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1

One unit of PRBCs raises the Hct by _____ %?

3%

2

Identify the areas of the upper extremities that are at high risk for developing position related nerve damage?

Ulnar Neuropathy, Brachial Plexus, Radial and median nerve

3

Most common ocular injury?

Corneal Abrasion

4

main complication with the supine lithotomy position?

Airway Obstruction and decreased Tidal Volumes

5

In the supine position abdominal contents cause a decrease in the patients ________?

Functional Residual Capacity (FRC) by 25%

6

The ________ lies in close proximity to the fixed first rib, clavicle and humerus and is predisposed to compression.

Brachial plexus

7

The number one nerve injury related to positioning involve the _______?

Ulnar Nerve

8

The classic site of injury to the ulnar nerve is?

Behind the ulnar groove behind the medial epicondyle of the humerus

9

This position is associated with the greatest number of ocular injuries?

Lateral

10

When supine the arms should not be abducted greater than ______ degrees and the wrist should be _______?

90, supinated (palms up)

11

Trendelenberg postion affects the body in what manner?

Increase: CVP, ICP, Intraocular pressure
Decrease: FRC and Pulmonary compliance

12

4 ways to avoid a Brachial Plexus injury?

Keep Head Midline
Arms kept at < 90 degrees
Elbows mildly flexed
Use a non-sliding mattress for Trendelenburg

13

Reverse trendelenberg affects the body in what manner?

Decreases venous return

14

What is the biggest concern for a patient in the sitting position?

Air embolism

15

what is the best way to detect a air embolism?

Esophageal stethoscope

16

3 goals of positioning?

Maximum exposure for the surgeon
Access to the patient for ventilation and monitoring
Promote satisfactory surgical results

17

Greater then ______ hours for surgery increase position related injuries?

4-5 hours

18

_________ accounts for 89% of all postop visual loss?

Ischemic optic neuropathy (ION)

19

1 Unit of PRBCs raises the Hgb _______ ?

1 gm

20

FFP is viable for _____ and has a volume of ______ ?

1 yr, 200-250 ml

21

1 unit of Platelets increase the count by____?

5,000 - 10,000

22

For every 4 units of PRBCs give ________?

1 unit of FFP

23

For every 8 units of PRBCs give ______, _______?

2 units of FFP, 4 pack of Platelets

24

Autologous blood can be obtained by ____, ____, _____?

Predepositing, Hemodilution (removing 1-2 units immediately intraoperatively), Post-op Salvage

25

_____ is the % of red cells to the total volume of blood?

HCT

26

TRALI stands for?

Transfusion Related Acute Lung Injury

27

In an anesthetized Pt with a NMBA on board. The most likely signs we will see of a transfusion reaction are ____, ____, ____?

Free Hgb in the Urine, increase in airway peak pressures and elevation in temp

28

________ is the second most common transfusion reaction?

Transfusion Related Acute Lung Injury (TRALI)

29

Albumin 5% replaces volume in a ___ to ___ ratio?

1 to 1

30

Albumin 25% expands volume by _____ and within _____ minutes?

2.5 - 5 times and within 15 minutes

31

Most common reason for coagulopathies are?

Lack of functioning Platelets

32

What is considered an acceptable urinary output?

0.5ml/kg/hr

33

What is the formula for calculating maintenance fluid?

4 ml/kg/hr for the first 10kg
For the next 10-20 kg add 2 ml/kg/hr
for each kg above 20 add an additional 1 ml/kg/hr

34

Most common transfusion reaction is?

Febrile

35

Types of transfusion reactions are?

Febrile, Allergic, Hemolytic

36

what genetic disease benifits from the administration of cryoprecipitate?

Hemophilia A ( factor VIII deficient)

37

What is the Hct of 1 unit of PRBCs?

70% Hct 250 ml's

38

Calculate the allowable blood loss if the Hct is 40 and allowable blood loss to a Hct of 30 in a 80 kg male Pt.

Estimated Blood volume: 75ml x 80kg= 6000ml.
RBCV40%= 6000x0.4=2400
RBCV30%= 6000x0.3=1800
2400-1800=400ml
allowable blood loss =3x400=1200 ml

39

Average blood volume per kg for female is?

65 ml/kg

40

Average blood volume per kg for male is?

70-75 ml/kg

41

Intraoperative fluid replacement for insensible loss is?

2 ml/kg

42

Intraoperative fluid replacement for minimal surgical trauma is?

2-4 ml/kg

43

Intraoperative fluid replacement for severe surgical trauma is?

6-8 ml/kg

44

Intraoperative fluid replacement for moderate surgical trauma is?

4-6 ml/kg

45

For every 1 ml blood loss replace it with ____ ml of crystalloid?

3 ml

46

Treatment of Hyperkalemia could entail?

Hyperventilation, IV Calcium, or D50 Insulin and bicarb

47

Citrate in PRBC units contribute to _____ and _____?

Metabolic Alkalosis and Hypocalcemia

48

Blood stored accumulates ___, ___ and decreases in ____?

H+ ions, K+ and decreases in 2,3 DPG

49

1 liter of LR contains what electrolytes and how much?

Na 130mEq, Cl 109mEq, K 4mEq, Ca 3 mEq, Lactate 28 mEq

50

1 liter of Normal Saline contains what electrolytes and how much

Na 154 mEq and Cl 154 Meq

51

Advanced Trauma Life Support (ATLS) Classification 1 R/T Blood loss?

750 ml or less, HR <100, BP normal, RR normal, Blanch ok, UOP normal, Anxious
Replace with crystalloid.

52

Advanced Trauma Life Support (ATLS) Classification 2 R/T Blood loss?

750-1500 ml, HR >100, BP normal, RR 20-30, Blanch + , UOP 20-30, Anxious
Replace with crystalloid

53

Advanced Trauma Life Support (ATLS) Classification 3 R/T Blood loss?

1500-2000 ml, HR >120, BP decreased, Blanch + , UOP 5-15, Anxious and confused
Replace with crystalloid and blood

54

Advanced Trauma Life Support (ATLS) Classification 4 R/T Blood loss?

> 2000 ml, HR >140, BP decreased, RR >35, Blanch + , No UOP, Anxious and confused and lethargic
GIVE BLOOD and crystalloid

55

A soaked 4x4 is equal to ____ ml?

10 ml

56

A soaked Lap pad is equal to ____ ml?

100-150 ml

57

Platelets are usually given when the count is less then _______?

50,000

58

Crystalloid intravascular half-life is?

20-30 min

59

Colloid intravascular half-life is between ____?

3-6 hrs

60

NPO deficit is given how much the first, second, and third hour?

1st hour give 1/2 the total NPO deficit
2nd hour give 1/4 the total NPO deficit
3rd hour give 1/4 the total NPO deficit

61

General rule of thumb after how many units of PRBCs do you give Ca+?

2 units