiac arrest? - ✔✔1. CALL FOR HELP
2. Get the defibrillator
3. Start documenting
>Meds (time and dose)
>Rhythms
>CPR start and stop time
4. Take orders from 1 doctor and know who is running the code
Mnemonic for cardiac emergencies: - ✔✔OMI
Oxygen
Monitors
IV fluids
In the case of an emergent inadequate HR or BP, what would be steps to anticipate: - ✔✔- CPR
- Defibrillator
- Epinephrine (for the BP)
- Amiodarone (heart food, for contractility)
An inadequate HR/BP indicates a ventricular rhythm issue (not perfusing)
In the case of a cardiac emergency with an adequate HR, what would be steps to anticipate? - ✔✔Medications...
