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Cardiopulmonary > Physiologic Monitoring > Flashcards

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
Q

Around 50-60 mmHg what will occur?

A

Dysrhythmia

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26
Q

When will you get a false reading on the pulse ox?

A

Nail polish, anemia (false high reading occur bc RBCs decreased), vasoconstriction

27
Q

What does the A-line monitor?

A

Arterial blood pressure

28
Q

Most common site for A-line placement?

A

Radial artery

29
Q

Transducer placed at…

A

Level of right atrium

30
Q

If the transducer is placed too high..

A

Reading will be falsely low and vice versa if too low

31
Q

What do you do with femoral A-lines?

A

Check with MD before ambulation, sitting or hip flexion

32
Q

What are some complications of continuous arterial pressure monitoring?

A

Soreness, ecchymosis, hematoma

33
Q

Where is the CVP placed?

A

Right atrium

34
Q

CVP directly reflects _____ and indirectly reflects_____

A

Right atrial pressure

Right ventricular end-diastolic pressure

35
Q

If the right ventricle is failing what happens to CVP?

A

It rises

36
Q

What kind of info does CVP provide?

A

Cardiac fxn and vascular volume

37
Q

Where is the swan ganz inserted?

A

Right atrium into right ventricle into pulmonary artery

38
Q

When is the swan ganz indicated?

A

When you need precise measurement of CP pressure, flow, and circulating volumes

39
Q

Any contraindications for swan ganz?

A

No

40
Q

What do pulmonary artery catheters detect?

A

Pulmonary edema, heart failure, sepsis

41
Q

What does the pulmonary art catheter measure?

A

Heart pressure flow

42
Q

Pulmonary arterial wedge pressure is indicative of

A

Left atrial and left ventricular end diastolic pressures

43
Q

Where is the ICP placed?

A

Side where the damage is

44
Q

Can PTs treat when ICP is > than 20mmHg?

A

No

45
Q

What does ICP maximize?

A

Perfusion

46
Q

EVD

A

Drains CSF, can be ambulated

47
Q

Bolt

A

Harder to ambulate

48
Q

What’s indicated when the Glasgow scale is less than 8?

A

Less than or equal to 8= intubate

49
Q

Do you keep the head of the bed elevated with normal pressures?

A

Yes

50
Q

How do you calculate CPP?

A

MABP- ICP

51
Q

What happens when CPP dips below 50mmHg?

A

Decreased tissue perfusion and prolonged at 40mmHg= inadequate to support brain fxn

52
Q

When is it appropriate to tx?

A

After pt rests

53
Q

What’s the protocol for CPT?

A

Trendelenberg, 15 min if ICP<25 & CPP > 50

54
Q

What’s the purpose of the PICC line?

A

Administer nutrition, meds

55
Q

Where is the PICC line placed?

A

Anteccubital fossa to the SVC and RA

56
Q

What are the risks of PICC?

A

Mechanical phlebitis, infection, venous thrombosis, catheter embolus

57
Q

Implications for PICC line would be

A

Do not take BP with PICC line inserted, allow slack, clarify orders with ROM

58
Q

TLC placement?

A

SVC, IJV, EJV, femoral

59
Q

What are the risks for TLC?

A

Pneumothorax, embolization, vessel and tissue damage, hemorrhage, infection, catheter displacement

60
Q

Implications for PT with the TLC

A

Defer if pneumothorax, avoid hyperextension of neck during bed mob

61
Q

PORT purpose

A

Vascular access for pts requiring repeated infusion of drugs

62
Q

Port placed where?

A

SVC, RA, subclavian IJV, over 3rd or 4th ribs

63
Q

What are some risks of the port?

A

Pneumothorax, infection, venous thrombosis, migration, embolus, hemothorax

Cardiopulmonary (6 decks)

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