Module 9 Part 2 Flashcards

1
Q

at minimum, BP should be recorded at least once every ___ minutes

A

5 minutes

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2
Q

According to ATLS, if only the patient’s carotid pulse ispalpable, the systolicblood pressureis ___-___ mm Hg

A

60-70mmHg

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3
Q

According to ATLS, if carotid and femoral pulses arepalpable, the systolicblood pressureis ___-___ mm Hg

A

70-80mmHg

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4
Q

According to ATLS, and if the radial pulse is alsopalpable, the systolicblood pressureis more than ___ mmHg

A

80mmHg

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5
Q

What is a Korotkoff sound?

A

auscultation of arterial pulsation when taking a manual BP

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6
Q

Automated noninvasive blood pressure monitors (also known as automated sphygmomanometers) employ the ________ methodto estimate the arterial blood pressure.

A

oscillometric

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7
Q

With peripheral NIBP measurements, as the site of measurement is moved more peripherally, the measured SP tends to ________, and the DP tends to _______

A

Increase

Decrease

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8
Q

The correlation between calf and upper arm blood pressures was found to be poor in this patient population.

A

cesarean section pts

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9
Q

These sounds are produced by turbulent blood flow within an artery during cuff deflation.

A

Korotkoff sounds

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10
Q

Equation for MAP calculation

A

[SBP + (DBP × 2)]/3

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11
Q

Calculate the MAP of a BP of 120/80

A

93mmHg

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12
Q

_________ comprises approximately two-thirds of a normal cardiac cycle.

A

diastole

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13
Q

The American Heart Association recommends that the bladder width for indirect blood pressure monitoring should approximate ___% of the circumference of the extremity

A

40%

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14
Q

Bladder length should be sufficient to encircle at least ___% of the extremity

A

80%

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15
Q

List the contraindicated scenarios (4) of NIBP use on an extremity

A

AV fistula
Local bone fractures
Open injury
PICC lines

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16
Q

Falsely _____ BP estimates result when cuffs are too small, when cuffs are applied too loosely, or when the extremity is below heart level.

A

High

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17
Q

Falsely _____ BP estimates result when cuffs are too large, when the extremity is above heart level, or after quick deflations

A

Low

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18
Q

What is the name of the non-invasive finger cuff that gives continuous SBP, DBP, MAP & advanced data such as SV, SVV, CO, SVR

A

ClearSight finger cuff

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19
Q

The gold standard for measuring BP is through ______

A

Art lines

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20
Q

Where should the A-line transducer be leveled to?

A

phlebostatic axis

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21
Q

Quick deflations can lead to a falsely ____ BP

A

Low

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22
Q

After intubation, ALWAYS verify _______

A

Placement

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23
Q

Presence of _____ reflects ventilation, pulmonary blood flow, aerobic metabolism

A

CO2

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24
Q

measurement and quantification of CO2

A

Capnometry

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25
Q

recording of the capnometry measurement

A

Capnography

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26
Q

continuous display of CO2 during phases of ventilation

A

Capnogram

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27
Q

______ capnography is most commonly used in the perioperative setting.

A

Time

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28
Q

How many phases are in a normal capnogram tracing?

A

4

29
Q

__-__represents baseline CO2

A

A-B

30
Q

__-__represents expiratory upstroke

A

B-C

31
Q

__-__represents expiratory plateau

A

C-D

32
Q

__represents end-tidal concentration of CO2

A

D

33
Q

__-__represents descent to original baseline

A

D-E

34
Q

This portion in a normal capnogram should approximate zero

A

Phase 1 (or A-B)

35
Q

This sample from phase 1 of a normal capnogram comes from the anatomic ________ and contains no CO2

A

deadspace

36
Q

This phase represents the rapid passing of initial expired gas through the upper airways

A

Phase 2 (or B-C)

37
Q

ETCO2is measured at the end of the ______ just prior to the beginning of phase ____

A

plateau

phase 4

38
Q

The _____ phase represents the plateau and records alveolar emptying of CO2

A

3rd phase

39
Q

The _____ phase is displayed as the rapid decrease in CO2concentration of sampled gas as a result of inspiration of air or O2

A

4th phase

40
Q

In a normal capnogram, phase ____ records a mixture of anatomical deadspace and alveolar gas

A

Phase 2

41
Q

What is the normal range for ET CO2?

A

35-45 mmHg

42
Q

Is the 3rd phase of a capnogram shorter or longer in a spontaneously breathing pt vs a mechanically vented pt?

A

Shorter

43
Q

What two co-morbidities are associated with a “shark fin” appearance on a capnogram?

A

Asthma

COPD

44
Q

During CPR, you should aim for an ET CO2 goal of ____ mmHg

A

10 mmHg

45
Q

This tracing pattern reflects ET tube disconnection, obstruction, kinked, or loss of circulatory function

A

Sudden loss of waveform

46
Q

In a hypoventilatory pt, will you see a low or high ET CO2 on your capnogram tracing?

A

High

47
Q

(T/F) The capnogram tracing reads 0 during peak expiration

A

False (peak inspiration)

48
Q

ET CO2 is measured at the end of the _______ phase

A

Expiratory (or 3rd phase, or C-D phase)

49
Q

In healthy population, difference between PaCO2 and EtCO2 < __ mmHg

A

5 mmHg

50
Q

EtCO2 may not accurately reflect PaCO2 if pt spontaneously ventilating through ____ or ________

A

NC

Face mask

51
Q
Will you see increased or decrease ET CO2 with:
decreased alveolar ventilation
increased CO2 production/delivery
Exhausted CO2 absorber
Rebreathing
A

Increased ET CO2 (be familiar with PP slide 35)

52
Q
Will you see increased or decrease ET CO2 with:
increased alveolar ventilation
decreased CO2 production/delivery
hyperventilation
complete airway obstruction
A

Decreased ET CO2 (be familiar with PP slide 35)

53
Q

ETT cuff leak will give you high or low ET CO2?

A

Low

54
Q

Complete airway obstruction = high or low ET CO2?

A

Low

55
Q

Circuit leak will give you a high or low ET CO2 reading?

A

High

56
Q

Hypothermic pt will have high or low ET CO2?

A

Low

57
Q

___________ is the standard of care for monitoring oxygenation

A

Pulse oximetry

58
Q

Pulse ox transmittance technology is based on the ____________ Law

A

Beer - Lambert Law

59
Q

The relationship of SaO2 and PaO2 is described by the __________ __________ curve

A

Oxyhemoglobin dissociation curve

60
Q

High SaO2 values cannot distinguish between normo-hyper oxygenation, which is very important in _________ patients

A

neonate

61
Q

Variations in pulse ox amplitude in the plethysmographic waveform may predict _______ __________

A

fluid responsiveness

62
Q

The incidence of hypoxemia ranges from ___ to ___ times less in patients monitored with pulse oximetry.

A

1.5-3 times

63
Q

When SpO2 is 80-100%, readings from the pulse ox will be within approximately -+ __%

A

+- 2%

64
Q

When SpO2 is <80%, readings from the pulse ox will be within approximately -+ __%

A

+- 5%

65
Q

Pulse oximeter readings are inaccurate when SpO2 is below ___%

A

70%

66
Q

According to recent studies, is nail polish still a problem with pulse ox readings?

A

Nope

67
Q

What are 2 examples of dyes that can cause a falsely low SpO2 reading?

A

methylene blue

indigo carmine

68
Q

methemoglobin absorbs light equally to oxyhemoglobin. As a result, pulse oximeter measurements are falsely _____-estimated when oxygen saturation is above 85% and _______-estimated when oxygen saturation is below 85%

A

under-estimated

over-estimated

69
Q

High levels of carboxyhemoglobin will cause an _____-estimation of SpO2

A

over-estimation