Clinical Monitoring Pt 1 (Ericksen) Exam 1 (incomplete) Flashcards
Which of the following are included in the Oxygenation monitoring standards? (select 3)
a.) Electrocardiogram
b.) Clinical observation
c.) Pulse oximetry
d.) ABG’s as indicated
b.) Clinical observation
c.) Pulse oximetry
d.) ABG’s as indicated
S2
According to the Ventilation monitoring standards, what should be monitored every 5 minutes?
a.) Respiratory rate (RR)
b.) Blood pressure (BP)
c.) Heart rate (HR)
d.) Temperature
a.) Respiratory rate (RR)
2,3
Which of the following are part of the Cardiovascular monitoring standards? (select 3)
a.) Electrocardiogram
b.) Auscultation as needed
c.) BP and HR every 5 minutes
d.) Chest excursion
a.) Electrocardiogram
b.) Auscultation as needed
c.) BP and HR every 5 minutes
2,3
What method is used for monitoring Oxygenation as per AANA standards?
a) Electrocardiogram
b) Pulse oximetry
c) Blood pressure monitoring
d) Capnography
b) Pulse oximetry
2,3
In the context of Ventilation monitoring, ETCO₂ refers to:
a) End Tidal Carbon Monoxide
b) End Tidal Carbon Dioxide
c) End Tidal Oxygen
d) End Tidal Nitrogen
b) End Tidal Carbon Dioxide
2,3
Additional means of monitoring depend on the needs of the _______, surgical technique, or procedure.
patient
2,3
Omission with reason must be _______.
charted
2,3
When neuromuscular blocking agents are administered, _______ monitoring is required
neuromuscular
2,3
T/F
Thermoregulation monitoring is only necessary when clinically significant changes in body temperature are anticipated or suspected.
True
2,3
Which of the following conditions are associated with a left shift in the oxygen-hemoglobin dissociation curve? (select 3)
a.) Alkalosis
b.) Hypocarbia
c.) Hypothermia
d.) Acidosis
e.) Hypercarbia
f.) Hyperthermia
a.) Alkalosis
b.) Hypocarbia
c.) Hypothermia
4-7
Factors that cause a right shift in the oxygen-hemoglobin dissociation curve include: (select 4)
a.) Hypocarbia
b.) Acidosis
c.) Hypercarbia
d.) Hyperthermia
e.) Hypothermia
f.) Increased 2,3-DPG
b.) Acidosis
c.) Hypercarbia
d.) Hyperthermia
f.) Increased 2,3-DPG
4-7
According to the oxygen-hemoglobin dissociation curve, a PO₂ of 60 mm Hg corresponds to an O₂ saturation of approximately:
a) 100%
b) 75%
c) 90%
d) 50%
c) 90%
4-7
At what PO2 does hemoglobin have an O2 saturation of 75%?
A) 20 mm Hg
B) 40 mm Hg
C) 60 mm Hg
D) 80 mm Hg
B) 40 mm Hg
5
What is the O2 saturation of hemoglobin at a PO2 of 27 mm Hg?
A) 25%
B) 50%
C) 75%
D) 90%
B) 50%
5
The Beer-Lambert law relates the transmission of light through a solution to:
a) The color of the solution
b) The concentration of the solute in the solution
c) The pH of the solution
d) The temperature of the solution
b) The concentration of the solute in the solution
4-7
Light can be _______, absorbed, or reflected as it passes through matter.
transmitted
4-7
According to the Beer-Lambert law, light absorption must be measured at wavelengths that are proportional to the number of _______.
solutes
4-7
What is the relationship between concentration and light absorption? (Select all that apply)
A) Low concentration leads to high absorption
B) High concentration leads to high absorption
C) Low concentration leads to low absorption
D) High concentration leads to low absorption
B) High concentration leads to high absorption
C) Low concentration leads to low absorption
7
How does the light path length affect absorption? (Select all that apply)
A) Less light path length results in more absorption
B) More light path length results in more absorption
C) Less light path length results in less absorption
D) More light path length results in less absorption
B) More light path length results in more absorption
C) Less light path length results in less absorption
7
Which of the following types of hemoglobin are present in adult blood? (select 4)
a.) Oxyhemoglobin (O₂Hb)
b.) Reduced Hb (Deoxyhemoglobin, deO₂Hb)
c.) Methemoglobin (metHb)
d.) Carboxyhemoglobin (COHb)
a.) Oxyhemoglobin (O₂Hb)
b.) Reduced Hb (Deoxyhemoglobin, deO₂Hb)
c.) Methemoglobin (metHb)
d.) Carboxyhemoglobin (COHb)
8
Co-oximetry is considered the gold standard for measuring which of the following? (select 3)
a.) Blood glucose
b.) Oxyhemoglobin (O₂Hb)
c.) Carboxyhemoglobin (COHb)
d.) Methemoglobin (metHb)
e.) Serum electrolytes
b.) Oxyhemoglobin (O₂Hb)
c.) Carboxyhemoglobin (COHb)
d.) Methemoglobin (metHb
8
What wavelength of light is primarily absorbed by deoxyhemoglobin (deO₂Hb)?
a) 660 nm (red)
b) 940 nm (infrared)
c) 600 nm (orange)
d) 700 nm (near infrared)
a) 660 nm (red)
9
Which type of hemoglobin absorbs more infrared light than deoxyhemoglobin?
a) Carboxyhemoglobin
b) Methemoglobin
c) Oxyhemoglobin (O₂Hb)
d) Fetal hemoglobin
c) Oxyhemoglobin (O₂Hb)
9
The pulsatility of arterial blood flow is used to estimate _______.
SaO₂ (arterial oxygen saturation)
10
The ratio of AC to DC light absorption is used to calculate the _______ of hemoglobin.
oxygen saturation
10
The following types of hemoglobin can be distinguished using co-oximetry: (select 4)
a.) Oxyhemoglobin (O₂Hb)
b.) Deoxyhemoglobin (deO₂Hb)
c.) Carboxyhemoglobin (COHb)
d.) Methemoglobin (metHb)
e.) Fetal hemoglobin (HbF)
a.) Oxyhemoglobin (O₂Hb)
b.) Deoxyhemoglobin (deO₂Hb)
c.) Carboxyhemoglobin (COHb)
d.) Methemoglobin (metHb)
10
What is the gold standard method if oximetry is inaccurate?
a) Capnography
b) Arterial blood gas (ABG)
c) Co-oximetry
d) Spirometry
c) Co-oximetry
10
Which components affect light absorption in pulse oximetry? (select all that apply)
a.) Skin
b.) Soft tissue
c.) Venous blood
d.) Arterial blood
e.) Capillary blood
all of the above
10
Carboxyhemoglobin (COHb) absorbs light in the 660 nm range similarly to which type of hemoglobin?
a) Deoxyhemoglobin
b) Methemoglobin
c) Oxyhemoglobin
d) Fetal hemoglobin
c) Oxyhemoglobin
11
What effect does an increase in Carboxyhemoglobin (COHb) have on SpO₂ readings?
a) It decreases SpO₂ readings
b) It has no effect on SpO₂ readings
c) It falsely elevates SpO₂ readings
d) It decreases accuracy of SpO₂ readings but doesn’t change the value
c) It falsely elevates SpO₂ readings
11
Each 1% increase of COHb will increase SpO₂ by _______.
1%
11
Many smokers have more than _______% COHb in their blood.
6%
11
Which of the following characteristics change as the pressure wave moves to the periphery, away from the heart? Select all that apply (2)
A) Arterial upstroke becomes steeper
B) Systolic peak becomes lower
C) Dicrotic notch appears earlier
D) End-diastolic pressure becomes lower
E) Arterial upstroke becomes slower
A) Arterial Upstroke becomes steeper
D) End-diastolic pressure becomes lower
systolic peak becomes higher & Dicrotic notch appears later
slide 31
Which of the following statements about the creation of waveforms are true? Select all that apply -4.
A) Waveforms are created by the summation of sine waves
B) Only the fundamental wave is needed for a typical arterial pressure wave
C) Fourier analysis helps in the analysis of summation of multiple sine waves
D) Typically, 6 to 10 harmonics are required for most arterial pressure waveforms
E) The projection of waveforms on screens is due to Fourier analysis
A) Waveforms are created by the summation of sine waves
C) Fourier analysis helps in the analysis of summation of multiple sine waves
D) Typicall, 6-10 harmonics are required for most arterial pressure waveforms
E) The projection of waveforms on screens is due to Fourier Analysis
slide 32
What does the presence of several bounces after a fast flush indicate about the arterial line setup?
A) It is correct and functioning properly
B) It is overdamped
C) It is underdamped
D) It is not connected
C) It is underdamped
slide 33
Which of the following are characteristics of an underdamped arterial line system? Select all that apply (3)
A) Elevated systolic pressure
B) Decreased systolic pressure
C) Several dicrotic notches
D) Multiple oscillations after the fast flush
E) Loss of detail in the waveform
A) Elevated Systolic Pressure
C) Several Dicrotic notches
D) Multiple oscillations after the fast flush
slide 34
Which of the following are characteristics of an overdamped arterial line system? Select all that apply (3)
A) Elevated systolic pressure
B) Decreased systolic pressure
C) Absent dicrotic notch
D) Multiple oscillations after the fast flush
E) Falsely narrowed pulse pressure
B) Decreased systolic pressure
C) Absent Dicrotic Notch
E) Falsely narrowed pulse pressure
slide 34
Which of the following are consequences of decreased vessel compliance due to aging? (Select all that apply-2)
A) Increased systolic blood pressure
B) Increased distensibility
C) Decreased diastolic blood pressure
D) Lower peripheral vascular resistance
A) Increased systolic blood pressure
C) Decreased diastolic blood pressure
slide 35
Select all effects of increasing intra-thoracic pressure during the inspiratory phase: select 5
A) Decreased LV preload
B) Decreased systemic venous return
C) Increased RV afterload
D) Increased total lung volume
E) Decreased RV preload
F) Decreased LV stroke volume
G) Decreased systemic arterial pressure
H) Increased pulmonary vascular resistance (PVR)
B. Decreased systemic venous return
C. Increased RV afterload
D. Increased total lung volume
E. Decreased RV preload
H. Increased pulmonary vascular resistance (PVR)
slide 38
During the inspiratory phase, what happens to intra-thoracic pressure and LV afterload?
A. Both increase
B. Intra-thoracic pressure increases and LV afterload decreases
C. Both decrease
D. Intra-thoracic pressure decreases and LV afterload increases
B. Intra-thoracic pressure increases and LV afterload decreases
slide 38
What effect does increased total lung volume during the inspiratory phase have on LV preload?
A. It decreases LV preload
B. It has no effect on LV preload
C. It increases LV preload
D. It stabilizes LV preload
C. It increases LV preload
slide 38
Which of the following occurs as a result of increased LV preload and decreased LV afterload?
A. Decreased LV stroke volume
B. Decreased cardiac output (CO)
C. No change in systemic arterial pressure
D. Increased LV stroke volume, CO, and systemic arterial pressure
D) Increased LV stroke volume, CO, and systemic arterial pressure
slide 38
What happens to systemic venous return and RV preload as intra-thoracic pressure increases?
A. Both increase
B. Both decrease
C. Systemic venous return increases, RV preload decreases
D. Systemic venous return decreases, RV preload increases
B. Both decrease
slide 38
What is the normal range of systolic pressure variation (SPV) in mechanically ventilated patients?
A)7-10 mm Hg
B) 3-5 mm Hg
C) 10-15 mm Hg
D) 15-20 mm Hg
A) 7-10 mm Hg
slide 41
What is the normal range for the Δ Up component of SPV in mechanically ventilated patients?
A)1-2 mm Hg
B) 2-4 mm Hg
C) 4-6 mm Hg
D) 6-8 mm Hg
B) 2-4 mm Hg
slide 41
What does an increased SPV indicate in mechanically ventilated patients?
A) They are volume overloaded
B) They have normal volume status
C) They are at risk for hypertension
D) They are volume responsive or have residual preload reserve
D) They are volume responsive or have residual preload reserve
slide 41
Which of the following statements are true regarding pulse pressure variation (PPV)? (Select all that apply - 5)
A) PPV utilizes maximum and minimum pulse pressures over the entire respiratory cycle
B) Normal PPV is less than 13-17%
C) PPV greater than 13-17% indicates a positive response to volume expansion
D) PPV readings are not affected by mechanical ventilation
E) PPV greater than 13-17% can be an early indicator of hypovolemia
F) PPV values are irrelevant for assessing volume status
G) PPV is used to assess fluid status in patients
Feel free to adjust or expand these answer choices as needed!
A) PPV utilizes maximum and minimum pulse pressures over the entire respiratory cycle
B) Normal PPV is less than 13-17%
C) PPV greater than 13-17% indicates a positive response to volume expansion
E) PPV greater than 13-17% can be an early indicator of hypovolemia
G) PPV is used to assess fluid status in patients
slide 42
In which scenarios would you expect a positive response to volume expansion based on PPV readings? (Select all that apply - 2)
A. PPV of 10%
B. PPV of 14%
C. PPV of 18%
D. PPV of 12%
B) PPV of 14%
C) PPV of 18%
slide 42
When a patient has a PPV reading of 14%, the appropriate action is to:
A) Give volume
B) Administer a diuretic
C) Monitor without intervention
D) Reduce fluid intake
A) Give volume
slide 42
