MONITORING: RESP Side notes

Question 1

Capnographs that may cause radiant heat

Answer 1

Mainstream

Question 2

Oxygenated absorb light at

Answer 2

660nm

Question 3

Deoxygenated absorb light at

Answer 3

960 nm

Question 4

Mandatory respiratory monitors during GA

Answer 4

Pulse oximeter
Capnography
Inspired O2 analyzer
Disconnect alarm
(also direct visualization)

Question 5

Beta angle is between phases III and

Answer 5

0 is usually about 90 degrees , may used to assess rebreathing.

Question 6

Inspiratory valve failure indication of Co2

Answer 6

Widening of the B angle with an elevation of both phases 0/ I and III

Question 7

An early sign of MH

Answer 7

Rapidly rising end-tidal CO2, carbon dioxide, if unresponsive to hyperventilation .

Question 8

Oxygenation is most easily measured by

Answer 8

pulse oximetry.

Question 9

Things that my results in falsely low saturation reading

Answer 9

Methylene blue
Indocyanine green
Indigo carmine
Isolsulfan blue.

Question 10

Best location for esophageal probe is

Answer 10

Lower third of the esophagus

Question 11

Correlates well with core temperature

Answer 11

Tympanic membrane.
Esophageal probe.

Question 12

Which phase of the capnography correlates with alveolar equillibrium (or alveolar gas plateau)?

Answer 12

End of phase III.

Question 13

During GA, ETCO2/PACO2 gradient is

Answer 13

5-10 mmHg

Question 14

Exhausted CO2/ incompetent expiratory valve will show on the monitor as

Answer 14

Tracing not going back to baseline

Question 15

Slow rate of rise in CO2 waveform indicates

Answer 15

COPD
Obstructed ETT

Question 16

If inspired CO2 does not return to zero, 2 possible caues.

Answer 16

Incompetent expiratory valve in ventilator
Exhausted Co2 absorbent.

Question 17

What determines the extent of intrapleural pressure 2nd to PEEP?

Answer 17

Pulmonary compliance

Question 18

PPV settings (CPAP and PEEP)

Answer 18

increase intrathoracic pressure . Pulmonary compliance determines the extent of this pressure. Small changes in pressure cause large change in lung volume

Question 19

The maximum setting of CPAP expiratory pressure without the use of artificial airway is

Answer 19

15 cm H2O

Question 20

Expiratory pressure > 15cm H2) require

Answer 20

artificial airway du to the risk of gastric regurgitation and aspiration.

Question 21

The major effect of PEEP on the lungs is to

Answer 21

Increased FRC

Question 22

The goal of PEEP is to

Answer 22

Improve the patient’s arterial oxygenation

Question 23

Employing PEEP elevated the

Answer 23

FRC and TV to a value greater than the closing capacity to result in improved compliance and a degree of resolution of ventilation /perfusion mismatch and the degree of pulmonary shunting.

Question 24

The constant pressure from PEEP or CPAP act to

Answer 24

Stabilize and maintain expansion of the alveoli

Question 25

When excess PEEP is added (greater than 20cm H2O) Which negative effects occur

Answer 25

Pneumomediastinum Subcutaenous emphysema Pneumoretroperitoneum Pneumopericardium

Question 26

Excessive PEEP and WOB

Answer 26

Increased by reducing lung compliance and increasing dead-space ventilation

Question 27

Ventilatory component that increase the risk of barotrauma

Answer 27

Young age Vent setting with high RR , there is stacking of breaths Increase TV 10-15ml/kg

Question 28

Which of the following is the highest circuit pressure generated during an INSPIRATORY cycle?

Answer 28

PEAK INSPIRATORY PRESSURE (PIP)

Question 29

PIP is an indication of

Answer 29

Dynamic compliance of the lungs

Question 30

Is there any contraindications to analyzing anesthetic gases during any procedure requiring inhalational anesthesia?

Answer 30

NO

Question 31

Gases measured by standard OR gas analyzers include

Answer 31

Oxygen Nitrogen Anesthetic agent

Question 32

Which oxygen analyzer is self -calibrating?

Answer 32

Paramagnetic

Question 33

Which statement is true regarding pulse oximetry? (A) Pulse oximetry artifact is due to excessive

Answer 33

ambient light, motion, and methylene ,blue dye.

Question 34

In the normal capnograph, what does Phase III indicate?

Answer 34

Alveolar gas plateau

Question 35

What causes an increased end-tidal carbon dioxide?

Answer 35

CNS depression

Question 36

Where is the best location to monitor blood pressure or patients undergoing right shoulder arthroscopy in the beach chair position?

Answer 36

LUE

Question 37

Which oxygen analyzer works by using the oxygen molecules’ unique attraction into magnetic fields?

Answer 37

Paramagnetic oxygen sensor

Question 38

Which o the following minimizes Phase I temperature loss?

Answer 38

Forced air warming

Question 39

What is the maximum allowable current leakage in the operating room?

Answer 39

10 MicroAm

Question 40

What monitor alarms when a high current ow to the ground exists?

Answer 40

Line isolation monitor

Question 41

What humidity levels are appropriate or the operating room?

Answer 41

50-55%

Question 42

During in usion o multiple units o packed red blood cells, what temperature is needed to avoid hypothermia?

Answer 42

(A) 37°C

Question 43

Which principle included in radiation safety?

Answer 43

(A) Time (B) Distance (C) Shielding

Question 44

What nerve injury may result rom prolonged pressure involving bag mask ventilation?

Answer 44

(A)Trigeminal and Facial nerves

Question 45

What does an “a” wave represent in a CVP tracing?

Answer 45

Atrial contraction

Question 46

When comparing sites or placement o a central venous catheter, which site carries the greatest risk or pneumothorax?

Answer 46

Subclavian vein

Question 47

What results when stimulating the ulnar nerve?

Answer 47

Contraction of the adductor pollicis

Question 48

Rationale: Recovery rom neuromuscular blockade is observed in the

Answer 48

orbicularis oculi prior to the adductor pollicis when using peripheral nerve stimulation.

Question 49

Range: Mean right atrial pressure

Answer 49

(1-10);

Question 50

Mean pulmonary artery pressure

Answer 50

(10-20);

Question 51

Pulmonary artery occlusive pressure range

Answer 51

5-15

Question 52

When monitoring central venous pressure (CVP), what causes the loss o “a” waves?

Answer 52

Atrial fibrillation

Question 53

Following intubation you are unable to palpate the tracheal tube cu in the sternal notch. T e breathing bag compliance is decreased. Breath sounds are unilateral. Where is the endotracheal tube most likely positioned?

Answer 53

Bronchus

Question 54

What is your greatest concern when in ating the pulmonary artery balloon?

Answer 54

Pulmonary artery rupture