Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gen Exam 2 > Monitoring > Flashcards

Monitoring Flashcards

(109 cards)

Start Studying
1
Q

AANA has 5 Standards for Anesthesia Monitoring

A

all 5 are needed for general
Temp & NMB maybe not for non-general

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

BP checked Q____min regardless of anesthetic

A

5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Temp Q

A

15 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

NM monitoring Q

A

15 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

most important monitor

A

Vigilance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

⭐️
Monitoring FiO2 (Oxygen Sensor)

A

oxygen sensor is distal to the CG outlet
as close to pt as possible
determine the concentration of oxygen moving to pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

⭐️
only monitor that can detect a hypoxic mixture of gases

A

Oxygen Sensor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If the machine does not have a working O2 sensor…

A

get a new machine
do not start the case without one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

All analyzers must have

A

low-level alarms, which are active while the machine is on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F
The Low O2 alarm can be temporarily silenced

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Required at all times when the anesthesia machine is in use

A

Oxygen Sensor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

polarographic (Clark electrode) & galvanic (fuel cell) are used to measure

A

Oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F
Oxygen is diamagnetic

A

false
O2 = paramag
other gases = diamag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Oxygen + magnetic field

A

O2 molecules are attracted & agitated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Oxygen Sensor: Paramagnetic
pressure difference is ____ to O2 partial pressure

A

proportional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is O2 a magnetic gas?

A

2 unpaired electrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When did Pulse Ox become a standard of care

A

‘86

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pulse Oximetry (SPO2)

A

-Pulse rate
-Estimate Oxygen (SaO2) saturation of Hgb
-time-delayed reading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pulse Oximetry (SPO2) estimates ___.

A

Oxygen (SaO2)
saturation of Hgb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

measures light absorbance

A

Spectrophotometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

solute concentrations measured by light transmitted through a solution

A

Lambert-Beer Law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

3 assumptions made for programming all pulseox devices:

A

-only oxyhemoglobin & reduced Hgb absorb light
-pulsations are d/t pulsatile arterial flow
-empirical experimental oxygen dissociation calibration curve for all humans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

An LVAD pt’s SpO2 will look like…

A

little oscillations
typically no pulse ox b/c they have no pulsatile flow

rely more on etCO2 and skin color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

⭐️
Pulse Oximeter (SpO2)
2 wavelengths of light

A

Red light: 660 nm (unoxygenated Hgb)
Infrared light: 940 nm (oxygenated Hgb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Pulse Oximeter (SpO2) algorithm
compares how 660 nm & 940 nm wavelengths are absorbed by deoxyhemoglobin and oxyhemoglobin, and calculates the SpO2 value using oxyhgb dissoc. curve
26
⭐️ T/F A high SpO2 is a sign that the tissues are utilization O2 properly.
False DOES NOT guarantee delivery of or utilization of O2 by the tissues
27
Can SpO2 indicate good ventilation?
No
28
apnea after preoxygenating with 100% FiO2 prior to induction = ___ min before SpO2 drops
6-8 min (Exam 1 material: at least 8 mins; 10 min if healthy)
29
IV Dyes that mess w/ SpO2 reading
Methylene Blue, Indigo Carmine, Indocyanine Green(ICG)
30
Will give us false high SaO2
Carboxy & methemo hgb
31
Methylene blue will give us a SaO2 reading that is....
much lower than actual
32
Which binds greater to hgb? O2 carboxyhgb
carboxyhgb (will push O2 off)
33
Cerebral Pulse Ox
-Beer–Lambert law -balance between cerebral oxygen delivery and consumption NR: 60-75%
34
⭐️ Pulse ox uses which law?
Beer Lambert
35
🔴 Cerebral Pulse Ox Changes greater than __% indicate potential neurological events due to decreased cerebral oxygenation
25
36
Cerebral Pulse Ox We want to see ___ between the two values
closeness not equal
37
Best to detect Ischemia or Infarction
Leads II or V5
38
arrhythmias & inferior wall ischemia
Lead II
39
anterior/lateral wall ischemia
V5
40
____ Lead monitor both II & V5 simultaneously
5 Lead
41
EKG leads contain
Silver Chloride
42
Which mode for: decreasing artifact? diagnosing ischemia?
Filtering mode Diagnostic mode
43
Lead V5 location
5th intercostal space at anterior axillary line
44
True V5 only possible with
5 Lead can do modified V5 with 3 lead
45
T/F Gases/volatiles The % we give to the pt will be higher than the expired %.
True some is always going to be absorbed
46
T/F The inspired % we give to the pt reflects how much is going into the brain.
False the expired % reflects this
47
IR Gas Analyzer is located...
on inspi & exp limbs
48
IR Gas Analyzer detects....
CO2, N2O & potent volatile anesthetics simultaneously using unique light absorption of the gases
49
Why is an appropriate level of - pressure matter for patient safety?
Negative pressure + emerging pt biting on ETT --> negative pressure pulmonary edema
50
Sub-atmospheric/Negative Pressure Alarm
- Neg pressure/reverse gas flow in circuit
51
Negative pressure can cause...(3)
pulmonary edema atelectasis hypoxia
52
High-Pressure Alarm causes
peak pressures > 40cm H2O Mainstem intubation APL valve closed with high gas flows
53
Continuous Pressure Alarm
obstruction or malfunctioning expiratory valve ie: APL closed w/ gas flow & ballooning anesthesia bag
54
Breathing Circuit Low-Pressure Alarms PRIMARY cause & other causes
circuit disconnect (70% of the time =Y-piece) -Faulty/leaking circuit -Faulty Ventilation Bag -Leaking from Bellows housing -**Leaking ETT cuff** -**Accidental Extubation** -Anesthesia Bag disconnected -Leaking or disconnected anesthesia machine hose
55
most serious cause of Low-Pressure Alarm
Leaking ETT cuff Accidental Extubation (70% of the time, its a circuit disconnect)
56
measures the tidal ventilation in anesthesia breathing circuits
flowmeters (not the fresh gas ones)
57
Flowmeter monitors
Vt in circuit Real-time flow metering Ultrasonic Flapper valves Mini turbine spirometer Range: 0-2.5 L/sec
58
Apnea Detection Alarm is associated with ___
flowmeters (not the FGF ones)
59
Apnea Detection Alarm
High-level alert must always be on
60
What causes the "upswing" (phase IV/terminal upswing)
-dec. compliance & FRC preg/obese (decreased FRC) don't ventil8 well retained CO2 @ end expiration is pushed out by extra weight
61
Which part of this graph is the airway deadspace?
62
Which part of this graph is the alveolar deadspace?
63
Where can we find the etCO2?
64
⭐️ Which part of the etCO2 capnog. is not always present?
Phase IV terminal “upswing”
65
⭐️ alpha angle increase
expiratory outflow obstruction COPD, bronchospasm, kinked ETT
66
⭐️ beta angle increase
rebreathing CO2 from faulty inspiratory valve
67
If etCO2 baseline is elevated....
breathing CO2 change absorbent canister
68
etCO2 waveform phases
Phase I: INSP Ends Phase II: EXP (deadspace & Upper Alveoli) Phase III: EXP (lower lung) Phase IV terminal “upswing”: (if present) Phase IV: INSP (fresh gas w/o CO2)
69
Phase IV should return to ___ with each new breath
0
70
which one detected CO2?
Right (turns yellow when exposed to CO2) semi-quantitative device
71
T/F Bicarbonate Administration can increase etCO2
True bicarb breaks down into CO2 & expired see slight elevation in 10-12 mins
72
MH will ____ etCO2
increase (remember: unexplained etCO2 rise is first sign of MH)
73
Sepsis/fever ____ etCO2
increase
74
Pulm. Emb ____ etCO2
decreases
75
A circuit disconnect ___ etCO2
decreases
76
Hyperventilation will ___ etCO2, but hypoventilation will ___ it.
hypervent= decrease etCO2 hypovent = increase
77
Low CO will ___ etCO2
decrease less blood circulation = less CO2 production
78
A pt will exhibit ___ etCO2 in cardiac arrest
decreased (good compressions & circulation will produce some etCO2, but very low; so none=dead)
79
waz gud anesthesia?
nm, just some airway obstruction, hbu?
80
NIBP
Ejection of pulsatile blood flow from the left ventricle causes pulsatile arterial pressures
81
Systolic (SBP)
peak pressure from left ventricle during systole
82
Diastolic (DBP)
lowest arterial pressure during diastole
83
Pulse Pressure
SBP – DBP
84
⭐️ Mean Arterial Pressure (MAP)
time - weighted average of arterial pressures during pulse cycle
85
get your mind out of the gutter....sheeesh
86
most accurately reflects hemodynamic status
R atrium
87
phlebostatic axis corresponds to
the right atrium
88
Accurate SVV fluid responsiveness/fluid challenge
-baseline bolus 200-250 ml -perform prior to fluid loss -helps determine what fluid they will respond to
89
FloTrac
-CO & SVV using arterial waveform (also CI) -connect to A-line -use for intraop fluid mgmt
90
Central Venous Pressure Monitoring (CVP)
Monitors R side of the heart (preload) & vascular volume sits above R atrium
91
⭐️ Must know a, c, v, x & y
92
CVP NR
2-6 mmHg
93
T/F CVP measures blood volume directly.
False estimate
94
Risks of Central Line Placement
**Microshock hazard** Pneumothorax Hemothorax Thrombus Thromboembolus Arterial Puncture Hematoma Infection ** Knotting/Breakage of Catheter Retained Wire Erosion through vessel/heart
95
temperature maintained by
balancing heat production (metabolism) & heat loss
96
T/F Anesthesia does not affect temp control mechanisms
False inhibits many of them
97
types of anesthesia that impair temp control
General & neuraxial
98
⭐️ Temp MONITORING STANDARD
Q15 min
99
General Anesthesia Temp decrease (3 phases):
1. rapid decrease over 30 min (0.5-1.5 ℃) – redistribution heat from core-to- peripheral tissue 2. Slow linear reduction phase of 0.3 ℃ / hr from heat loss exceeding heat production 3. Plateau phase (~thermo-regulatory vasoconstriction)
100
T/F All volatiles and gases impair thermoregulatory control
False N2O does not
101
T/F Neuraxial anesthesia impairs temp control to the same extent as GA
True
102
Which monitors both sides of the brain? sedline BIS
sedline
103
BIS monitor
-monitors only 1 side of frontal lobe -Composite analyzed EEG tracing
104
BIS ranges
65-85: sedation 40-65: general anesthesia
105
BIS limiting factors
-Variable Indexes per agent -Age – brain maturation affects EEG -Hypothermia (slows brain activity) **-Neurological Impairment (unreliable measuring)** -Interference from medical devices (same for sedline)
106
SedLine Monitor
-4 waves of EEG -both hemispheres of frontal lobe
107
SedLine Monitor general anesthesia
30-45
108
AMG vs EMG
AMG: hand, toe, face EMG: better if tucked
109
NMB – *Quant*itative Monitoring
-safe extubation and prevention of residual paralysis -Uses both: AMG (acceleromyography) & EMG (electromyography)

Gen Exam 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions