monitoring the anesthesized patient

Question 1

bad CRT

Answer 1

over 2 seconds

Question 2

palpable arterial pulses

Answer 2

lingual

Question 3

pulse pressure

Answer 3

systolic-diastolic

weak-hypovolemia, ventricular failure, severe arrhythmias, pericardial disease/effusion, subaortic stenosis

bounding-PDA, aortic insufficiency, vasodilation, anemia

Question 4

heart rate

Answer 4

increased: pain/inadequate level of anesthesia, anesthetic drugs, hypotension, hypoxia, hypercarbia, anemia, fever
decreased: increased vagal tone/reflexes, excessive anesthetic depth, anesthetic drugs, hypertension, hypoxia, hypothermia, hyperkalemia, increased intracranial pressure

Question 5

ventilatory system

Answer 5

decreased ventilation: direct CNS depression, respiratory muscle relaxation

effort/pattern: thoracic, abdominal, diaphragmatic

effects of NMBD: paralysis

Question 6

auscult

Answer 6

under utilized skill

recommended for patients with chest trauma, cardiac or pulmonary disease, post thoracotomy, mechanical ventilation

checking ET tube placement

Question 7

reflexes and muscle tone

Answer 7

ocular-papebral reflex, PLR

withdrawal-auricular, pedal, anal

jaw tone

eye position

muscle relaxation

Question 8

blood loss

Answer 8

1 ml blood=1 gm

check fluids levels in suction containers

Question 9

surgeries with profound blood loss

Answer 9

small patients/pediatrics

rhinoscopies/rhinotomies

splenic/hepatic surgery

amputations

laminectomies

thoracotomies

fractures

enucleations

total ear canal ablations

Question 10

urine output

Answer 10

relatively non-invasive

estimate cardiac output

minimal acceptable urine output (1-2 ml/kg/hr)