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Principles of Anesthesia 1 (Summer 2023) > Exam 1 (Monitoring) > Flashcards

Exam 1 (Monitoring) Flashcards

1
Q

What monitoring device is always necessary for anesthesia?

A

EtCO2, even with nasal cannula

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2
Q

Red wavelengths operate at what wavelength?

A

660nm

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3
Q

Infrared wavelengths of light operate at?

A

940nm

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4
Q

deO2Hb absorbs more or less red light than O2Hb?

A

more

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5
Q

O2Hb absorbs more or less infrared light than deO2Hb?

A

less

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6
Q

What is the formula for the DC & AC ratio?

A

R= (AC660 / DC 660) / (AC 940 / DC 940)

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7
Q

At what nm does carboxyhemoglobin absorb as much light as O2Hb?

A

660nm

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8
Q

What Hb does not abosrb light at 940nm?

A

Carboxyhemoglobin

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9
Q

Each 1% increase in COHb will increase/decrease SpO2 by ____%?

A
  • Increase
  • 1%
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10
Q

Venous blood pulsations will increase/decrease SpO2?

A

decrease

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11
Q

Will methylene blue injection increase or decrease SpO2?

A

decrease

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12
Q

When are PulseOx and ABG within +/- 2%?

A

When sats >70%

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13
Q

Are sats reading affected by anesthetic vapors?

A

No

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14
Q

What are some disadvantages to PulseOx?

A
  • Poor function with poor perfusion
  • Delayed hypoxic event detection
  • Erratic w/ dysrhythmias
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15
Q

What are some disadvantages to PulseOx?

A
  • Poor function with poor perfusion
  • Delayed hypoxic event detection
  • Erratic w/ dysrhythmias
  • Inaccurate w/ different hemoglobins
  • etc
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16
Q

Where should PulseOx not be placed?

A

Index fingers to prevent corneal abbrasions

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17
Q

Where should PulseOx be placed with epidurals?

A

On the toe d/t vasodilation

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18
Q

What is phase I of the Korotkoff sounds?
What about phase V?

A
  • SBP
  • DBP (very hard to hear in kids)
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19
Q

What part of automatic BP monitoring is in most agreement with invasive?
What about least in agreement?

A
  • The MAP, it is the closet to invasive
  • Least agreement is the SBP
20
Q

What conditions produce errors with non-invasive BP monitoring?
How are the reading affected>?

A
  • atherosclerosis
  • edema
  • obesity
  • chronic HTN
  • SBP will read low & DBP will read high
21
Q

The MAP will be ____ during hypertension?
What about hypotension?

A
  • Underestimated
  • Overestimated
22
Q

Use caution with non-invasive BP monitoring in Pt’s with following conditions?

A
  • severe coagulopathies
  • peripheral neuropathies
  • arterial/venous insufficiency
  • recent thrombolytic therapy
23
Q

Wave #1 of an arterial line waveform comes when?

A

After the R-wave

24
Q

With arterial waveforms as the measuring site moves more distal, what happens to the waveform (4)?

A
  • arterial upstroke is steeper
  • systolic peak is higher
  • Dicrotic notch is later
  • End-diastolic pressure is lower
25
Q

How many waveforms are required for an acurate a-line tracing?

A

6-10 harmonic waves

26
Q

Multiple dicrotic notches means the the A-line bag is?

A

Underdamped

27
Q

What measurement is false with an underdamped A-line?

A

SBP is elevated

28
Q

How does the inspiratory phase of positive pressure ventilation affect intra-thoracic pressure & LV preload & afterload?

A
  • Intra-thoracic pressure increases
  • LV Preload increases
  • LV afterload decreases
29
Q

How does inspiratory phase of positive pressure ventilation affect PVR, RV pre- & afterload, & venous return?

A
  • PVR increases
  • RV preload decreases
  • RV afterload increases
  • venous return decreases
30
Q

Increased SPV is an indication of what?

A

hypovolemia

31
Q

What is the difference between SPV & PPV?

A
  • SPV is measured at end-expiratory
  • PPV is measured over the entire respiratory cycle
32
Q

Stroke volume variation correlated resistance & compliance based on?

A

Age & gender

33
Q

What challenges does the Mainstream sampling have?

A
  • Water vapor
  • secretions
  • blood
  • more interfaces for disconnects
34
Q

What challenges does the Side-stream sampling have?

A
  • kinked sample tubing
  • water vapor
  • failure of sampling pump
  • leaks in line
  • slow response time
35
Q

Which gas is not absorbed by IR radiation?

A

O2

36
Q

Side-stream analyzers do not account for what in values?

A

H2O

37
Q

What are the Cons of Fuel or Galvanic cell O2 analyzers?

A
  • Short life span (months)
  • Slow response time (monitor O2 in inspiratory limb)
38
Q

What are the Pros of Paramagnetic O2 analyzers?

A
  • Rapid response
  • Breath by breath monitoring
39
Q

The total pressure exerted by a mixture of gases is equal to the sum of the partial pressures of each gas is who’s law?

A

Dalton

40
Q

Which type of SSEP is MOST COMMONLY monitored during surgical procedures?

A

Short-latency

41
Q

Which of the four types of adult hemoglobin is LEAST LIKELY to be measured at the 940 nm wavelength?

A

Carboxyhemoglobin

42
Q

What is the amount of tidal volume exhaled during phase I?

A

1/3

43
Q

Physiologic effects of hypocarbia are:
- respiratory alkalosis and increased ICP.
- blunting of respiratory drive and respiratory acidosis.
- respiratory alkalosis and potassium shift to intravascular space.
- blunting of respiratory drive and decreased cerebral blood flow.

A

blunting of respiratory drive and decreased cerebral blood flow.

44
Q

The capnogram has a prolonged upstroke with an alpha angle >110 degrees, what is the problem causing the change?

A

The ETT is partially obstructed.

45
Q

What are the LIKELY causes of decreased EtCO2?
- Hypothermia and poor gas sampling.
- Hyperventilation and increased metabolic rate.
- Hyperthermia and cardiac arrest.
- Hypothermia and rebreathing.

A

Hypothermia and poor gas sampling.

Principles of Anesthesia 1 (Summer 2023) (14 decks)

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