Clinical Monitoring Pt 1 (Ericksen) Exam 1 (incomplete) Flashcards by Kaitlyn McDow

Which of the following are included in the Oxygenation monitoring standards? (select 3)

a.) Electrocardiogram
b.) Clinical observation
c.) Pulse oximetry
d.) ABG’s as indicated

b.) Clinical observation
c.) Pulse oximetry
d.) ABG’s as indicated

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According to the Ventilation monitoring standards, what should be monitored every 5 minutes?

a.) Respiratory rate (RR)
b.) Blood pressure (BP)
c.) Heart rate (HR)
d.) Temperature

a.) Respiratory rate (RR)

2,3

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Which of the following are part of the Cardiovascular monitoring standards? (select 3)

a.) Electrocardiogram
b.) Auscultation as needed
c.) BP and HR every 5 minutes
d.) Chest excursion

a.) Electrocardiogram
b.) Auscultation as needed
c.) BP and HR every 5 minutes

2,3

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What method is used for monitoring Oxygenation as per AANA standards?

a) Electrocardiogram
b) Pulse oximetry
c) Blood pressure monitoring
d) Capnography

b) Pulse oximetry

2,3

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In the context of Ventilation monitoring, ETCO₂ refers to:

a) End Tidal Carbon Monoxide
b) End Tidal Carbon Dioxide
c) End Tidal Oxygen
d) End Tidal Nitrogen

b) End Tidal Carbon Dioxide

2,3

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Additional means of monitoring depend on the needs of the _______, surgical technique, or procedure.

patient

2,3

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Omission with reason must be _______.

charted

2,3

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When neuromuscular blocking agents are administered, _______ monitoring is required

neuromuscular

2,3

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T/F
Thermoregulation monitoring is only necessary when clinically significant changes in body temperature are anticipated or suspected.

True

2,3

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Which of the following conditions are associated with a left shift in the oxygen-hemoglobin dissociation curve? (select 3)

a.) Alkalosis
b.) Hypocarbia
c.) Hypothermia
d.) Acidosis
e.) Hypercarbia
f.) Hyperthermia

a.) Alkalosis
b.) Hypocarbia
c.) Hypothermia

4-7

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Factors that cause a right shift in the oxygen-hemoglobin dissociation curve include: (select 4)

a.) Hypocarbia
b.) Acidosis
c.) Hypercarbia
d.) Hyperthermia
e.) Hypothermia
f.) Increased 2,3-DPG

b.) Acidosis
c.) Hypercarbia
d.) Hyperthermia
f.) Increased 2,3-DPG

4-7

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According to the oxygen-hemoglobin dissociation curve, a PO₂ of 60 mm Hg corresponds to an O₂ saturation of approximately:

a) 100%
b) 75%
c) 90%
d) 50%

c) 90%

4-7

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At what PO2 does hemoglobin have an O2 saturation of 75%?

A) 20 mm Hg
B) 40 mm Hg
C) 60 mm Hg
D) 80 mm Hg

B) 40 mm Hg

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What is the O2 saturation of hemoglobin at a PO2 of 27 mm Hg?

A) 25%
B) 50%
C) 75%
D) 90%

B) 50%

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The Beer-Lambert law relates the transmission of light through a solution to:

a) The color of the solution
b) The concentration of the solute in the solution
c) The pH of the solution
d) The temperature of the solution

b) The concentration of the solute in the solution

4-7

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Light can be _______, absorbed, or reflected as it passes through matter.

transmitted

4-7

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According to the Beer-Lambert law, light absorption must be measured at wavelengths that are proportional to the number of _______.

solutes

4-7

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What is the relationship between concentration and light absorption? (Select all that apply)

A) Low concentration leads to high absorption
B) High concentration leads to high absorption
C) Low concentration leads to low absorption
D) High concentration leads to low absorption

B) High concentration leads to high absorption
C) Low concentration leads to low absorption

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How does the light path length affect absorption? (Select all that apply)

A) Less light path length results in more absorption
B) More light path length results in more absorption
C) Less light path length results in less absorption
D) More light path length results in less absorption

B) More light path length results in more absorption

C) Less light path length results in less absorption

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Which of the following types of hemoglobin are present in adult blood? (select 4)

a.) Oxyhemoglobin (O₂Hb)
b.) Reduced Hb (Deoxyhemoglobin, deO₂Hb)
c.) Methemoglobin (metHb)
d.) Carboxyhemoglobin (COHb)

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Co-oximetry is considered the gold standard for measuring which of the following? (select 3)

a.) Blood glucose
b.) Oxyhemoglobin (O₂Hb)
c.) Carboxyhemoglobin (COHb)
d.) Methemoglobin (metHb)
e.) Serum electrolytes

b.) Oxyhemoglobin (O₂Hb)
c.) Carboxyhemoglobin (COHb)
d.) Methemoglobin (metHb

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What wavelength of light is primarily absorbed by deoxyhemoglobin (deO₂Hb)?

a) 660 nm (red)
b) 940 nm (infrared)
c) 600 nm (orange)
d) 700 nm (near infrared)

a) 660 nm (red)

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Which type of hemoglobin absorbs more infrared light than deoxyhemoglobin?

a) Carboxyhemoglobin
b) Methemoglobin
c) Oxyhemoglobin (O₂Hb)
d) Fetal hemoglobin

c) Oxyhemoglobin (O₂Hb)

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The pulsatility of arterial blood flow is used to estimate _______.

SaO₂ (arterial oxygen saturation)

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The ratio of AC to DC light absorption is used to calculate the _______ of hemoglobin.

oxygen saturation | 10

The following types of hemoglobin can be distinguished using co-oximetry: (select 4) a.) Oxyhemoglobin (O₂Hb) b.) Deoxyhemoglobin (deO₂Hb) c.) Carboxyhemoglobin (COHb) d.) Methemoglobin (metHb) e.) Fetal hemoglobin (HbF)

a.) Oxyhemoglobin (O₂Hb) b.) Deoxyhemoglobin (deO₂Hb) c.) Carboxyhemoglobin (COHb) d.) Methemoglobin (metHb) | 10

What is the gold standard method if oximetry is inaccurate? a) Capnography b) Arterial blood gas (ABG) c) Co-oximetry d) Spirometry

c) Co-oximetry | 10

Which components affect light absorption in pulse oximetry? (select all that apply) a.) Skin b.) Soft tissue c.) Venous blood d.) Arterial blood e.) Capillary blood

all of the above | 10

Carboxyhemoglobin (COHb) absorbs light in the 660 nm range similarly to which type of hemoglobin? a) Deoxyhemoglobin b) Methemoglobin c) Oxyhemoglobin d) Fetal hemoglobin

c) Oxyhemoglobin | 11

What effect does an increase in Carboxyhemoglobin (COHb) have on SpO₂ readings? a) It decreases SpO₂ readings b) It has no effect on SpO₂ readings c) It falsely elevates SpO₂ readings d) It decreases accuracy of SpO₂ readings but doesn't change the value

c) It falsely elevates SpO₂ readings | 11

Each 1% increase of COHb will increase SpO₂ by _______.

1% | 11

Many smokers have more than _______% COHb in their blood.

6% | 11

Detection of which type of hemoglobin saturation due to venous blood pulsations results in a reduction of presumed arterial SpO₂? a) Carboxyhemoglobin b) Methemoglobin c) Deoxyhemoglobin d) Oxyhemoglobin

d) Oxyhemoglobin | 11

Venous blood pulsations can cause the detection of venous O₂Hb saturation, resulting in a reduction of presumed arterial _______.

SpO2 | 11

How can ambient light interference in pulse oximetry usually be resolved? a.) By alternating red/infrared light b.) By using ultraviolet light c.) By increasing the light intensity d.) By using blue light

a.) By alternating red/infrared light | 12

Which issue is specifically related to low perfusion in pulse oximetry? a) Falsely elevated SpO₂ readings b) Reduced signal amplitude c) Increased signal noise d) Overestimation of venous oxygen saturation

b) Reduced signal amplitude | 12

Very new pulse oximeters use up to _______ wavelengths to address additional light absorbers.

12 | 12

What is the accuracy range of pulse oximetry when measured against arterial blood gases (ABGs) with a saturation greater than 70%? a) +/- 1% b) +/- 2% c) +/- 3% d) +/- 5%

b) +/- 2% | 13

Which of the following are reasons why pulse oximetry is considered economical? (select 3) a.) It uses reusable probes b.) It requires frequent calibration c.) It is battery-operated d.) It is noninvasive, reducing the need for additional supplies e.) It involves high initial setup costs

a.) It uses reusable probes c.) It is battery-operated d.) It is noninvasive, reducing the need for additional supplies | 13

The use of tone modulation in pulse oximetry helps in quickly assessing a patient's _______ status.

oxygenation | 13

Which of the following is an advantage of pulse oximetry in monitoring patients during surgery? a) Delayed detection of hypoxic events b) Non-continuous monitoring c) Affected by anesthetic vapors d) Provides continuous and real-time monitoring

d) Provides continuous and real-time monitoring | 13

Optical interference, such as from _______ and _______ can affect the accuracy of pulse oximetry readings.

* nail polish * covering | 14

In what situation might pulse oximetry give inaccurate readings due to motion artifact? a) Patient is lying still b) Patient has stable perfusion c) Patient is shivering or moving d) Patient is sedated

c) Patient is shivering or moving | 14

T/F One disadvantage of pulse oximetry is that it functions poorly in conditions of low perfusion.

True | 14

15-30

Which of the following characteristics change as the pressure wave moves to the periphery, away from the heart? Select all that apply (2) A) Arterial upstroke becomes steeper B) Systolic peak becomes lower C) Dicrotic notch appears earlier D) End-diastolic pressure becomes lower E) Arterial upstroke becomes slower

A) Arterial Upstroke becomes steeper D) End-diastolic pressure becomes lower **systolic peak becomes higher & Dicrotic notch appears later** | *slide 31*

Which of the following statements about the creation of waveforms are true? Select all that apply -4. A) Waveforms are created by the summation of sine waves B) Only the fundamental wave is needed for a typical arterial pressure wave C) Fourier analysis helps in the analysis of summation of multiple sine waves D) Typically, 6 to 10 harmonics are required for most arterial pressure waveforms E) The projection of waveforms on screens is due to Fourier analysis

A) Waveforms are created by the summation of sine waves C) Fourier analysis helps in the analysis of summation of multiple sine waves D) Typicall, 6-10 harmonics are required for most arterial pressure waveforms E) The projection of waveforms on screens is due to Fourier Analysis | *slide 32*

The typical arterial pressure wave is a result of the combination of which types of waves? A) Longitudinal and transverse waves B) Fundamental wave and harmonic waves C) Standing wave and traveling wave D) Electromagnetic waves

B) Fundamental wave and harmonic waves | *slide 32*

What does the presence of several bounces after a fast flush indicate about the arterial line setup? A) It is correct and functioning properly B) It is overdamped C) It is underdamped D) It is not connected

C) It is underdamped | *slide 33*

The square wave test involves performing a fast flush. What is this test used to evaluate? A) The patient's blood pressure B) The integrity of the arterial line setup C) The heart rate D) The oxygen saturation level

B) The integrity of the arterial line setup | *slide 33*

During a square wave test, what is the maximum number of oscillations that should be observed after a fast flush? A) 1 B) 3 C) 4 D) 2

D) 2 | *slide 33*

Which of the following are characteristics of an underdamped arterial line system? Select all that apply (3) A) Elevated systolic pressure B) Decreased systolic pressure C) Several dicrotic notches D) Multiple oscillations after the fast flush E) Loss of detail in the waveform

A) Elevated Systolic Pressure C) Several Dicrotic notches D) Multiple oscillations after the fast flush | *slide 34*

Which of the following are characteristics of an overdamped arterial line system? Select all that apply (3) A) Elevated systolic pressure B) Decreased systolic pressure C) Absent dicrotic notch D) Multiple oscillations after the fast flush E) Falsely narrowed pulse pressure

B) Decreased systolic pressure C) Absent Dicrotic Notch E) Falsely narrowed pulse pressure | *slide 34*

Select all conditions that can lead to changes in the pressure gradient within blood vessels: select 3 A) Atherosclerosis B) Hypothermia C) Increased vessel distensibility D) Septic shock

A) Atherosclerosis, B) Hypothermia D) Septic shock | *slide 35*

Which of the following are consequences of decreased vessel compliance due to aging? (Select all that apply-2) A) Increased systolic blood pressure B) Increased distensibility C) Decreased diastolic blood pressure D) Lower peripheral vascular resistance

A) Increased systolic blood pressure C) Decreased diastolic blood pressure | *slide 35*

What are complications from the arterial line (3) A) Distal ischemia B) Local infection C) Increased flow to the limb D) Arterial embolization

A) Distal ischemia B) Local infection D) Arterial embolization **also hemorrhage/hematoma & peripheral neuropathy** | *slide 36*

Select all conditions that may cause peripheral neuropathy from an arterial line: select 2 A. Hemorrhage B. Catheter being left in too long C. Decreased flow D. Sepsis

B) Catheter being left in too long C) Decreased flow | *slide 36*

One of the most common complications of arterial lines is __________ and __________.

hemorrhage, hematoma | *slide 36*

What can pressure waveform analysis help identify in patients? A. Presence of residual preload reserve B. Cardiac output levels C. Oxygen saturation levels D. Blood glucose levels

A. Presence of residual preload reserve | *slide 37*

Pressure waveform analysis is used to determine if a patient can tolerate a: A. Blood transfusion B. Fluid bolus/challenge C. Medication adjustment D. Ventilator setting change

B. Fluid bolus/challenge | *slide 37*

Cyclic arterial blood pressure variations due to respiratory-induced changes in intrathoracic pressure can be observed during: A. Iron Lung Therapy B. Spontaneous breathing C. Positive pressure ventilation (PPV) D. Use of a Mapleson circuit

C. Positive pressure ventilation (PPV) | *slide 37*

Pressure waveform analysis can be used to assess which of the following in patients? (Select all that apply - 3) A. Hemodynamic stability B. Hydration status (Are they dry?) C. Pulmonary function D. Residual preload reserve

A. Hemodynamic stability B. Hydration status (Are they dry?) D. Residual preload reserve | *slide 37*

Select all effects of increasing intra-thoracic pressure during the inspiratory phase: select 5 A) Decreased LV preload B) Decreased systemic venous return C) Increased RV afterload D) Increased total lung volume E) Decreased RV preload F) Decreased LV stroke volume G) Decreased systemic arterial pressure H) Increased pulmonary vascular resistance (PVR)

B. Decreased systemic venous return C. Increased RV afterload D. Increased total lung volume E. Decreased RV preload H. Increased pulmonary vascular resistance (PVR) | *slide 38*

During the inspiratory phase, what happens to intra-thoracic pressure and LV afterload? A. Both increase B. Intra-thoracic pressure increases and LV afterload decreases C. Both decrease D. Intra-thoracic pressure decreases and LV afterload increases

B. Intra-thoracic pressure increases and LV afterload decreases | *slide 38*

What effect does increased total lung volume during the inspiratory phase have on LV preload? A. It decreases LV preload B. It has no effect on LV preload C. It increases LV preload D. It stabilizes LV preload

C. It increases LV preload | *slide 38*

Which of the following occurs as a result of increased LV preload and decreased LV afterload? A. Decreased LV stroke volume B. Decreased cardiac output (CO) C. No change in systemic arterial pressure D. Increased LV stroke volume, CO, and systemic arterial pressure

D) Increased LV stroke volume, CO, and systemic arterial pressure | *slide 38*

What happens to systemic venous return and RV preload as intra-thoracic pressure increases? A. Both increase B. Both decrease C. Systemic venous return increases, RV preload decreases D. Systemic venous return decreases, RV preload increases

B. Both decrease | *slide 38*

Select all effects of the expiratory phase on the cardiovascular system: select 3. A. Decreased RV stroke volume B. Increased LV stroke volume C. Reduced LV filling D. Decreased systemic arterial blood pressure E. Increased pulmonary blood flow

A) Decreased RV stroke volume C) Reduced LV filling D) Decreased systemic arterial blood pressure | *slide 40*

Which of the following statements are true regarding blood pressure changes during the respiratory cycle? (Select all that apply - 2) A) BP goes up on inspiration B) BP remains unchanged during the respiratory cycle C) BP decreases on inspiration and increases on expiration D) BP goes down on expiration

A) BP goes up on inspiration D) BP goes down on expiration | *slide 40*

What is the effect of the decreased RV stroke volume during expiration on the left ventricle? A) Increased LV filling B) Increased LV stroke volume C) Reduced LV filling D) Increased systemic arterial BP

C) Reduced LV filling | *slide 40*

What is the normal range of systolic pressure variation (SPV) in mechanically ventilated patients? A)7-10 mm Hg B) 3-5 mm Hg C) 10-15 mm Hg D) 15-20 mm Hg

A) 7-10 mm Hg | *slide 41*

What is the normal range for the Δ Up component of SPV in mechanically ventilated patients? A)1-2 mm Hg B) 2-4 mm Hg C) 4-6 mm Hg D) 6-8 mm Hg

B) 2-4 mm Hg | *slide 41*

What does an increased SPV indicate in mechanically ventilated patients? A) They are volume overloaded B) They have normal volume status C) They are at risk for hypertension D) They are volume responsive or have residual preload reserve

D) They are volume responsive or have residual preload reserve | *slide 41*

Which of the following statements are true regarding pulse pressure variation (PPV)? (Select all that apply - 5) A) PPV utilizes maximum and minimum pulse pressures over the entire respiratory cycle B) Normal PPV is less than 13-17% C) PPV greater than 13-17% indicates a positive response to volume expansion D) PPV readings are not affected by mechanical ventilation E) PPV greater than 13-17% can be an early indicator of hypovolemia F) PPV values are irrelevant for assessing volume status G) PPV is used to assess fluid status in patients Feel free to adjust or expand these answer choices as needed!

A) PPV utilizes maximum and minimum pulse pressures over the entire respiratory cycle B) Normal PPV is less than 13-17% C) PPV greater than 13-17% indicates a positive response to volume expansion E) PPV greater than 13-17% can be an early indicator of hypovolemia G) PPV is used to assess fluid status in patients | *slide 42*

In which scenarios would you expect a positive response to volume expansion based on PPV readings? (Select all that apply - 2) A. PPV of 10% B. PPV of 14% C. PPV of 18% D. PPV of 12%

B) PPV of 14% C) PPV of 18% | *slide 42*

When a patient has a PPV reading of 14%, the appropriate action is to: A) Give volume B) Administer a diuretic C) Monitor without intervention D) Reduce fluid intake

A) Give volume | *slide 42*

Which conditions or factors can lead to an SVV greater than 10-13%? (Select all that apply - 3) A. Hypovolemia B. Volume responsiveness C. Hypervolemia D. Residual preload reserve E. Pulmonary hypertension

A. Hypovolemia B. Volume responsiveness D. Residual preload reserve | *slide 43*

What is the normal range for stroke volume variation (SVV)? A. 5-8% B. 10-13% C. 14-17% D. 18-20%

B. 10-13% | *slide 43*

Which of the following statements is true? A. SPV can be used interchangeably with SVV. B. SVV is calculated using pulse pressure variation. C. SPV and SVV are both used to assess fluid responsiveness but are not interchangeable. D. SVV does not involve arterial pulse pressure waveform analysis.

C. SPV and SVV are both used to assess fluid responsiveness but are not interchangeable. | *slide 43*

Which of the following conditions are necessary for predicting accurate results in BP variation? (Select all that apply - 5) A. Mechanical ventilation with tidal volume of 8 to 10 mL/kg B. Positive end-expiratory pressure (PEEP) ≥ 5 mm Hg C. Irregular cardiac rhythm D. Normal intra-abdominal pressure E. An open chest cavity F. Regular cardiac rhythm G. Supine positioning

A. Mechanical ventilation with tidal volume of 8 to 10 mL/kg B. Positive end-expiratory pressure (PEEP) ≥ 5 mm Hg D. Normal intra-abdominal pressure F. Regular cardiac rhythm G. Supine Positioning | *slide 44*

Which patient conditions will make pressure waveform analysis inaccurate? (Select 3) A. Atrial fibrillation (Afib) B. Normal intra-abdominal pressure C. Trendelenburg positioning D. Closed chest cavity E. Open chest cavity

A. Atrial fibrillation (Afib) C. Trendelenburg positioning E. Open chest cavity | *slide 44*

Clinical Monitoring Pt 1 (Ericksen) Exam 1 (incomplete) Flashcards

(81 cards)