Cardiac stuff to memorize part 2

Question 1

fluid challenge if SVV is >?

Answer 1

13%

Question 2

what is the a wave?

Answer 2

atrial contraction end diastole

Question 3

what is the c wave?

Answer 3

early systole, tricuspid bulging

Question 4

waht is the x descent?

Answer 4

atrial relaxation mid systole

Question 5

what is the v wave?

Answer 5

Passive atrial filling
systolic filling of the atrium late systole

Question 6

what is the y descent?

Answer 6

early ventricular filling early diastole

Question 7

Distance from RA to sublcavian vein?

Answer 7

10cm

Question 8

distance from RA to right EJ?

Answer 8

10-15

Question 9

distance from RA to righ IJ?

Answer 9

15-20

Question 10

distance to RA from femoral?

Answer 10

25-40cm

Question 11

normal RA pressure?

Answer 11

0-8

Question 12

normal RV pressure?

Answer 12

20-30/0-8

Question 13

normal PA pressure?

Answer 13

20-30/8-15

Question 14

normal PCWP/LA pressure?

Answer 14

8-12

Question 15

absolute contraindications to PAC?

Answer 15

tricuspid or pulmonic valve stenosis
RA/RV masses
Tetraology of Fallot (read up on this)

Question 16

relative contraindications to PAC?

Answer 16

severe arrhythmias (LBB, CHB)
coagulopathy
newly inserted pacer wires

Question 17

if patient has a LBB what do you need when placing a PAC?

Answer 17

external pacer becaue you can cause a RBB leader to total heart block

Question 18

who is at increased risk of endobronchial hemorrhage with PAC?

Answer 18

elderly, female, PHTN, mitral stenosis, coagulopathic, distal placement of balloon, balloon hyperinflation

Question 19

mortality rate with endobronchial hemorrhage?

Answer 19

50-70%

Question 20

how does hyperthermic CPB affect PAC?

Answer 20

increased risk of catheter migration and stiffening, pull back PAC when going on bypass

Question 21

normal distance to insert PAC from RIJ?

Answer 21

50-55cm

Question 22

how would PAC cause thrombocytopenia?

Answer 22

increased platlet consumption from heparinzed catheter

Question 23

complications of PAC

Answer 23

arrythmias
endobronchial hemorrhage
pulmonary infarction
catheter knotting and entrapment
valvular damage
thrombocytopenia
thrombus formation
balloon rupture

Question 24

What does NIRS do? where are the sensors?

Answer 24

assess perfusion and O2 delivery ot the brain. 2 sensors midline forehead

Question 25

normal NIRS reading? what ammount of change is signfificant?

Answer 25

normal value about 60s change of > 20% is significant

Question 26

intervention to improve values on NIRS readings?

Answer 26

rule out mechanical causes: head position, cannula position increase supply of O2 delivery: increase CO, BP, HGB, oxygen carrying capacity, increased PaCO2, HCT decrease demand: increase anesthetic, decrease temp

Question 27

what does transveousn pacing pace?

Answer 27

RV

Question 28

what do first, second, third, fourth, and fifth letters of pacer mean?

Answer 28

1st: chamber paced 2nd: chamber sensed 3rd: response (I, T, D, or none) 4th: progammability 5th: arrhythmia control (pacing, shock, dual, none)

Question 29

describe asynchronous mode

Answer 29

fixed rate, paces no matter what, doesn't sense the patient, can cause VT/Vfib from R on T

Question 30

What is demand mode?

Answer 30

synchronous mode. detects inrinsic activity and either triggers or inhibits pacing

Question 31

time of increased stimulation in CABG?

Answer 31

incision sternotomy and retraction sympathetic nerve dissection pericardectomy aortic cannulation laryngoscopy

Question 32

times of decreased stimulation in CABG?

Answer 32

pre incision waiting for draping and prep peripheral vein graft harvest IMA dissection Venous cannulation