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SRNAProfessionalGuide II > Clinical Monitoring in Anesthesia > Flashcards

Clinical Monitoring in Anesthesia Flashcards

1
Q

Standards for minimum requirements set by the

A

AANA

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2
Q

Standards for monitoring

A

Set a legal precedence

Morbidity and mortality decrease

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3
Q

When was standards for monitoring established

A

1974

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4
Q

Expected standard of care established by

A

JCAHO

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5
Q

Harvard established also in

A

1986

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6
Q

Which standard number

A

Standard V professional practice manual

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7
Q

What are the standards for monitoring

A 
Ventilation
Oxygen
Circulation
Body Temperature
Neuromuscular function
Positioning
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8
Q

AANA standard for Ventilation

A

Continuous ETCO2 monitoring

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9
Q

Verify intubation by (3)

A

Auscultation
Positive chest excursion ( Bilaterally)
Presence of Exhaled CO2

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10
Q

AANA Standards for Oxygenation

A

Continous clinical observation
Continuous Pulse Oximetry
ABG (if indicated)

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11
Q

AANA Standards for Circulation

A

Continous ECG and heart sounds
KEEP volume level where you NEED to hear it
BP and HR at least q5minutes

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12
Q

AANA Standards for Body Temperature

A

Continuous monitoring on all PEDIATRIC patients receiving GA

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13
Q

Goal for body temperature

A

GREATER than 97F

LESS Than 97, WRITTEN UP

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14
Q

The colder the patient

A

the longer the anesthetics stay on board

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15
Q

Neuromuscular blockade need

A

Train of Four q15 minutes

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16
Q

Need to show proof of

A

Reversal of agent need to be documented

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17
Q

Reverse with

A

Neogstigmine and Glycopyrrolate

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18
Q

INVASIVE monitors

A

Foley
Arterial line
CVP
PA catheter

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19
Q

Urine output

A

1 ml/kg/hr

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20
Q

Case over 3 hours, what may be indicated?

A

Foley may be indicated

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21
Q

Brown port

A

CVP , position of the bed

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22
Q

Ditstal port

A

Brown

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23
Q

Your senses is

A

the ART of anesthesia

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24
Q

Vigilance include

A

Vigilance, sight, hearing, Touch, smell

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25
Q

Stethocoscope

A

Precordial vs Esophageal

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26
Q

Required for every PEDIATRIC patient

A

Precordial

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27
Q

Precordial does what

A 
Metal chest piece connected
Easily detect changes in breath and heart sound
EndoBRONCHIAL INTUBATION (
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28
Q

Mainstay of intubation

A

Capnography

29
Q

Sampling port by

A

Elbow of the circuit

30
Q

To analyze the particle size and the concentration of the gas both inspired and exhaled

A

MASS SPECTOMETER

31
Q

Which part of the most important to monitor

A

EXHALATION of the gas

32
Q

Most soluble

A

Isoflurane

33
Q

Least soluble

A

Desflurane

34
Q

ETCO2 scavenging

A

None

35
Q

Clinical Application of Capnometry best indicator of MH

A

Increased CO2

36
Q

If CO2 start dropping

A

Monitor BP (estimate Co)

37
Q

Respiration Mandatory

A

Apnea monitor

38
Q

Hyperventilating (CO2 low) for craniotomy

A

Decrease CBF (CO2 low to 20 mmHg)

39
Q

Mannitol in craniotomy

A

decrease brain volume and Diuresis

40
Q

Phase of CApnograpy

A

I- IV

41
Q

Phase I is

A

Dead space Ventilation

42
Q

Baseline elevattion indicates

A

CO2 absorbent exhausted
Incompetent ex or inspiratory valve
Bain circuit flow too low

43
Q

CO2 should be

A

Zero unless rebreathing occurs

44
Q

PHase II

A

Exhalation , should be steep

45
Q

Prolonged upstroke of Phase II

A

Mechanical obstruction

Slow emptying of the lungs (COPD/ Bronchospasm)

46
Q

Phase III is

A

Plateau

47
Q

Phase III represents

A

maximum CO2 at end of phase

48
Q

Right main stem would see

A

Change in Phase III

49
Q

Phase IV

A

Inspiratory phased

50
Q

Prolonged phase IV

A

Restrictive lung disease

51
Q

Smaller and smaller Waveerform

A

Endobronchial or ESOPHAGEAL intubation

52
Q

Decreases height of capnography

A

Decrease in CO

53
Q

Esophageal intubation

A

smaller waverform of CO2

54
Q

Waveform increasing , gradual

A

Hypoventilating

55
Q

Long inspiratory phase

A

sticky inspiratory valve

56
Q

Cardiogenic Oscillations

A

Artifarct

57
Q

O2 analyzer

A

Inspiratory limb

58
Q

Require pulsatile (issues with cold finger)

A

Nitro paste on finger, put pulse ox back on

59
Q

Oximetry involves the measurement of oxyhemoglobin (HbO2) concentration based on the

A

Lambert-Beer law

60
Q

IV dye will

A

Pulse ox will decrease

61
Q

O2 saturation is

A

directly proportional to the hemoglobin

62
Q

SaO2 30 is

A

60

63
Q

SaO2 40 is

A

75

64
Q

No waveform

A

Digital palpation

65
Q

No CO

A

NO pulse ox

66
Q

Most commonly used is

A

Lead II

67
Q

Too small

A

Falsely high readings

68
Q

Too large

A

falsely low readings

69
Q

Correct size is

A

20-50% > than diameter of patient extremity

SRNAProfessionalGuide II (13 decks)

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