Clinical Office Procedures Ch 3 – Flashcards
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A bacterial spore consists of a hard, thick-walled capsule that can resist adverse conditions
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true
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The purpose of sanitization is to remove all microorganisms and spores from a contaminated article
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false
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According to OSHA, gloves do not need to be worn during the sanitization process
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false
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Glutaraldehyde (Cidex) is a high-level disinfectant
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true
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OSHA recommends a 10% bleach solution for decontaminating blood spills
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?
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Sterilization is the process of destroying all forms of microbial life except for bacterial spores
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false
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Autoclave tape indicates whether an autoclaved item is sterile
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false
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The wrapper used to autoclave articles should prevent contaminants from getting in during handling and storage
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true
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Tap water should be used in an autoclave
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false
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The inside if the autoclave should be wiped every day with a damp cloth
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true
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The agent used to destroy microorganisms on an article of depends on the size of the article
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?
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The purpose of the Hazard Communications Standard is to make sure that employees do not use hazardous chemicals in the workplace
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false
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The Hazard Communications Standard requires that the label of hazardous chemical include information on how to store and handle the chemicals
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false
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Stethoscopes must be decontaminated using a high level disinfectant
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false
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Protective eyewear must be worn when working with isopropyl alcohol
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?
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The shelf life of a disinfectant indicates how long a disinfectant retains its effectiveness
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true
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The best means of determining the effectiveness of the sterilization process are biologic indicators
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true
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The proper time for sterilizing an article in the autoclave depends on what is being autoclaved
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true
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A pack that has been in the storage cupboard for 4 weeks should be re-sterilized
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?
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Ethylene oxide gas is used by medical manufacturers to sterilize disposable items
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true
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Antiseptic
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A substance that kills disease-producing microorganisms but not their spores (usually applied to living tissues)
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Autoclave
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An apparatus for the sterilization of materials, using steam under pressure
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Contaminate
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To soil, stain, pollute; to make impure
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Critical Item
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To soil, stain, pollute; to make impure
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Decontaminate
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The use of physical or chemical means to remove or destroy pathogens on an item so that it is no longer capable of transmitting disease, making it safe to handle
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Detergent
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An agent that cleanses by emulsifying dirt and oil
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Disinfectant
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An agent used to destroy pathogenic microorganisms but not their spores (usually applied to inanimate objects)
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Hazardous chemical
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Any chemical that presents a threat to the health and safety of an individual coming into contact with it
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Incubate
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To provide proper conditions for growth and development
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Load
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The articles that are being sterilized
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Material Safety Data Sheets
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A sheet that provides information regarding a chemical and its hazards, and measures to take to avoid injury and illness when handling the chemical
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Noncritical item
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An item that comes in contact with intact skin but not mucous membrane
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Sanitization
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A process to remove organic matter from an article and to lower the number of microorganisms to a safe level as determined by the public health requirements
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Semi-critical item
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An item that comes in contact with non-intact skin or intact mucous membranes
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Spore
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A hard, thick-walled capsule formed by some bacteria that contains only the essential parts of the protoplasm of the bacterial cell
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Sterilization
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The process of destroying all forms of microbial life, including bacterial spores
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Thermolabile
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Easily affected or changed by heat
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How does one determine what type of physical or chemical agent to use to destroy microorganisms on an article
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?
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List 2 disease that are caused by bacteria that produce spores
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a. (botulism) Clostridium botulinum b. (tetanus) Clostridium tetani
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What is the purpose of the Hazard Communications Standard
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Ensure that employees are informed of the hazards associated with chemicals in the workplace
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List 4 examples of the hazardous chemicals that may be used in a medical office
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a. Glutaraldehyde b. Chlorine c. Phenolics d. Quaternary ammonium compounds
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What information must be included on a hazardous chemical label as required by the Hazard Communications Standard
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Label must include the possible hazards of the chemical and the steps that can be taken to protect against those risks
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List and describe the information that must be included in a Material Safety Data Sheet
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Contains info regarding the chemical, its hazards and measures to take to prevent injury while handling the chemical
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What is the purpose of sanitizing an article
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To prevent cross-contamination
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What is the advantage of using the ultrasound method to clean instruments
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Instruments don't have to be handled during the cleaning process
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Why should gloves be worn during the sanitization procedure
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To prevent re-contamination
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What is the definition of high-level disinfection
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a. A process that destroys all microorganisms with the exception of bacterial spores b. Used on semi-critical items
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List 1 example of an item that required high-level disinfection and 1 example of a high-level disinfectant
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a. Fiberoptic sigmoidoscope b. 2% glutaraldehyde (Cidex)
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List 2 examples of items that can be disinfected through intermediate-level disinfection and list 1 example of an intermediate-level disinfectant
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a. Stethoscope, blood pressure cuffs, tuning forks, percussion hammers, crutches b. Isopropyl alcohol
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List 2 examples of items that are disinfected by low-level disinfection
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Examining tables, laboratory counters, walls
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What disinfectant does OSHA recommend for the decontamination of blood spills
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Household bleach
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Why is it important to remove all organic matter from an article before it is disinfected
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?
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Explain the difference between the shelf life and use life of a chemical disinfectant
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a. Shelf life = how long a chemical disinfectant can be stored before use and still be effective b. Use life = period of time a disinfecting solution is effective after it has been activated
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What is the purpose of the pressure used in the autoclaving process
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Used to attain a higher temperature
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Why is it important that all air be removed from the autoclave during the sterilization process
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When air is present, the temperature is reduced
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What are the most common temperature and pressure used to sterilize materials with the autoclave
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Usually operated at 15 pounds of pressure per square inch at a temp of 250 F
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What information does the CDC recommend be recorded in an autoclave log regarding each cycle
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?
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What is the function of a sterilization indicator
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a. Determine the effectiveness of the process b. Makes sure sterilization occurred
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What is the purpose of wrapping articles to be autoclaved
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Wrapping is to protect items from being re-contaminated during handling and storage
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List 2 properties of a good wrapper for use in autoclaving
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a.Should allow steam to penetrate b. Should not tear or puncture easily
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List 3 examples of wrapping material used for the autoclave, and identify an advantage of each type
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a. Sterilization paper, disposable and inexpensive b. Sterilization pouches, good visibility c. Muslin, flexible and economical
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Why is more time needed to autoclave a large minor office surgery pack
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More items or a bigger pack means it will take longer for the steam to permeate to the center
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What is event-related sterility
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The sterile pack is considered sterile indefinitely unless event occurs that interferes with sterility
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Describe the care an autoclave should receive on a daily basis
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a. Wipe outside with damp cloth and mild detergent b. Wipe inside with damp cloth c. Clean rubber gasket on door d. Inspect rubber door gasket for damage
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Why is a longer exposure period needed to ensure sterilization when using the dry-heat oven
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a. Because microorganisms and spores are more resistant to dry heat than moist heat b. Dry heat permeates more slowly and unevenly than moist heat
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What effect does moist heat have on instruments with sharp cutting edges
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Moist heat will dull sharp edges of instruments
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How does the medical manufacturing industry use ethylene oxide gas sterilization
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Used for producing pre-packaged, pre-sterilized disposable items
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What guidelines must be followed when using cold sterilization
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a. Only used chemicals that are designated sterility by US EPA b. Item must be submerged in chemical for long period of time (6-24 hours)
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When was this MSDS last revised
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8/8/13
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Is glutaraldehyde soluble in water
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yes
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Describe the appearance and odor of glutaraldehyde
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a.Bluish-green liquid b.Sharp odor
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What is the pH of glutaraldehyde
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7.5-8.5
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Is glutaraldehyde flammable
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no
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Is glutaraldehyde stable
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Stable under recommended storage conditions
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What conditions should be avoided with glutaraldehyde
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Avoid direct sunlight and temperatures above 104oF
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How can glutaraldehyde enter the body
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Skin, eyes, inhalation and ingestion
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What symptoms occur if glutaraldehyde comes in contact with skin
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Moderate irritation, may aggravate existing dermatitis
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What symptoms occur if glutaraldehyde is splashed into the eyes
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Serious eye irritant, may cause irreversible damage, which could permanently impair vision
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What symptoms occur if glutaraldehyde is inhaled
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Vapors may be severely irritating and cause stinging sensations in the eyes, nose, throat, and lungs. May aggravate pre-existing asthma
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What symptoms occur if glutaraldehyde is ingested
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May cause irritation or chemical burns of the mouth, throat, esophagus, and stomach. May cause vomiting, diarrhea, epigastric distress, headache, dizziness, faintness, mental confusion, and general systemic illness
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What preexisting conditions can an individual possess that can be aggravated by glutaraldehyde
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a. Asthma b. Dermatitis
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Does glutaraldehyde cause cancer
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no
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What are the emergency and first aid procedures for glutaraldehyde on the skin
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Wash skin with soap and water for 15 minutes. If skin redness or irritation persists, seek medical attention. Remove contaminated clothing and wash before reuse
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What are the emergency and first aid procedures for glutaraldehyde in the eyes
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Immediately flush with water for 15 minutes. Seek medical attention
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What are the emergency and first aid procedures for glutaraldehyde after inhalation
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Remove to fresh air. If irritation persists, seek medical attention
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What are the emergency and first aid procedures for glutaraldehyde after ingestion
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Do not induce vomiting. Seek medical attention immediately. Call a physician or poison Control Center
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What should be done if gluaraldehyde is spilled
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Ventilate area; wear protective gloves and eye gear. Wipe with sponge, mop, or towel. Flush with large quantities of water. Collect liquid and discard it
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What is the disposal method for glutaraldehyde
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Container must be triple rinsed and disposed of in accordance with federal, state, and/or local regulations. Used solution should be flushed thoroughly with water into sewage disposal system in accordance with federal, state and/or local regulations
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How should glutaraldehyde be stored
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Store in cool, dry place away from direct sunlight or sources of intense heat. Keep container tightly closed when not in use
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What type of ventilation is needed when working with glutaraldehyde
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Ensure adequate ventilation to maintain recommended exposed limit
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What skin and eye protection should be taken with glutaraldehyde
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a. Wear chemical-resistant protective gloves. Butyl rubber, nitrile rubber, polyethylene, or double-gloved latex b. Safety goggles or safety glasses
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If the Cidex Plus is left unopened on the shelf, when would it expire and need to be discarded
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8/7/16
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You open and activate the Cidex Plus on 9/1/14. What date should you write on the container
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9/29/14
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You next fill a disinfectant container with Cidex Plus and disinfect some articles in it. On what date would the Cidex Plus be unusable and need to be disposed of
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9/29/14
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On what date would you need to discard the rest of the container or Cidex Plus if it is not used
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9/29/14
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The medical assistant opens a hemostat before placing it in a sterilization pouch
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correct
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Tap water is used to fill the water reservoir in the autoclave
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a. Incorrect b. Water reservoir is filled with demineralized water
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When loading the autoclave, the medical assistant places glass jars in an upright positions
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a. Incorrect b. Jars and containers need to be placed on their sides with the top off
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The medical assistant places 4 sterilization pouches on top of each other in the autoclave
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a. Incorrect b. Pouches need to be at least 2-3 inches apart for maximum steam penetration
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The medical assistant places small packs to be sterilized approximately 1-3 inches apart in the autoclave
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correct
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Spore strips are placed in the autoclave where steam will penetrate them most easily
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a. Incorrect b. Spore strips should be placed in the most difficult place for steam to penetrate
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The medical assistant begins timing the load in the autoclave after the proper temperature of 250oF has been reached
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correct
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The medical assistant removes the load from the autoclave while it is still wet
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a. Incorrect b. Water/dampness makes the transfer of microorganisms easier
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The medical assistant notices a tear in one of the wrappers while removing articles from the autoclave. They rewraps and re-sterilizes the article
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correct
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The medical assistant notices that a sterilized wrapped article stored on the storage shelf has opened up. They re-tapes the pack and places it back on the shelf
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a. Incorrect b. The article needs to be re-sterilized
