Blood And Fluid

Question 1

One unit of PRBCs raises the Hct by _____ %?

Answer 1

3%

Question 2

Identify the areas of the upper extremities that are at high risk for developing position related nerve damage?

Answer 2

Ulnar Neuropathy, Brachial Plexus, Radial and median nerve

Question 3

Most common ocular injury?

Answer 3

Corneal Abrasion

Question 4

main complication with the supine lithotomy position?

Answer 4

Airway Obstruction and decreased Tidal Volumes

Question 5

In the supine position abdominal contents cause a decrease in the patients ________?

Answer 5

Functional Residual Capacity (FRC) by 25%

Question 6

The ________ lies in close proximity to the fixed first rib, clavicle and humerus and is predisposed to compression.

Answer 6

Brachial plexus

Question 7

The number one nerve injury related to positioning involve the _______?

Answer 7

Ulnar Nerve

Question 8

The classic site of injury to the ulnar nerve is?

Answer 8

Behind the ulnar groove behind the medial epicondyle of the humerus

Question 9

This position is associated with the greatest number of ocular injuries?

Answer 9

Lateral

Question 10

When supine the arms should not be abducted greater than ______ degrees and the wrist should be _______?

Answer 10

90, supinated (palms up)

Question 11

Trendelenberg postion affects the body in what manner?

Answer 11

Increase: CVP, ICP, Intraocular pressure
Decrease: FRC and Pulmonary compliance

Question 12

4 ways to avoid a Brachial Plexus injury?

Answer 12

Keep Head Midline
Arms kept at < 90 degrees
Elbows mildly flexed
Use a non-sliding mattress for Trendelenburg

Question 13

Reverse trendelenberg affects the body in what manner?

Answer 13

Decreases venous return

Question 14

What is the biggest concern for a patient in the sitting position?

Answer 14

Air embolism

Question 15

what is the best way to detect a air embolism?

Answer 15

Esophageal stethoscope

Question 16

3 goals of positioning?

Answer 16

Maximum exposure for the surgeon
Access to the patient for ventilation and monitoring
Promote satisfactory surgical results

Question 17

Greater then ______ hours for surgery increase position related injuries?

Answer 17

4-5 hours

Question 18

_________ accounts for 89% of all postop visual loss?

Answer 18

Ischemic optic neuropathy (ION)

Question 19

1 Unit of PRBCs raises the Hgb _______ ?

Answer 19

1 gm

Question 20

FFP is viable for _____ and has a volume of ______ ?

Answer 20

1 yr, 200-250 ml

Question 21

1 unit of Platelets increase the count by____?

Answer 21

5,000 - 10,000

Question 22

For every 4 units of PRBCs give ________?

Answer 22

1 unit of FFP

Question 23

For every 8 units of PRBCs give ______, _______?

Answer 23

2 units of FFP, 4 pack of Platelets

Question 24

Autologous blood can be obtained by ____, ____, _____?

Answer 24

Predepositing, Hemodilution (removing 1-2 units immediately intraoperatively), Post-op Salvage

Question 25

_____ is the % of red cells to the total volume of blood?

Answer 25

HCT

Question 26

TRALI stands for?

Answer 26

Transfusion Related Acute Lung Injury

Question 27

In an anesthetized Pt with a NMBA on board. The most likely signs we will see of a transfusion reaction are ____, ____, ____?

Answer 27

Free Hgb in the Urine, increase in airway peak pressures and elevation in temp

Question 28

________ is the second most common transfusion reaction?

Answer 28

Transfusion Related Acute Lung Injury (TRALI)

Question 29

Albumin 5% replaces volume in a ___ to ___ ratio?

Answer 29

1 to 1

Question 30

Albumin 25% expands volume by _____ and within _____ minutes?

Answer 30

2.5 - 5 times and within 15 minutes

Question 31

Most common reason for coagulopathies are?

Answer 31

Lack of functioning Platelets

Question 32

What is considered an acceptable urinary output?

Answer 32

0.5ml/kg/hr

Question 33

What is the formula for calculating maintenance fluid?

Answer 33

4 ml/kg/hr for the first 10kg For the next 10-20 kg add 2 ml/kg/hr for each kg above 20 add an additional 1 ml/kg/hr

Question 34

Most common transfusion reaction is?

Answer 34

Febrile

Question 35

Types of transfusion reactions are?

Answer 35

Febrile, Allergic, Hemolytic

Question 36

what genetic disease benifits from the administration of cryoprecipitate?

Answer 36

Hemophilia A ( factor VIII deficient)

Question 37

What is the Hct of 1 unit of PRBCs?

Answer 37

70% Hct 250 ml's

Question 38

Calculate the allowable blood loss if the Hct is 40 and allowable blood loss to a Hct of 30 in a 80 kg male Pt.

Answer 38

``` Estimated Blood volume: 75ml x 80kg= 6000ml. RBCV40%= 6000x0.4=2400 RBCV30%= 6000x0.3=1800 2400-1800=400ml allowable blood loss =3x400=1200 ml ```

Question 39

Average blood volume per kg for female is?

Answer 39

65 ml/kg

Question 40

Average blood volume per kg for male is?

Answer 40

70-75 ml/kg

Question 41

Intraoperative fluid replacement for insensible loss is?

Answer 41

2 ml/kg

Question 42

Intraoperative fluid replacement for minimal surgical trauma is?

Answer 42

2-4 ml/kg

Question 43

Intraoperative fluid replacement for severe surgical trauma is?

Answer 43

6-8 ml/kg

Question 44

Intraoperative fluid replacement for moderate surgical trauma is?

Answer 44

4-6 ml/kg

Question 45

For every 1 ml blood loss replace it with ____ ml of crystalloid?

Answer 45

3 ml

Question 46

Treatment of Hyperkalemia could entail?

Answer 46

Hyperventilation, IV Calcium, or D50 Insulin and bicarb

Question 47

Citrate in PRBC units contribute to _____ and _____?

Answer 47

Metabolic Alkalosis and Hypocalcemia

Question 48

Blood stored accumulates ___, ___ and decreases in ____?

Answer 48

H+ ions, K+ and decreases in 2,3 DPG

Question 49

1 liter of LR contains what electrolytes and how much?

Answer 49

Na 130mEq, Cl 109mEq, K 4mEq, Ca 3 mEq, Lactate 28 mEq

Question 50

1 liter of Normal Saline contains what electrolytes and how much

Answer 50

Na 154 mEq and Cl 154 Meq

Question 51

Advanced Trauma Life Support (ATLS) Classification 1 R/T Blood loss?

Answer 51

750 ml or less, HR <100, BP normal, RR normal, Blanch ok, UOP normal, Anxious Replace with crystalloid.

Question 52

Advanced Trauma Life Support (ATLS) Classification 2 R/T Blood loss?

Answer 52

750-1500 ml, HR >100, BP normal, RR 20-30, Blanch + , UOP 20-30, Anxious Replace with crystalloid

Question 53

Advanced Trauma Life Support (ATLS) Classification 3 R/T Blood loss?

Answer 53

1500-2000 ml, HR >120, BP decreased, Blanch + , UOP 5-15, Anxious and confused Replace with crystalloid and blood

Question 54

Advanced Trauma Life Support (ATLS) Classification 4 R/T Blood loss?

Answer 54

> 2000 ml, HR >140, BP decreased, RR >35, Blanch + , No UOP, Anxious and confused and lethargic GIVE BLOOD and crystalloid

Question 55

A soaked 4x4 is equal to ____ ml?

Answer 55

10 ml

Question 56

A soaked Lap pad is equal to ____ ml?

Answer 56

100-150 ml

Question 57

Platelets are usually given when the count is less then _______?

Answer 57

50,000

Question 58

Crystalloid intravascular half-life is?

Answer 58

20-30 min

Question 59

Colloid intravascular half-life is between ____?

Answer 59

3-6 hrs

Question 60

NPO deficit is given how much the first, second, and third hour?

Answer 60

1st hour give 1/2 the total NPO deficit 2nd hour give 1/4 the total NPO deficit 3rd hour give 1/4 the total NPO deficit

Question 61

General rule of thumb after how many units of PRBCs do you give Ca+?

Answer 61

2 units