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1
Q

Terms

A

Definitions

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2
Q

CVP - Normal values; related to…

A

2-6 mmHg; Right heart fx

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3
Q

PAP - Normal values; related to…

A

25/8 Mean 14 Range 9-18 mmHg; Lungs

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4
Q

PCWP - Normal values; related to…

A

4-12 mmHg; Left heart fx

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5
Q

CO - Normal values

A

4-8 L/min

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6
Q

Usual cause high CVP

A

Fluid overload, diurese

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7
Q

When CVP low

A

Usually dehydration or vasodilation, give fluids or vasoconstrictors

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8
Q

Possible pathology increased CVP

A

Right heart failure, cor pulmonale, tricuspid valve stenosis

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9
Q

(xray)Central venous catheter placement

A

Tip should rest in right atrium or vena cava

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10
Q

(xray) Pulmonary artery catheter placement

A

Tip should be over the right lower lung field

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11
Q

Most common complication of PA catheter insertion

A

Arrythmias

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12
Q

How you will know you are in the pulmonary artery

A

Dicrotic notch

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13
Q

How to fix pressure dampening (dicrotic notch absent)

A

a. Check for air bubbles b. Aspirate (to remove potential clot)
c. Flush catheter
d. Rotate catheter

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14
Q

Hb range

A

12-16 gm/dL

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15
Q

Vd/Vt - Formula; range

A

PaCO2-(PeCO2)/PaCO2; 20-40%, up to 60% if ventilated

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16
Q

High Vd/Vt usually relates to

A

Pulmonary embolus

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17
Q

Alveolar air equation (PAO2)

A

((Pb-PH2O)FIO2) - PaCO2/0.8

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18
Q

A-a Gradient - Formula; values

A

A-aDO2 = PAO2 - PaO2; Normal 25-65. 65-299 = V/Q mismatch, >300 = shunt

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19
Q

It is best to obtain the A-a gradient when

A

The patient is on 100% FIO2

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20
Q

Arterial Oxygen Content - Formula; values

A

CaO2 = (Hbx1.34xSaO2) + (PaO2x0.003);

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22
Q

Venous Oxygen Content - Formula; values

A

CvO2 = (Hbx1.34xSv02) + (PvO2x0.003);

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24
Q

Arterial-Venous Oxygen Content Difference - Values

A

C(a-v)O2; Normal 4-5 vol%; difference INCREASES when Qt is DECREASING

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25
Q

Best measurement of oxygen being delivered to the tissues

A

CaO2

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26
Q

The CvO2 should be drawn from

A

Pulmonary artery

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27
Q

P/F ratio - values

A

Normal >380 (PaO2 of 80/21%), <200 ARDS

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28
Q

Fick Equation

A

Qt = VO2/C(a-v)02x10

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29
Q

If a BP cuff and an arterial line display different values. Trust the

A

BP cuff

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30
Q

Neonate, acceptable PaO2

A

50-80 mmHg, all other values same

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31
Q

(xray) Obliterated costophrenic angles; concave superior surface; meniscus

A

Pleural effusion

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32
Q

(xray) Flattened diaphragm

A

Air trapping

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33
Q

(xray) Radiolucent

A

Normal

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34
Q

(xray) Fluffy infiltrates, butterfly/batwing pattern

A

Pulmonary edema

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35
Q

(xray) Air bronchogram

A

Pneumonia

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36
Q

(xray) Ground glass, honeycomb, reticulogranular

A

ARDS/IRDS

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37
Q

(xray) Thumb sign

A

Acute epiglottitis

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38
Q

(xray) Steeple sign

A

Croup

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39
Q

(xray) Airway placement

A

2-5 cm above carina; level w/ 4th rib/T-4, aortic knob

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40
Q

(xray) Chest tube placement

A

Should be in the neural space

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41
Q

Primary Dx tool for bronchiectasis

A

Bronchogram

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42
Q

Used to determine risk for aspiration

A

Barium swallow

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43
Q

Low K+ can cause

A

Metabolic alkalosis

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44
Q

Hypokalemia - cause; ECG

A

Excessive fluid loss (vomiting, dehydration); Flattened T-wave

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45
Q

Cl- follows

A

Na+

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46
Q

Eosinophils associated w/

A

Asthma, allergic reactions

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47
Q

Monocytes associated w/

A

TB

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48
Q

PT - use; values

A

Monitors Warfarin (Coumadin) Therapys, 12-15 sec

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49
Q

APTT - use; values

A

Monitors Heparin therapy; 24-32 sec

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50
Q

Acid Fast stain

A

Tuberculosis

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51
Q

Culture

A

Identifies organism

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52
Q

Sensitivity

A

Identifies which antibiotics kills organism

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53
Q

TcPO2/TcPCO2 electrodes should be moved

A

Q4H

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54
Q

TcPO2/TcPCO2 calibration

A

Room air and zeroing solution

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55
Q

Best indicator of perfusion

A

Urine output

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56
Q

Dry non-productive cough

A

Think cancer

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57
Q

Digital clubbing

A

Chronic hypoxemia (think COPD)

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58
Q

Neck vein distension

A

Associate with CHF and COPD

59
Q

Night sweats

A

TB

60
Q

Cold and clammy skin

A

Think myocardial infarction

61
Q

Unilateral wheeze

A

Foreign body; broncoscopy

62
Q

Rhonchi

A

Suction

63
Q

Mild stridor

A

Cool mist, racemic epi

64
Q

Moderate stridor

A

Racemic epi

65
Q

Severe stridor

A

Intubate

66
Q

Pulsus paradoxus

A

BP rises and falls during inspiratory and expiratory efforts. Severe air trapping. Status asthmaticus

67
Q

Test when S3/S4 heart sounds are heard

A

Echocardiogram

68
Q

S3/S4 associations

A

S3 CHF, S4 cardiomegally

69
Q

(ECG) Best lead to assess left ventricle

A

Lead V5

70
Q

(ECG) Best lead to determine overall electrical condition

A

Lead II

71
Q

Tx sinus tach

A

Oxygen

72
Q

Tx sinus brady

A

Oxygen and atropine

73
Q

Tx PVCs

A

Oxygen if occasional, lidocaine if frequent

74
Q

Tx asystole

A

Confirm in two chest leads, CPR, epi, atropine

75
Q

Tx V-tach

A

Pulse - Lidocaine and cardioversion

77
Q

Tx V-fib

A

Defibrillate

78
Q

Tx 1st degree heart block

A

Atropine

79
Q

Tx 2nd degree heart block

A

Atropine, pacing

80
Q

Tx 3rd degree heart block

A

Pacemaker

81
Q

Reasons for cardiac electrical current deviation

A

Hypertrophy, infarction

82
Q

(ECG) Ischemia

A

Current lack of oxygen; Inverted T-wave (may also be caused by digitalis toxicity)

83
Q

(ECG) Injury

A

Cardiac tissue in a state of dying; S-T elevation

84
Q

(ECG) Infarction

A

Dead cardiac tissue; significant Q-wave

85
Q

The SVC should always be

A

Greater than the FVC. If FVC is greater, PT effort is poor (i.e. wanting disability)

86
Q

FVC loop - Round

A

Large fixed airway obstruction (such as vocal cord paralysis or cancer)

87
Q

FRC measurement

A

Nitrogen washout or plethsymograph

88
Q

Only obstructive Dz associated w/ poor DLco

A

Emphysema

89
Q

Pre-Post BD reversibility considered significant if

A

There is a 12%/200mL or greater increase in flows

90
Q

Selection of best test

A

Best FEV1 + FVC

91
Q

Calibration syringe - Results close together but far from correct

A

Inaccurate but precise

92
Q

ICP

A

5-10 mmHg; Tx suggested >20 mmHg; keep PT sedated

93
Q

PaCO2 range for PT w/ increased ICPs

A

25-30

94
Q

Drugs to Tx increased ICPs

A

Diamox, Osmitrol

95
Q

APGAR 7-10

A

Provide routine care

96
Q

APGAR 4-6

A

Support w/ O2, warmth, stimulation

97
Q

APGAR 0-3

A

Code

98
Q

Gestational age ranges

A

42 Postterm

99
Q

Venturi mask, bed covers may

A

Accidentally occlude entrainment port and increase FIO2

100
Q

Problem suspected w/ pulse-dose O2 delivery system

A

Switch to continuous mode

101
Q

Oxygen concentrator (molecular sieve) can produce up to

A

6 lpm

102
Q

CPAP problem w/ infants

A

If infant is crying, pressure is lost

103
Q

100% body humidity

A

44 mg/L

104
Q

Ultrasonic neb frequency

A

Can not be changed

105
Q

Back pressure does this to FIO2

A

Increases

106
Q

Common home vents

A

PLV 100, LP 6, LP 10, PB Companion, Intermed Bear

107
Q

Oral ET tube should be

A

20-24 lips

108
Q

Nasal ET tube should be

A

25-29 at nares

109
Q

PetCO2 during code

A

Will first read low, then rise w/ adequate ventilation

110
Q

Best equipment to continually measure flow

A

Fleisch pneumotachometer

111
Q

Helium dilution uses this type of analyzer

A

Wheatstone bridge

112
Q

Nitrogen washout equipment that measures nitrogen

A

Geissler tube ionizer

113
Q

Polarographic analyzer reads low FIO2

A

Change batteries

114
Q

Polarographic analyzer will not read

A

If batteries are good, replace electrolyte solution

115
Q

Galvanic fuel cell troubleshoot

A

Change cell (don’t change solution or battery, the cell IS the battery)

116
Q

BVM collapses easily

A

Change bag, otherwise replace air-inlet valve

117
Q

BVM difficult

A

Ensure patient valve is not stuck open, does PT have low lung compliance?

118
Q

Facilitate suction of left main stem bronchus

A

Coude tip catheter

119
Q

Suction catheter diameter should not exceed

A

1/2 diameter of ETT

120
Q

Difficult suction troubleshoot

A

Suction pressure range -> Increase cath size -> Increase suction time

121
Q

Change Cidex

A

Every 14 days

122
Q

Cidex is tuberculocidal in

A

20 minutes

123
Q

Post-Op IS goal

A

1/2 amount achieved pre-op

124
Q

Initiation of MV - Rate; Vt

A

Rate 8-12, Vt 8-12 mL/kg

125
Q

Dynamic compliance

A

Exhaled Vt/PIP-PEEP

126
Q

Static compliance

A

Exhaled Vt/Pplat-PEEP; 25-100 mL/cmH20 acceptable

127
Q

If PaO2 is low

A

Raise FIO2 5-10% until 60%, then add/raise PEEP by 5

128
Q

If PaO2 is high

A

Lower FIO2 until <60%, then lower PEEP in increments of 5

129
Q

Most important alarm in paralyzed PT

A

Low PEEP. If low PEEP alarm not available, then low volume or disconnect

130
Q

Best position for gas distribution during MV

A

Semi-Fowler’s

131
Q

If patient is in distress from suctioning

A

Decrease suction time

132
Q

Avoid PEP therapy during

A

Epistaxis, middle ear infections, sinus problems

133
Q

Low exhaled Vt w/ chest tube

A

Adjust Vt to maintain ABG values

134
Q

Excessive bubbling in suction control bottle

A

Too much suction pressure

135
Q

Excessive bubbling in water seal chamber

A

Clamp tube proximal PT, if bubbling stops, problem is inside the PT

136
Q

If glass bottle breaks

A

Submerge chest tube into water from any container

137
Q

Heliox 80/20 correction factor

A

1.8

138
Q

Heliox 70/30 correction factor

A

1.6

139
Q

Cardioversion must be done on

A

The R-wave of ECG. Ensure synchronization is on

140
Q

Bleeding during bronchoscopy

A

Instill epi, then apply pressure with bronchoscope

141
Q

AHI > 30

A

Severe sleep apnea. Next step is titration study

142
Q

Transport vent volumes fall

A

Check tank

CRT (4 decks)

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