Miscellaneous - Midterm Wrap Up

Question 1

What can happen if CVC is placed in RA?

Answer 1

Dysrythmias

Thrombus Formation

Cardiac Peforation

Question 2

Complications of Floating PA Catheter

Answer 2

• PA Rupture
• RBBB
• Complete Heart Block if pre-existing LBBB
• Dysrhythmias

Question 3

How many days til an increase in catheter related infection?

Answer 3

3 Days

Question 4

What is most common complication of obtaining CVC access?

Answer 4

Dysrhythmias

Question 5

What is best way to treat PACs/PVCs when placing CVC?

Answer 5

Withdraw catheter and start over

Question 6

Transducer above Phlebostatic axis _________ CVP and below th axis _______ CVP

Answer 6

Above = Decreases CVP

Below = Increases CVP

Question 7

Swan Parts:

Proximal Injecate Port

Answer 7

Blue - Right Atria

Question 8

Swan Parts:

Thermistor

Answer 8

Calculates CO by thermodilution

Question 9

Swan Parts:

Red Port

Answer 9

Balloon Inflation Port

Question 10

How to know when Swan tip is not in correct Lung Zone

Answer 10

PAOP > LVEDP

Non Phasic PAOP Tracing

Cant aspiration blood when Wedged

Question 11

Factors of ECG Monitoring

Answer 11

Electrode Location

Conduction Pathway & Speed

Muscle Mass

Question 12

What converts electrical energy to acoustic energy in an Ultrasound?

Answer 12

Piezoelectric Material

Question 13

What are the Three Ultrasound Probes

Answer 13

• Phased Array - narrow Probe
• Curved Linear Array - wider probe, convex view
• Linear Arraw - rectangular, for surface structures

Question 14

Ultrasound Modes

Answer 14

B Mode

M Mode

Color Flow Doppler

Continuous Wave Doppler

Pulsed Wave Doppler

Question 15

What does ultrasound gain correspond to?

Answer 15

Brightness

Question 16

What is Echogenicity?

Answer 16

Measure of ability to reflect sound waves

Question 17

Hyperechoic

Answer 17

White

EX: Bones, tendons, upper nerves

Question 18

Hypoechoic

Answer 18

Gray

EX: Fat, Lower nerves

Question 19

Anechoic

Answer 19

Black

Ex: Arteries & Veins

Question 20

Absolute Contraindications for TEE

Answer 20

Peforated Viscus

Esophageal Abmormalities

Active Upper GI Bleed

Question 21

Patient position for TEE

Answer 21

Left Lateral Decubitus

Question 22

PreOP TEE Considerations

Answer 22

Detailed PreOp Workup

Most recent EF

Reason for TEE

Low EF = difficult sedation

Question 23

Chromosome Associated w/ Malignant Hyperthermia

Answer 23

Ryanodine 1 Receptor on Chromosome 19

Question 24

Malignant Hyperthermia

Answer 24

Can occur > 1 hr after emergence

Fam. hx plays big role

Rarely happens w/o triggering agents

Question 25

Test for diagnosing Malignant Hyperthermia

Answer 25

Caffeine Halothane Contracture Test

Question 26

Symptoms of Malignant Hyperthermia

Answer 26

Tachycardia
↑ETCO2
Metabolic Acidosis
Muscle Rigidity
Hyperkalemia
↑Temperature

Question 27

How to Treat Malignant Hyperthermia

Answer 27

Stop Gas

Give IV Dantrolene

Hyperventilate w/ 100% O2

Treat Electrolytes

ABG

Cool Patient

Question 28

What part of the brain controls body temperature?

Answer 28

Hypothalamus

Question 29

How does the body attempt to release heat when hot?

Answer 29

Sweat and Relax Muscles

Question 30

How does the body try to retain heat in a cold environment?

Answer 30

Shivering, Tense Muscles, and Arrector Pilli muscles raise hair

Question 31

Common Intraoperative Complications of Hypothermia

Answer 31

Shivering

Vasoconstriction

Bleeding