Clinical Monitoring

Question 1

This analyzes the cycle of increasing and decreasing SV and systemic arterial BP in response to end-respiratory pressure

Answer 1

SPV: systolic pressure variance

Question 2

SPV: normal range

Normal delta up:

Normal delta down:

Answer 2

normal range: 7-10 mmHg

up: 2-4 mmHg

down: 5-6 mmHg

** with someone severely dehydrated the delta down is greatest not delta up

Question 3

Increased SPV = _____ response or have residual preload reserve

Answer 3

volume response

** increaed SPV –> ealry indicator of hypovolemia

Question 4

This analyzes the maximum and minimum pulse pressure over the entire respiratory cycle

Answer 4

PPV: pulse pressure variance

Question 5

PPV: pulse pressure viarance

normal range

elevated range

Answer 5

N: < 13-17%

elevated >13-17%

Question 6

What does a PPV > 13-17% indicate?

Answer 6

positive response to volume expansion

Question 7

what is the formula for PPV

Answer 7

Maximual difference in arterial pulse pressure divided by average of maximum and minimum pulse pressure

PPV = (PPmax- PPmin)/ [(PPmax + PPmin)/2]

Question 8

____ computer analysis of arterial pulse pressure waveform. It correlates resistance and compliance based on age and gender

Answer 8

SVV: stroke volume variation

Question 9

What is the formula for SVV?

Answer 9

SVV= (SV max- SV min)/ SV mean

Question 10

What is the normal value for SVV?

Answer 10

N: 10-13%

Question 11

A SVV >10-13% indicates what?

Answer 11

positive response to volume expansion –> give fluids

Question 12

These factors help predict _____ results:

-mechanical ventilation with Vt of 8-10 mL/kg
-PEEP greater than or equal to 5 mmHg
-normal intra-abdominal pressure
-a closed chest

Answer 12

accurate results

Question 13

Increased contraction does what to LVEDP

Answer 13

decreased LVEDP

Question 14

Gas sampling system:

Total response time includes what three things?

Answer 14

transiet time: time for the gas sample to reach the analyzer

rise time: time taken by the analyzer to react tot he change in gas concentration

side-stream responses: dependent on sampling tubing inner diameter, length, and gas sampling rate
-bigger flow with wider diameter (faster)
-longer length the longer it takes to get to the analyzer

Question 15

_____ _____: conentration determined according to mass/charge ratio

-abduncance of ions at specific mass/charge ratios is determined and rt the fractional composition of gas mixture

-can calculate up to 8 different gases

Answer 15

Mass spectrometry (used commonly)

Question 16

______ _____ (Raman scattering): high piowered argon laser produces photons that collide with gas molecules in a gas sample

-scattered photons are measured n. a spectrum that inditifes each gas and its concentration

-not in use

Answer 16

Raman Spectroscopy

Question 17

_____ _____: measurement of energy absorbed from narrow band of wavelengths of IR radiation as it passes through a gas sample (measures concentration of gas)

Answer 17

Infrared analysis

** asymmetric, polyatomic molecules of various gases absorb IR light at specific wavelengths

Question 18

What is the most common infrared analyzers?

Answer 18

Non-dispersive

Question 19

Infrared analysis can and cannot measure what?

Answer 19

Can: CO2, nitrous oxide, water, Volatile anesthetic gases

cannot: oxygen

Question 20

With IR analysis: less light = _____

Answer 20

higher concentration of gas

Question 21

Water vapor:

Side-stream analyzers report ambient temperature and pressure dry values, so recommendations for analyzers should report results at BTPS.

What does BTPS stand for?

Answer 21

Body temperature pressure saturated

Question 22

mmHg of water vapor?

Answer 22

47 mmHg

Question 23

What type of analyzers are fuel/galvanic cell and paramagnetic ?

Answer 23

oxygen analyzers

Question 24

This oxygen analyzer measures the current priduced when oxygen diffuses across a membrane

-the current is proportional to the partial pressure of the analyzer

Answer 24

fuel cell/Galvanic cell

Question 25

this O2 analyzer has a slow response time, short life span (dependent on O2 exposure), and is best to analyze in the inspiratory limb

Answer 25

fuel cell/Galvanic cell

Question 26

This oxygen analyzer detects the change in sample line pressure resulting from the attraction of oxygen by switched magnetic fields

-signal changes during switching correlates with O2 concentration

-this analyzer is used in most side-stream analyzers

-rapid response, breath-by-breath monitoring

Answer 26

Paramagnetic oxygeen analyzer

Question 27

Oxygen Monitoring:

sampling inside the inspiratory limb ensures: ____

sampling inside the expiratory limb ensures: _____

Answer 27

I: ensures oxygen delivery (analyzes hypoxic mixtures)

e: ensures complete pre-oxygenation “de-nitrogenation” (ETO2 above 90% = adequate)

Question 28

pipeline crossover

incorrectly filled tank

faikure of proportioning system

will cause what alarm

Answer 28

Low O2 alarm

Question 29

What two populations are we worried about with high O2 alarm?

Answer 29

premature infants

patients on chemotherapeutic drug (bleomycin)

Question 30

_____ pressure gauges: requires no powr alwasy on and have high reliability

no alarm system so it must be continually scanned

Answer 30

mechanical pressure gauges