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apa 1 /sim S. Horvath > levi monitoring powerpoint > Flashcards

levi monitoring powerpoint Flashcards

1
Q

contraindication for esophageal stethoscope

A

hx of esophageal varies or strictures, bariatric surgery

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2
Q

what does standard V require you monitor

A

ventilation, oxygenation, cv status, body temp, neuromuscular function and status, patient positioning.

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3
Q

red light is how many nm and is absorbed by

A

660, deoxyhemoglobin

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4
Q

infrared light is how many nm and is absorbed by

A

940, oxyhemoglobin

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5
Q

what law is the basis for pulse ox

A

beer lamberts

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6
Q

absence of end tidal CO2 is indicative of

A

esophageal intubation, accidental disconnect from breathing system, cardiac arrest

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7
Q

ETCO2 is __ lower than ABG

A

2-5

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8
Q

A to B

A

baseline. sample comes from deadspace and contains no CO2. should equal 0

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9
Q

b to c

A

exp upstroke. mix of dead space and alveolar gas

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10
Q

c to d

A

exp plateau - records alveolar emptying of CO2

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11
Q

D

A

end tidal concentration represents rapid decrease in CO2 conc

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12
Q

D - E

A

descent to original baseline. rapid decrease of CO2 as patient breathes in

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13
Q

normal PR

A

.12-.2sec

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14
Q

QRS

A

.06 to .10sec

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15
Q

QT

A
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16
Q

anesthetics inhibit central thermoregulation by interfering with ___ function

A

hypothalmic

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17
Q

causes of high ETCO2

A

mh, fever, hypoventilatin, CNS depressent, met alka, bicarb admin, skeletal muscle activity, sz

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18
Q

causes of low ETCO2

A

hypothermia, low cardiac output, hypovolemia, pain, anxiety, hyperventilation, hypotensive

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19
Q

if ETOC2 wave isnt returning to baseline what is happening

A

rebreathing - exhausted CO2 absorber, inadequate fresh gas flow

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20
Q

sloping of plateau phase (phase3) is indicative of

A

prolongation of expiration, obstruction, v/q mismatch, COPD, emphysema, kinked ETT/ anything that makes breathing out take longer

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21
Q

what do you see in patient with spontaneous insp asynchronous with controlled ventilation

A

curave cleft

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22
Q

two types of infrared spectrometry

A

mono and poly

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23
Q

mono absorption spectrum is ___ of halogenated agents, while poly is ___

A

similar , different

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24
Q

which monitor must be programmed with the agent selected

A

monochromatic

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25
Q

which monitor can measure both gases simultaneously if you change from one agent to another

A

poly

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26
Q

raman spectrometry uses

A

scattered light

27
Q

what does the respirometer/ventimeter on the old anesthesia machine measure.

A

TV and min vent (digital now)

28
Q

where is the resp/ventimeter located on the old AGM

A

exhalation limb

29
Q

what does peak insp pressure monitor

A

positive pressure created by mechanical ventilation of the lungs

30
Q

why would low pressure alarm sound

A

disconnect, leak

31
Q

what is the high pressure alarm usually set at

A

40

32
Q

excessive airway pressure may indicate __ pulm compliance

A

low… pulm edema, paralytic wearing off, COPD, ARDS, asthma

33
Q

if high pressure alarm is going off check for

A

kink or mucous plug

34
Q

is ecg a measure of heart function?

A

no

35
Q

standard 1mv change represents a deflection of __mm on paper strip

A

10

36
Q

since R and L ventricular performance is parallel in healthy hearts, ___ can also be assessed by CVP

A

LV filling

37
Q

stimulation of ulnar nerve causes contraction of

A

adductor pollis muscle

38
Q

stimulation of facial nerve causes contraction of

A

orbitcularis oculi

39
Q

which muscle recovers faster from neuromuscular blockage?

A

orbitcularis oculi

40
Q

which med is a depolarizing paralytic

A

succs. activates the receptors first then blocks them afterwards - fassiculation

41
Q

which agents give you a fade?

A

non-depolarizers - roc vec panc

42
Q

does 4 twitches guarantee they are going to breathe well?

A

no - represents 70%

43
Q

3 twitches

A

75-80% para

44
Q

2 twitches

A

80-85% para

45
Q

1 twitches

A

90-95% para

46
Q

no twitches

A

100% paralyzed

47
Q

how does tetany work

A

actely is released into receptor site. TOF may elicit a response.

48
Q

tentany MOA

A

competitive antagonism

49
Q

with non-depolarizers, what do you see in tetany

A

fade

50
Q

what is oliguria defined as

A

UOP

51
Q

what provides early evidence of cerebral ischemia

A

eeg

52
Q

4 types of evoked potentials

A

visual , auditory , somatosensory, motor

53
Q

goal is to titrate concentration of anesthesia to maintain BIS near

A

60

54
Q

BIS less than 60 indicates

A

high probability of unresponsiveness and low prob of awareness

55
Q

what should you use during a carotid surgery to monitor oxygen

A

cerebral oximetry monitoring

56
Q

what represents burst suppresssion

A

20

57
Q

what BIS number is light mod sedation

A

80

58
Q

what alters evoked potentials

A

general anesthesia

59
Q

alpha angle increased

A

exp air flow obstructed… copd, bronchospasm, kinked ett

60
Q

beta angle increased

A

rebreathing

61
Q

during spinal/epidural anesthesia hypothermia occurs secondary to

A

internal redistribution of heat.

62
Q

sympathetic blockade causes

A

vasodilation w peripheral pooling of blood

63
Q

you dont lose twitches until what percent are blocked

A

70

apa 1 /sim S. Horvath (17 decks)

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