Module 9 Part 2 Flashcards by Cooper Hewett

at minimum, BP should be recorded at least once every ___ minutes

5 minutes

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According to ATLS, if only the patient’s carotid pulse ispalpable, the systolicblood pressureis ___-___ mm Hg

60-70mmHg

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According to ATLS, if carotid and femoral pulses arepalpable, the systolicblood pressureis ___-___ mm Hg

70-80mmHg

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According to ATLS, and if the radial pulse is alsopalpable, the systolicblood pressureis more than ___ mmHg

80mmHg

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What is a Korotkoff sound?

auscultation of arterial pulsation when taking a manual BP

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Automated noninvasive blood pressure monitors (also known as automated sphygmomanometers) employ the ________ methodto estimate the arterial blood pressure.

oscillometric

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With peripheral NIBP measurements, as the site of measurement is moved more peripherally, the measured SP tends to ________, and the DP tends to _______

Increase

Decrease

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The correlation between calf and upper arm blood pressures was found to be poor in this patient population.

cesarean section pts

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These sounds are produced by turbulent blood flow within an artery during cuff deflation.

Korotkoff sounds

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Equation for MAP calculation

[SBP + (DBP × 2)]/3

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Calculate the MAP of a BP of 120/80

93mmHg

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_________ comprises approximately two-thirds of a normal cardiac cycle.

diastole

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The American Heart Association recommends that the bladder width for indirect blood pressure monitoring should approximate ___% of the circumference of the extremity

40%

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Bladder length should be sufficient to encircle at least ___% of the extremity

80%

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List the contraindicated scenarios (4) of NIBP use on an extremity

AV fistula
Local bone fractures
Open injury
PICC lines

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Falsely _____ BP estimates result when cuffs are too small, when cuffs are applied too loosely, or when the extremity is below heart level.

High

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Falsely _____ BP estimates result when cuffs are too large, when the extremity is above heart level, or after quick deflations

Low

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What is the name of the non-invasive finger cuff that gives continuous SBP, DBP, MAP & advanced data such as SV, SVV, CO, SVR

ClearSight finger cuff

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The gold standard for measuring BP is through ______

Art lines

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Where should the A-line transducer be leveled to?

phlebostatic axis

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Quick deflations can lead to a falsely ____ BP

Low

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After intubation, ALWAYS verify _______

Placement

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Presence of _____ reflects ventilation, pulmonary blood flow, aerobic metabolism

CO2

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measurement and quantification of CO2

Capnometry

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recording of the capnometry measurement

Capnography

continuous display of CO2 during phases of ventilation

Capnogram

______ capnography is most commonly used in the perioperative setting.

Time

How many phases are in a normal capnogram tracing?

__ - __ represents baseline CO2

A-B

__ - __ represents expiratory upstroke

B-C

__ - __ represents expiratory plateau

C-D

__ represents end-tidal concentration of CO2

__ - __ represents descent to original baseline

D-E

This portion in a normal capnogram should approximate zero

Phase 1 (or A-B)

This sample from phase 1 of a normal capnogram comes from the anatomic ________ and contains no CO2

deadspace

This phase represents the rapid passing of initial expired gas through the upper airways

Phase 2 (or B-C)

ET CO2 is measured at the end of the ______ just prior to the beginning of phase ____

plateau | phase 4

The _____ phase represents the plateau and records alveolar emptying of CO2

3rd phase

The _____ phase is displayed as the rapid decrease in CO2 concentration of sampled gas as a result of inspiration of air or O2

4th phase

In a normal capnogram, phase ____ records a mixture of anatomical deadspace and alveolar gas

Phase 2

What is the normal range for ET CO2?

35-45 mmHg

Is the 3rd phase of a capnogram shorter or longer in a spontaneously breathing pt vs a mechanically vented pt?

Shorter

What two co-morbidities are associated with a "shark fin" appearance on a capnogram?

Asthma | COPD

During CPR, you should aim for an ET CO2 goal of ____ mmHg

10 mmHg

This tracing pattern reflects ET tube disconnection, obstruction, kinked, or loss of circulatory function

Sudden loss of waveform

In a hypoventilatory pt, will you see a low or high ET CO2 on your capnogram tracing?

High

(T/F) The capnogram tracing reads 0 during peak expiration

False (peak inspiration)

ET CO2 is measured at the end of the _______ phase

Expiratory (or 3rd phase, or C-D phase)

In healthy population, difference between PaCO2 and EtCO2 < __ mmHg

5 mmHg

EtCO2 may not accurately reflect PaCO2 if pt spontaneously ventilating through ____ or ________

NC | Face mask

``` Will you see increased or decrease ET CO2 with: decreased alveolar ventilation increased CO2 production/delivery Exhausted CO2 absorber Rebreathing ```

Increased ET CO2 (be familiar with PP slide 35)

``` Will you see increased or decrease ET CO2 with: increased alveolar ventilation decreased CO2 production/delivery hyperventilation complete airway obstruction ```

Decreased ET CO2 (be familiar with PP slide 35)

ETT cuff leak will give you high or low ET CO2?

Low

Complete airway obstruction = high or low ET CO2?

Low

Circuit leak will give you a high or low ET CO2 reading?

High

Hypothermic pt will have high or low ET CO2?

Low

___________ is the standard of care for monitoring oxygenation

Pulse oximetry

Pulse ox transmittance technology is based on the ____________ Law

Beer - Lambert Law

The relationship of SaO2 and PaO2 is described by the __________ __________ curve

Oxyhemoglobin dissociation curve

High SaO2 values cannot distinguish between normo-hyper oxygenation, which is very important in _________ patients

neonate

Variations in pulse ox amplitude in the plethysmographic waveform may predict _______ __________

fluid responsiveness

The incidence of hypoxemia ranges from ___ to ___ times less in patients monitored with pulse oximetry.

1.5-3 times

When SpO2 is 80-100%, readings from the pulse ox will be within approximately -+ __%

+- 2%

When SpO2 is <80%, readings from the pulse ox will be within approximately -+ __%

+- 5%

Pulse oximeter readings are inaccurate when SpO2 is below ___%

70%

According to recent studies, is nail polish still a problem with pulse ox readings?

Nope

What are 2 examples of dyes that can cause a falsely low SpO2 reading?

methylene blue | indigo carmine

methemoglobin absorbs light equally to oxyhemoglobin. As a result, pulse oximeter measurements are falsely _____-estimated when oxygen saturation is above 85% and _______-estimated when oxygen saturation is below 85%

under-estimated | over-estimated

High levels of carboxyhemoglobin will cause an _____-estimation of SpO2

over-estimation

Module 9 Part 2 Flashcards

(69 cards)