miscellaneous monitors and equipment

Question 1

what is the best method of assessing deep neuro muscular block

Answer 1

post tetanic count

Question 2

clinical recovery from NMB happens when TOF achieves

Answer 2

> 0.9

Question 3

results of TOF will not be accurate for up to ______ after sustained tetany assessment

Answer 3

6 minutes

Question 4

when to use post tetanic count

Answer 4

to assess depth of NMB when no twitches are present
-6-10 post tetanic twitches suggests T1 will come back at any minute

Question 5

cerebral oximetry
utilizes what to monitor
measures what O2 sat

Answer 5

utilizes near infrared spectrometry (NIRS)
measures venous O2
regional NOT global monitoring

Question 6

placement of cerebral oximetry

Answer 6

sensor placed on patients scalp usually over frontal lobe
contains a light emitting diode with two light sensors

Question 7

what change from baseline suggests a reduction in cerebral oxygenation?

Answer 7

25% change from baseline

Question 8

classify this brain wave

Answer 8

beta
13-30 cycles/second
high frequency and low voltage
associated with awake mental stimulation and light anesthesia

Question 9

classify this brain wave

Answer 9

alpha
frequency 8-12 cycles/second
associated with awake but restful state (eyes closed)

Question 10

classify this brain wave

Answer 10

theta
4-7 cycles/second
associated with GA and children during normal sleep

Question 11

classify this brain wave

Answer 11

delta
<4 cycles/second
associated with GA, deep sleep, or brain ischemia/injury

Question 12

classify this brain wave

Answer 12

burst suppression
associated with GA, hypothermia, CPB, and cerebral ischemia (esp if its unilateral burst suppression)

Question 13

classify this brain wave

Answer 13

isoelectricity. absence of electrical activity associated with very deep anesthesia or death

Question 14

how brain waves change during anesthesia
what increases beta wave activity
what waves predominate during GA
what is associated with burst suppression
what is associated with isoelectricity

Answer 14

induction and light anesthesia is associated with increased beta activity
theta and delta waves predominate during GA
deep anesthesia produces burst suppression
at 1.5-2 MAC GA causes complete suppression or isoelectricity

Question 15

which anesthetic agent increases beta wave activity

Answer 15

nitrous oxide alone

Question 16

which anesthetic agent is associated with epileptiform EEG activity

Answer 16

sevo
(etomidate can produce myoclonus but does NOT produce epileptiform EEG activity)

Question 17

how does ketamine affect EEG

Answer 17

can increase high frequency cortical activity and may confuse EEG interpretation- the patient may be deeper than the EEG suggests

Question 18

what EEG waveform is suggestive of cerebral ischemia

Answer 18

unilateral burst suppression

Question 19

the development of new _______ waves signify the brain is at risk for ischemia

Answer 19

delta waves

Question 20

when does burst suppression start on BIS

Answer 20

20

Question 21

as the level of anesthesia becomes deeper, what happens to the physical characteristics of the EEG waveform

Answer 21

lower frequency (slower)
higher amplitude (taller)

Question 22

what can impair the accuracy of the bis (3)

Answer 22

hypothermia, electromyographic interference, encephalopathy

Question 23

patient safety index monitor target range for GA

Answer 23

its similar to BIS but target range is 25-50

Question 24

macroshock voltage and clinical consequences
1mA
5mA
10-20mA
50mA
100mA

Answer 24

Question 25

microshock voltage and clinical consequences
10uA
100uA

Answer 25

Question 26

grounded v not grounded
OR supply
equipment

Answer 26

OR supply: not grounded
equipment: grounded

Question 27

primary purpose of line isolation monitor

Answer 27

ensures OR supply is not grounded but does alert when the OR has become grounded. it will alarm when 2-5mA of leak current is detected

Question 28

if LIM (line isolation monitor) sounds, what should you do

Answer 28

un plug the last piece of equipment that was plugged in