more cards Flashcards
(139 cards)
1
Q
Terms
A
Definitions
2
Q
CVP - Normal values; related to…
A
2-6 mmHg; Right heart fx
3
Q
PAP - Normal values; related to…
A
25/8 Mean 14 Range 9-18 mmHg; Lungs
4
Q
PCWP - Normal values; related to…
A
4-12 mmHg; Left heart fx
5
Q
CO - Normal values
A
4-8 L/min
6
Q
Usual cause high CVP
A
Fluid overload, diurese
7
Q
When CVP low
A
Usually dehydration or vasodilation, give fluids or vasoconstrictors
8
Q
Possible pathology increased CVP
A
Right heart failure, cor pulmonale, tricuspid valve stenosis
9
Q
(xray)Central venous catheter placement
A
Tip should rest in right atrium or vena cava
10
Q
(xray) Pulmonary artery catheter placement
A
Tip should be over the right lower lung field
11
Q
Most common complication of PA catheter insertion
A
Arrythmias
12
Q
How you will know you are in the pulmonary artery
A
Dicrotic notch
13
Q
How to fix pressure dampening (dicrotic notch absent)
A
a. Check for air bubbles b. Aspirate (to remove potential clot)
c. Flush catheter
d. Rotate catheter
14
Q
Hb range
A
12-16 gm/dL
15
Q
Vd/Vt - Formula; range
A
PaCO2-(PeCO2)/PaCO2; 20-40%, up to 60% if ventilated
16
Q
High Vd/Vt usually relates to
A
Pulmonary embolus
17
Q
Alveolar air equation (PAO2)
A
((Pb-PH2O)FIO2) - PaCO2/0.8
18
Q
A-a Gradient - Formula; values
A
A-aDO2 = PAO2 - PaO2; Normal 25-65. 65-299 = V/Q mismatch, >300 = shunt
19
Q
It is best to obtain the A-a gradient when
A
The patient is on 100% FIO2
20
Q
Arterial Oxygen Content - Formula; values
A
CaO2 = (Hbx1.34xSaO2) + (PaO2x0.003);
22
Q
Venous Oxygen Content - Formula; values
A
CvO2 = (Hbx1.34xSv02) + (PvO2x0.003);
24
Q
Arterial-Venous Oxygen Content Difference - Values
A
C(a-v)O2; Normal 4-5 vol%; difference INCREASES when Qt is DECREASING
25
Q
Best measurement of oxygen being delivered to the tissues
A
CaO2
26
Q
The CvO2 should be drawn from
A
Pulmonary artery
27
P/F ratio - values
Normal >380 (PaO2 of 80/21%), <200 ARDS
28
Fick Equation
Qt = VO2/C(a-v)02x10
29
If a BP cuff and an arterial line display different values. Trust the
BP cuff
30
Neonate, acceptable PaO2
50-80 mmHg, all other values same
31
(xray) Obliterated costophrenic angles; concave superior surface; meniscus
Pleural effusion
32
(xray) Flattened diaphragm
Air trapping
33
(xray) Radiolucent
Normal
34
(xray) Fluffy infiltrates, butterfly/batwing pattern
Pulmonary edema
35
(xray) Air bronchogram
Pneumonia
36
(xray) Ground glass, honeycomb, reticulogranular
ARDS/IRDS
37
(xray) Thumb sign
Acute epiglottitis
38
(xray) Steeple sign
Croup
39
(xray) Airway placement
2-5 cm above carina; level w/ 4th rib/T-4, aortic knob
40
(xray) Chest tube placement
Should be in the neural space
41
Primary Dx tool for bronchiectasis
Bronchogram
42
Used to determine risk for aspiration
Barium swallow
43
Low K+ can cause
Metabolic alkalosis
44
Hypokalemia - cause; ECG
Excessive fluid loss (vomiting, dehydration); Flattened T-wave
45
Cl- follows
Na+
46
Eosinophils associated w/
Asthma, allergic reactions
47
Monocytes associated w/
TB
48
PT - use; values
Monitors Warfarin (Coumadin) Therapys, 12-15 sec
49
APTT - use; values
Monitors Heparin therapy; 24-32 sec
50
Acid Fast stain
Tuberculosis
51
Culture
Identifies organism
52
Sensitivity
Identifies which antibiotics kills organism
53
TcPO2/TcPCO2 electrodes should be moved
Q4H
54
TcPO2/TcPCO2 calibration
Room air and zeroing solution
55
Best indicator of perfusion
Urine output
56
Dry non-productive cough
Think cancer
57
Digital clubbing
Chronic hypoxemia (think COPD)
58
Neck vein distension
Associate with CHF and COPD
59
Night sweats
TB
60
Cold and clammy skin
Think myocardial infarction
61
Unilateral wheeze
Foreign body; broncoscopy
62
Rhonchi
Suction
63
Mild stridor
Cool mist, racemic epi
64
Moderate stridor
Racemic epi
65
Severe stridor
Intubate
66
Pulsus paradoxus
BP rises and falls during inspiratory and expiratory efforts. Severe air trapping. Status asthmaticus
67
Test when S3/S4 heart sounds are heard
Echocardiogram
68
S3/S4 associations
S3 CHF, S4 cardiomegally
69
(ECG) Best lead to assess left ventricle
Lead V5
70
(ECG) Best lead to determine overall electrical condition
Lead II
71
Tx sinus tach
Oxygen
72
Tx sinus brady
Oxygen and atropine
73
Tx PVCs
Oxygen if occasional, lidocaine if frequent
74
Tx asystole
Confirm in two chest leads, CPR, epi, atropine
75
Tx V-tach
Pulse - Lidocaine and cardioversion
77
Tx V-fib
Defibrillate
78
Tx 1st degree heart block
Atropine
79
Tx 2nd degree heart block
Atropine, pacing
80
Tx 3rd degree heart block
Pacemaker
81
Reasons for cardiac electrical current deviation
Hypertrophy, infarction
82
(ECG) Ischemia
Current lack of oxygen; Inverted T-wave (may also be caused by digitalis toxicity)
83
(ECG) Injury
Cardiac tissue in a state of dying; S-T elevation
84
(ECG) Infarction
Dead cardiac tissue; significant Q-wave
85
The SVC should always be
Greater than the FVC. If FVC is greater, PT effort is poor (i.e. wanting disability)
86
FVC loop - Round
Large fixed airway obstruction (such as vocal cord paralysis or cancer)
87
FRC measurement
Nitrogen washout or plethsymograph
88
Only obstructive Dz associated w/ poor DLco
Emphysema
89
Pre-Post BD reversibility considered significant if
There is a 12%/200mL or greater increase in flows
90
Selection of best test
Best FEV1 + FVC
91
Calibration syringe - Results close together but far from correct
Inaccurate but precise
92
ICP
5-10 mmHg; Tx suggested >20 mmHg; keep PT sedated
93
PaCO2 range for PT w/ increased ICPs
25-30
94
Drugs to Tx increased ICPs
Diamox, Osmitrol
95
APGAR 7-10
Provide routine care
96
APGAR 4-6
Support w/ O2, warmth, stimulation
97
APGAR 0-3
Code
98
Gestational age ranges
42 Postterm
99
Venturi mask, bed covers may
Accidentally occlude entrainment port and increase FIO2
100
Problem suspected w/ pulse-dose O2 delivery system
Switch to continuous mode
101
Oxygen concentrator (molecular sieve) can produce up to
6 lpm
102
CPAP problem w/ infants
If infant is crying, pressure is lost
103
100% body humidity
44 mg/L
104
Ultrasonic neb frequency
Can not be changed
105
Back pressure does this to FIO2
Increases
106
Common home vents
PLV 100, LP 6, LP 10, PB Companion, Intermed Bear
107
Oral ET tube should be
20-24 lips
108
Nasal ET tube should be
25-29 at nares
109
PetCO2 during code
Will first read low, then rise w/ adequate ventilation
110
Best equipment to continually measure flow
Fleisch pneumotachometer
111
Helium dilution uses this type of analyzer
Wheatstone bridge
112
Nitrogen washout equipment that measures nitrogen
Geissler tube ionizer
113
Polarographic analyzer reads low FIO2
Change batteries
114
Polarographic analyzer will not read
If batteries are good, replace electrolyte solution
115
Galvanic fuel cell troubleshoot
Change cell (don't change solution or battery, the cell IS the battery)
116
BVM collapses easily
Change bag, otherwise replace air-inlet valve
117
BVM difficult
Ensure patient valve is not stuck open, does PT have low lung compliance?
118
Facilitate suction of left main stem bronchus
Coude tip catheter
119
Suction catheter diameter should not exceed
1/2 diameter of ETT
120
Difficult suction troubleshoot
Suction pressure range -> Increase cath size -> Increase suction time
121
Change Cidex
Every 14 days
122
Cidex is tuberculocidal in
20 minutes
123
Post-Op IS goal
1/2 amount achieved pre-op
124
Initiation of MV - Rate; Vt
Rate 8-12, Vt 8-12 mL/kg
125
Dynamic compliance
Exhaled Vt/PIP-PEEP
126
Static compliance
Exhaled Vt/Pplat-PEEP; 25-100 mL/cmH20 acceptable
127
If PaO2 is low
Raise FIO2 5-10% until 60%, then add/raise PEEP by 5
128
If PaO2 is high
Lower FIO2 until <60%, then lower PEEP in increments of 5
129
Most important alarm in paralyzed PT
Low PEEP. If low PEEP alarm not available, then low volume or disconnect
130
Best position for gas distribution during MV
Semi-Fowler's
131
If patient is in distress from suctioning
Decrease suction time
132
Avoid PEP therapy during
Epistaxis, middle ear infections, sinus problems
133
Low exhaled Vt w/ chest tube
Adjust Vt to maintain ABG values
134
Excessive bubbling in suction control bottle
Too much suction pressure
135
Excessive bubbling in water seal chamber
Clamp tube proximal PT, if bubbling stops, problem is inside the PT
136
If glass bottle breaks
Submerge chest tube into water from any container
137
Heliox 80/20 correction factor
1.8
138
Heliox 70/30 correction factor
1.6
139
Cardioversion must be done on
The R-wave of ECG. Ensure synchronization is on
140
Bleeding during bronchoscopy
Instill epi, then apply pressure with bronchoscope
141
AHI > 30
Severe sleep apnea. Next step is titration study
142
Transport vent volumes fall
Check tank
