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My APA Anesthesia 1 > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

6 things to monitor under standards

A
  • ventilation (clinical obsv and expired CO2)
  • oxygen (clinical obsv and pulse ox)
  • Cardiovascular status (EKG)
  • Temp
  • neuromuscular
  • patient positioning
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2
Q

wavelength absorbed by deoxyhemoglobin

A

660nm (Red)

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3
Q

wavelength absorbed by oxyhemoglobin

A

940nm (infrared)

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4
Q

Law that pulse ox is based on

A

Beer Lamberts Law

pulse ox reads as a ratio of red/infrared light

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5
Q

Reasons for inaccurate pulse ox measurements (6)

A
  • hypoperfusion (vasoconstriction, hypothermia, hypotension)
  • motion artifacti
  • methylene blue
  • Anemia (Hgb < 5)
  • cautery interference
  • Abnormal Hgb
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6
Q

what makes oxygen saturation curve shift to left?

A
  • decreased PCO2
  • decreased temp
  • Alkalosis
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7
Q

what makes oxygen saturation curve shift to right?

A
  • Increased PCO2
  • Increased Temp
  • Acidosis
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8
Q

Chest movement does not confirm what?

A

Ventilation

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9
Q

value of precordial/esophageal stethoscope?

A
  • assurance of ventilation

- detect changes in breath sounds

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10
Q

what do you place the stethoscope precordial bell?

A

Suprasternal notch

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11
Q

What does an absense of an ETCO2 waveform mean? (3)

A
  • esophageal intubation
  • accidental disconnect
  • cardiac arrest
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12
Q

what does ETCO2 data display?

A
  • Adequacy of ventilation

- confirms placement

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13
Q

ETCO2 # vs Arterial CO2 #

A

ETCO2 2-5 lower

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14
Q

sharkfin capnograph means?

A

bronchospasm/asthma/COPD

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15
Q

short building then tall building capnograph means? or could also be?

A

increasing ETCO2/hypoventilation

also: hypercapnic, MH, Thyroid issue, increased BP, CO2 absorbing from insufflation in Lap case

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16
Q

decreasing/shorter buildings capnograph? Could also mean?

A

decreasing ETCO2/hyperventilation

also: hypotension, decreased C.O. (MI), slowing metabolism

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17
Q

whole ETCO2 waveform same size but trending up screen. Could also be what?

A

Rebreathing CO2 (could be faulty inspiratory valve)

18
Q

Notch in ETCO2? name and what it is

A

Curare Cleft - when paralysis is wearing off and diaphram starts to move a bit

19
Q

wavelength of light 3.3um, similar spectrum as agents, and monitor must be programmed with agent selected

A

monochromatic infrared spectrometry

20
Q

wavelength 7-13um, spectrum different from agents, monitor can identify agent, monitor can describe concentration of gas and multiple gasses

A

polychromatic infrared spectrometry

21
Q

alarm that detects lack of minimum inspiratory pressure, could signify disconnect or leak in system?

A

Low pressure alarm

22
Q

methemaglobinemia and CO poisoning will read what on pulse ox?

A
  • ~85%

- 100%

23
Q

what could a wider CO2 to ETCO2 gradient/discrepancy mean?

24
Q

Where is ETCO2 actually measured on waveform

A

D (second corner of top plateau)

25
Where is Inhalation on ETCO2 waveform
A-B: initial bottom of plateau
26
rapid passing of MIXED GAS through upper airway in ETCO2 waveform?
B-C: first upstroke of waveform
27
Records alveolar emptying of CO2 on ETCO2 waveform/?
C-D: Expiratory plateau (normal is flat)
28
Another breath in on waveform?
D-E: next inhalation - down stroke of waveform
29
Alarm that may indicate low pulm compliance?
high peak inspiratory alarm
30
1 mV change on ECG monitor is same as?
10mm change on paper strip
31
Frequency of TEE?
5 mHz
32
CVP/RAP determine?
RV end diastolic volume | in healthy hearts this should mirror LV as well
33
biggest heat loss for surgery?
Open bowel - larger the incision, the larger the heat losse
34
what muscle does Ulnar nerve stimulate?
Adductor pollicis
35
what muscle does Facial nerve stimulate?
orbicularis oculi
36
where do NMBs work?
Post-synaptic cleft
37
definition of Oliguria
< 0.5ml/kg/hr
38
indications for foley
- CHF - Renal - shock - surgeries with large fluid shifts - intraop diuretics
39
used when surgical procedure is associated with potential for neurological injury.
Evoked potentials - spinal fusion, craniotomy
40
efferent – stimulate at head and monitor at periphery
Motor evoked potential
41
afferent pathway to brain, start at feet ( periphery) and monitor at head
somatosensory evoked potentials
42
what monitoring needs a baseline before drug admin and needs to stay within 10-20% of baseline
Cerebral Oximetry

My APA Anesthesia 1 (8 decks)

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