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Principles I -Josh > Blood And Fluid > Flashcards

Blood And Fluid Flashcards

1
Q

One unit of PRBCs raises the Hct by _____ %?

A

3%

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2
Q

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

A

Ulnar Neuropathy, Brachial Plexus, Radial and median nerve

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3
Q

Most common ocular injury?

A

Corneal Abrasion

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4
Q

main complication with the supine lithotomy position?

A

Airway Obstruction and decreased Tidal Volumes

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5
Q

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

A

Functional Residual Capacity (FRC) by 25%

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6
Q

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

A

Brachial plexus

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7
Q

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

A

Ulnar Nerve

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8
Q

The classic site of injury to the ulnar nerve is?

A

Behind the ulnar groove behind the medial epicondyle of the humerus

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9
Q

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

A

Lateral

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10
Q

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

A

90, supinated (palms up)

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11
Q

Trendelenberg postion affects the body in what manner?

A

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

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12
Q

4 ways to avoid a Brachial Plexus injury?

A

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

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13
Q

Reverse trendelenberg affects the body in what manner?

A

Decreases venous return

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14
Q

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

A

Air embolism

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15
Q

what is the best way to detect a air embolism?

A

Esophageal stethoscope

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16
Q

3 goals of positioning?

A

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

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17
Q

Greater then ______ hours for surgery increase position related injuries?

A

4-5 hours

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18
Q

_________ accounts for 89% of all postop visual loss?

A

Ischemic optic neuropathy (ION)

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19
Q

1 Unit of PRBCs raises the Hgb _______ ?

A

1 gm

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20
Q

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

A

1 yr, 200-250 ml

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21
Q

1 unit of Platelets increase the count by____?

A

5,000 - 10,000

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22
Q

For every 4 units of PRBCs give ________?

A

1 unit of FFP

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23
Q

For every 8 units of PRBCs give ______, _______?

A

2 units of FFP, 4 pack of Platelets

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24
Q

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

A

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

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25
Q

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

A

HCT

26
Q

TRALI stands for?

A

Transfusion Related Acute Lung Injury

27
Q

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

A

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

28
Q

________ is the second most common transfusion reaction?

A

Transfusion Related Acute Lung Injury (TRALI)

29
Q

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

A

1 to 1

30
Q

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

A

2.5 - 5 times and within 15 minutes

31
Q

Most common reason for coagulopathies are?

A

Lack of functioning Platelets

32
Q

What is considered an acceptable urinary output?

A

0.5ml/kg/hr

33
Q

What is the formula for calculating maintenance fluid?

A

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

34
Q

Most common transfusion reaction is?

A

Febrile

35
Q

Types of transfusion reactions are?

A

Febrile, Allergic, Hemolytic

36
Q

what genetic disease benifits from the administration of cryoprecipitate?

A

Hemophilia A ( factor VIII deficient)

37
Q

What is the Hct of 1 unit of PRBCs?

A

70% Hct 250 ml’s

38
Q

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.

A 
Estimated Blood volume: 75ml x 80kg= 6000ml.
RBCV40%= 6000x0.4=2400
RBCV30%= 6000x0.3=1800
2400-1800=400ml
allowable blood loss =3x400=1200 ml
39
Q

Average blood volume per kg for female is?

A

65 ml/kg

40
Q

Average blood volume per kg for male is?

A

70-75 ml/kg

41
Q

Intraoperative fluid replacement for insensible loss is?

A

2 ml/kg

42
Q

Intraoperative fluid replacement for minimal surgical trauma is?

A

2-4 ml/kg

43
Q

Intraoperative fluid replacement for severe surgical trauma is?

A

6-8 ml/kg

44
Q

Intraoperative fluid replacement for moderate surgical trauma is?

A

4-6 ml/kg

45
Q

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

A

3 ml

46
Q

Treatment of Hyperkalemia could entail?

A

Hyperventilation, IV Calcium, or D50 Insulin and bicarb

47
Q

Citrate in PRBC units contribute to _____ and _____?

A

Metabolic Alkalosis and Hypocalcemia

48
Q

Blood stored accumulates ___, ___ and decreases in ____?

A

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

49
Q

1 liter of LR contains what electrolytes and how much?

A

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

50
Q

1 liter of Normal Saline contains what electrolytes and how much

A

Na 154 mEq and Cl 154 Meq

51
Q

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

A

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

52
Q

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

A

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

53
Q

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

A

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

54
Q

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

A

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

55
Q

A soaked 4x4 is equal to ____ ml?

A

10 ml

56
Q

A soaked Lap pad is equal to ____ ml?

A

100-150 ml

57
Q

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

A

50,000

58
Q

Crystalloid intravascular half-life is?

A

20-30 min

59
Q

Colloid intravascular half-life is between ____?

A

3-6 hrs

60
Q

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

A

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

61
Q

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

A

2 units

Principles I -Josh (7 decks)

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