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My APA Anesthesia 1 > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

6 things to monitor under standards

A
  • ventilation (clinical obsv and expired CO2)
  • oxygen (clinical obsv and pulse ox)
  • Cardiovascular status (EKG)
  • Temp
  • neuromuscular
  • patient positioning
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2
Q

wavelength absorbed by deoxyhemoglobin

A

660nm (Red)

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3
Q

wavelength absorbed by oxyhemoglobin

A

940nm (infrared)

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4
Q

Law that pulse ox is based on

A

Beer Lamberts Law

pulse ox reads as a ratio of red/infrared light

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5
Q

Reasons for inaccurate pulse ox measurements (6)

A
  • hypoperfusion (vasoconstriction, hypothermia, hypotension)
  • motion artifacti
  • methylene blue
  • Anemia (Hgb < 5)
  • cautery interference
  • Abnormal Hgb
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6
Q

what makes oxygen saturation curve shift to left?

A
  • decreased PCO2
  • decreased temp
  • Alkalosis
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7
Q

what makes oxygen saturation curve shift to right?

A
  • Increased PCO2
  • Increased Temp
  • Acidosis
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8
Q

Chest movement does not confirm what?

A

Ventilation

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9
Q

value of precordial/esophageal stethoscope?

A
  • assurance of ventilation

- detect changes in breath sounds

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10
Q

what do you place the stethoscope precordial bell?

A

Suprasternal notch

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11
Q

What does an absense of an ETCO2 waveform mean? (3)

A
  • esophageal intubation
  • accidental disconnect
  • cardiac arrest
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12
Q

what does ETCO2 data display?

A
  • Adequacy of ventilation

- confirms placement

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13
Q

ETCO2 # vs Arterial CO2 #

A

ETCO2 2-5 lower

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14
Q

sharkfin capnograph means?

A

bronchospasm/asthma/COPD

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15
Q

short building then tall building capnograph means? or could also be?

A

increasing ETCO2/hypoventilation

also: hypercapnic, MH, Thyroid issue, increased BP, CO2 absorbing from insufflation in Lap case

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16
Q

decreasing/shorter buildings capnograph? Could also mean?

A

decreasing ETCO2/hyperventilation

also: hypotension, decreased C.O. (MI), slowing metabolism

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17
Q

whole ETCO2 waveform same size but trending up screen. Could also be what?

A

Rebreathing CO2 (could be faulty inspiratory valve)

18
Q

Notch in ETCO2? name and what it is

A

Curare Cleft - when paralysis is wearing off and diaphram starts to move a bit

19
Q

wavelength of light 3.3um, similar spectrum as agents, and monitor must be programmed with agent selected

A

monochromatic infrared spectrometry

20
Q

wavelength 7-13um, spectrum different from agents, monitor can identify agent, monitor can describe concentration of gas and multiple gasses

A

polychromatic infrared spectrometry

21
Q

alarm that detects lack of minimum inspiratory pressure, could signify disconnect or leak in system?

A

Low pressure alarm

22
Q

methemaglobinemia and CO poisoning will read what on pulse ox?

A
  • ~85%

- 100%

23
Q

what could a wider CO2 to ETCO2 gradient/discrepancy mean?

A

Shunt

24
Q

Where is ETCO2 actually measured on waveform

A

D (second corner of top plateau)

25
Q

Where is Inhalation on ETCO2 waveform

A

A-B: initial bottom of plateau

26
Q

rapid passing of MIXED GAS through upper airway in ETCO2 waveform?

A

B-C: first upstroke of waveform

27
Q

Records alveolar emptying of CO2 on ETCO2 waveform/?

A

C-D: Expiratory plateau (normal is flat)

28
Q

Another breath in on waveform?

A

D-E: next inhalation - down stroke of waveform

29
Q

Alarm that may indicate low pulm compliance?

A

high peak inspiratory alarm

30
Q

1 mV change on ECG monitor is same as?

A

10mm change on paper strip

31
Q

Frequency of TEE?

A

5 mHz

32
Q

CVP/RAP determine?

A

RV end diastolic volume

in healthy hearts this should mirror LV as well

33
Q

biggest heat loss for surgery?

A

Open bowel - larger the incision, the larger the heat losse

34
Q

what muscle does Ulnar nerve stimulate?

A

Adductor pollicis

35
Q

what muscle does Facial nerve stimulate?

A

orbicularis oculi

36
Q

where do NMBs work?

A

Post-synaptic cleft

37
Q

definition of Oliguria

A

< 0.5ml/kg/hr

38
Q

indications for foley

A
  • CHF
  • Renal
  • shock
  • surgeries with large fluid shifts
  • intraop diuretics
39
Q

used when surgical procedure is associated with potential for neurological injury.

A

Evoked potentials

  • spinal fusion, craniotomy
40
Q

efferent – stimulate at head and monitor at periphery

A

Motor evoked potential

41
Q

afferent pathway to brain, start at feet ( periphery) and monitor at head

A

somatosensory evoked potentials

42
Q

what monitoring needs a baseline before drug admin and needs to stay within 10-20% of baseline

A

Cerebral Oximetry

My APA Anesthesia 1 (8 decks)

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