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Physiologic Monitoring Flashcards

1
Q

What is a normal reading for ECG?

A

60-90 b/min

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2
Q

What is the normal MAP? What is a contraindication?

A

60-110

Below or above the range. Consult MD

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3
Q

What is the norm for CVP?

A

2-6mmHg

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4
Q

What is the purpose of the tracheal tube?

A

Access upper airway for those with airway obstruction
Safe suctioning
Mech ventilation
Airway protection

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5
Q

What are some complications of the trach tube?

A 
Ulcer
Erosion
Fistula
Laryngeal damage
Infection
Dislodgement
Airway obstruction
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6
Q

How long can you have an ET-T?

A

7-10 days

Can go up to 11 but after a tracheostomy is required

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7
Q

Where is the trach inserted?

A

3-4th tracheal rings

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8
Q

What should the cuff pressure be?

A

Below 25 cmH2O to minimize ischemic damage of tracheal mucosa.

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9
Q

What can be administered for a person with a trach in terms of exercise?

A

C/S ROM and prone positioning to pts tolerance

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10
Q

What is the difference between fenestrated and unfenestrated trach?

A

Fenestrated- hole in posterior wall of tube above cuff, used to assess pts readiness for extinction and permit speech ass gases pass thru. GET THEM OFF VENT ASAP. This is weening.

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11
Q

Do you tx if patient is weening?

A

NO, pt needs all the energy to learn to breathe on their own

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12
Q

What cavity is the chest tube placed in?

A

Pleural or mediastinal

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13
Q

What does the chest tube do?

A

Remove excess fluid or air

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14
Q

What are some indications of the chest tube?

A

Trauma, car accidents, open heart replacement, hemothorax, pneumothorax, bronchopleural fistula, empyema, mediastinal fluid

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15
Q

Where is it inserted for fluid drainage?

A

4th & 5th intercostal space at midaxillary line

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16
Q

Where is the chest tube inserted for pneumothorax?

A

2nd intercostal space at midclav line

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17
Q

Why is it inserted laterally?

A

Avoid discomfort when supine and sitting

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18
Q

Is pain related to size of tube?

A

No

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19
Q

Drainage has 3 compartments-

A

Under-water-seal drainage
Collection chamber
Suction chamber

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20
Q

Air bubbles indicate what?

A

Leakage which can lead to bronchopleural fistula (except in suction chamber)

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21
Q

What can kind of exercises would you do with a pt with a chest tube?

A

ROM to shoulders and breathing exercises. DONT KINK LINE

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22
Q

Pulse ox detects what?

A

Early hypoxemia

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23
Q

At what PaO2 will you see cyanosis?

A

90 mmHg

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24
Q

SpO2 of 90%= PaO2 ____mmHg

A

60

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25
Around 50-60 mmHg what will occur?
Dysrhythmia
26
When will you get a false reading on the pulse ox?
Nail polish, anemia (false high reading occur bc RBCs decreased), vasoconstriction
27
What does the A-line monitor?
Arterial blood pressure
28
Most common site for A-line placement?
Radial artery
29
Transducer placed at...
Level of right atrium
30
If the transducer is placed too high..
Reading will be falsely low and vice versa if too low
31
What do you do with femoral A-lines?
Check with MD before ambulation, sitting or hip flexion
32
What are some complications of continuous arterial pressure monitoring?
Soreness, ecchymosis, hematoma
33
Where is the CVP placed?
Right atrium
34
CVP directly reflects _____ and indirectly reflects_____
Right atrial pressure | Right ventricular end-diastolic pressure
35
If the right ventricle is failing what happens to CVP?
It rises
36
What kind of info does CVP provide?
Cardiac fxn and vascular volume
37
Where is the swan ganz inserted?
Right atrium into right ventricle into pulmonary artery
38
When is the swan ganz indicated?
When you need precise measurement of CP pressure, flow, and circulating volumes
39
Any contraindications for swan ganz?
No
40
What do pulmonary artery catheters detect?
Pulmonary edema, heart failure, sepsis
41
What does the pulmonary art catheter measure?
Heart pressure flow
42
Pulmonary arterial wedge pressure is indicative of
Left atrial and left ventricular end diastolic pressures
43
Where is the ICP placed?
Side where the damage is
44
Can PTs treat when ICP is > than 20mmHg?
No
45
What does ICP maximize?
Perfusion
46
EVD
Drains CSF, can be ambulated
47
Bolt
Harder to ambulate
48
What’s indicated when the Glasgow scale is less than 8?
Less than or equal to 8= intubate
49
Do you keep the head of the bed elevated with normal pressures?
Yes
50
How do you calculate CPP?
MABP- ICP
51
What happens when CPP dips below 50mmHg?
Decreased tissue perfusion and prolonged at 40mmHg= inadequate to support brain fxn
52
When is it appropriate to tx?
After pt rests
53
What’s the protocol for CPT?
Trendelenberg, 15 min if ICP<25 & CPP > 50
54
What’s the purpose of the PICC line?
Administer nutrition, meds
55
Where is the PICC line placed?
Anteccubital fossa to the SVC and RA
56
What are the risks of PICC?
Mechanical phlebitis, infection, venous thrombosis, catheter embolus
57
Implications for PICC line would be
Do not take BP with PICC line inserted, allow slack, clarify orders with ROM
58
TLC placement?
SVC, IJV, EJV, femoral
59
What are the risks for TLC?
Pneumothorax, embolization, vessel and tissue damage, hemorrhage, infection, catheter displacement
60
Implications for PT with the TLC
Defer if pneumothorax, avoid hyperextension of neck during bed mob
61
PORT purpose
Vascular access for pts requiring repeated infusion of drugs
62
Port placed where?
SVC, RA, subclavian IJV, over 3rd or 4th ribs
63
What are some risks of the port?
Pneumothorax, infection, venous thrombosis, migration, embolus, hemothorax

Cardiopulmonary (6 decks)

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