Mixed Venos Oximery / ABG interpretation

Question 1

Definition of monitoring ?

Answer 1

To warn or remind

Question 2

4 Principles of monitoring ?

Answer 2

1. ) Achieve survival
2. ) Utilize trends rather than isolated values.
3. ) Employ multiple rather than single indexes
   
   • CO
   • HR
   • BP
   • Urine
4. ) Coordinate with clinical judgment

Question 3

Complications of monitoring ?

Answer 3

1. ) Procedural Pneumothoraxes
2. ) Equipment malfunction
3. ) Data Interpretation
4. ) Data value

Question 4

The goal of cardiovascular system is not to maintain Ideal pressures but to provide what ?

Answer 4

Adequate tissue perfusion and tissue oxygenation.

Question 5

Parameters not frequently reviewed ?

Answer 5

• Urine output

- Tissue Oxygenation

Question 6

Causes of Hypoxia

Answer 6

1. ) Hypoxemia
2. ) Hypoperfusion
3. ) Anemia Qualitative/Quantitative
4. ) Histo-toxic
   
   • Cyanide poisoning
   • Sepsis
   • Cellular inabilities

Question 7

4 oxygen assessment tests to assess pulmonary function ?

Answer 7

1. ) Arterial gas exchange
2. ) Pulse Oximeter
3. ) Arterial blood gases
4. ) Intrapulmonary shunts

Question 8

2 oxygen assessment tests to peripheral utilization ?

Answer 8

1. ) SVO2

2. ) O2 consumption measurement

Question 9

5 reflectors of total oxygen balance ?

Answer 9

1. ) PvO2
2. ) Ca-CvO2
3. ) SvO2
4. ) O2 extraction ratio
5. ) Lactic Acid

Question 10

Formula for C.O. ?

Answer 10

Stroke Volume X HR

Question 11

What is the end point for adequacy ?

Answer 11

Determine if adequate C.O.

Question 12

Minute volume formula ?

Answer 12

volume of gas inhaled or exhaled from a person’s lungs per minute.
Tidal Volume X Respiratory Rate = Minute Volume

Question 13

* what are the 4 variables of SvO2 ? **

Answer 13

• C.O.
• SaO2
• VO2
• Hgb

Question 14

Perfusion is relative to need.

Answer 14

• Increased patient need

- Increased cardiac performance

Question 15

Decreased SVO2 may be due to what 4 things?

Answer 15

↓ C.O.
↓ O2 saturation
↓ Hgb
↑ Metabolic Rate

Question 16

Homeostatic Mechanisms of O2 balance ?

Answer 16

↑ C.O. to meet O2 demands

↑ O2 extraction

Question 17

Mixed venous oximetry does not address

Answer 17

Individual organ beds

Question 18

PA variability ?

Answer 18

PvO2 = 40

Sat % = 75

Question 19

Cerebral variability ?

Answer 19

PvO2 = 37

Sat % = 69

Question 20

Renal variability ?

Answer 20

PvO2 = 74

Sat % = 94

Question 21

Skeletal Muscle Variability ?

Answer 21

PvO2 = 32

Sat % = 60

Question 22

Skin variability ?

Answer 22

PvO2 = 75

Sat % = 95

Question 23

Intestinal variability ?

Answer 23

PvO2 = 45

Sat % = 80

Question 24

When might pulse oximetry be inappropriate ?

Answer 24

• Hypothermic
• Vasoconstricted
• Underperfused

Question 25

Shivering will cause what ?

Answer 25

Increase metabolic demand

Question 26

Abnormal high venous saturations may be due to what 6 conditions ?

Answer 26

1. ) Cirrhosis
2. ) Liver Failure
3. ) AV fistulas
4. ) Portacaval shunt
5. ) Sepsis
6. ) Vascular shunt

Question 27

4 medical conditions which may produce abnormally high venous saturations ?

Answer 27

1. ) Paget’s disease
2. ) Pancreatitis
3. ) Cyanide poisoning
4. ) Rapid catheter withdrawal

Question 28

Name 2 metabolic acids ?

Answer 28

Pyruvic Acid

Lactic Acid

Question 29

PaO2 is the ?

Answer 29

Diving force of perfusion

Question 30

What blood gas reflects ventilation ?

Answer 30

Co2

Question 31

Base deficit / excess reflects what ?

Answer 31

Metabolic component

Question 32

Metabolic acids are excreted by what organ ?

Answer 32

Kidneys

Question 33

Respiratory acids are excreted by what organ ?

Answer 33

Lungs

Question 34

Carbonic acid, Pyruvic acid, and Lactic acids are _____ ?

Answer 34

Metabolic

Question 35

Metabolic acids are assessed in blood gases by assessing ?

Answer 35

Base excess or deficit

Question 36

Metabolic alkalosis is characterized by what ?

Answer 36

Base excess

Question 37

Metabolic acidosis is characterized by what ?

Answer 37

Base deficit