Monitoring

Question 1

Inferior MI - leads and artery involved

Answer 1

• II, III, AVF

- right

Question 2

Posterior MI - leads and artery involved

Answer 2

• inversion (reciprocal changes): V1, V2

- left circumflex

Question 3

Lateral MI - leads and artery involved

Answer 3

I, AVL, V5, V6

-left circumflex

Question 4

Anterior MI - leads and artery involved

Answer 4

• I, AVL, V1-V4

- LAD

Question 5

Anteroseptal MI - leads and artery involved

Answer 5

• V1-V4

- LAD

Question 6

what arrhythmia is associated with mitral valve replacement?

Answer 6

third-degree: complete heart block

Question 7

left bundle branch block

Answer 7

• V1: negative RS complex
• I, AAVL, V6: wide

*caution PA catheter can lead to complete heart block

Question 8

right bundle branch block

Answer 8

-V1

Question 9

digitalis toxicity

Answer 9

• digitalis effect: ST-segment sloping
• increased by verapamil, quinidine, amiodarone
• avoid digoxin in WPW

Question 10

hypothermia

Answer 10

-J-point of Osborn waves

Question 11

pericardial tamponade

Answer 11

• low voltage P wave and QRS complex

- varying amplitude

Question 12

pulmonary embolus

Answer 12

-Q waves in III, AVF

Question 13

MI EKG signs

Answer 13

• new Q waves
• broadening of Q waves
• new QS deflections

Question 14

best type of arterial line cannula

Answer 14

short and narrow

Question 15

phlebostatic axis

Answer 15

4th intercostal space at midaxillary line - R atrium

Question 16

CVP waveforms

Answer 16

A - atrial contraction
X - atrial diastole
C - tricuspid closure
X1 - ventricular contraction
V - atrial filling
Y - passive ventricular filling

Question 17

how long after pacer wire insertion do you have to wait before inserting a CVC

Answer 17

1-2 months

Question 18

where should the pulmonary artery catheter tip lie?

Answer 18

west lung zone 3 - below the L atrium

Question 19

R atrial pressure

Answer 19

1-10

mean 5

Question 20

R ventricular pressure

Answer 20

15-30/0-8

mean: 25/5

Question 21

PA pressure

Answer 21

15-30/5-15

mean 23/9

Question 22

mean pulmonary pressure

Answer 22

10-20

mean: 15

Question 23

PAWP

Answer 23

5-15

mean 10

Question 24

L atrial pressure

Answer 24

4-12

mean 8

Question 25

L ventricular pressure

Answer 25

90-140

mean 130

Question 26

systemic vascular resistance: normal value, equation, and what it measures

Answer 26

900-1400 (1500-2000 index)

80 x (MAP-R atrial pressure)/CO

measures L ventricular afterload

Question 27

pulmonary vascular resistance: normal value, equation, and what it measures

Answer 27

150-250 (250-400 index)

80 x (PA MAP-L atrial pressure)/CO

measures R ventricular afterload

Question 28

RV pressures above 40 indicate?

Answer 28

chronic pulmonary HTN

Question 29

normal SvO2

Answer 29

65-75%

Question 30

ventricle depolarizes from ______ to _____ and repolarizes from _____ to ______

Answer 30

endocardium to epicardium

epicardium to endocardium

Question 31

best leads for ischemia detection?

Answer 31

V5, V6

II

Question 32

BIS - numbers to keep between that reduces anesthesia awareness

Answer 32

40-60

Question 33

ACT: normal and during bypass

Answer 33

normal: 80-120
bypass: 300-400

Question 34

heparin resistance: definition, mechanism of action, and additional name

Answer 34

need increased amount of heparin to increase ACT

binds to antithrombin III, accelerates rate at which it inhibits thrombin

heparin tachyphylaxis

Question 35

aPTT

Answer 35

better for monitoring low amounts of heparin

normal 28-32