Quiz 2 SUPP Flashcards
What can happen despite adequate oxygenation?
Hypoventilation, hypercapnia and impending respiratory arrest can occur despite adequate oxygenation, particularly during the supplemental administration of O2.
During moderate or deep sedation what do we still have to monitor for?
continuously monitor for the presence of expired carbon dioxide.
Parts of monitoring ventilation Continuously
Verify intubation of the trachea
Auscultate bilateral breath sounds
Observe chest excursion
Confirm presence of carbon dioxide in the expired gas.
Continuously monitor end-tidal carbon dioxide during controlled or assisted ventilation.
Use spirometry and ventilatory pressure monitors as indicated.
What does chest movement not do?
Chest movement does not confirm ventilation, just the attempt for spontaneous ventilation. Obstructed patient will still have chest movement.
Condensation in the airway device
Does not show adequacy
Presence of airway movement does not assure adequate gas exchange
Positioning for precordial stethoscope
Heavy bell-shaped piece of metal placed over the chest or suprasternal notch
Two types of ETC02 sampling and what do we use today?
Mainstream/Non-diverting
Sidestream/Diverting- This is what we use
Normal/abnormal capnography waveforms
Slide 36
What are the other gas analyzers
Multiple gas analyzers:
Continual analysis of inhaled and exhaled
concentrations of respiratory and anesthetic gases.
Useful during inhalation anesthetic.
No contraindications to use.
The SRNA as Clinical monitor of patient breathing: Slide 56:
What are the ongoing assessments used to evaluate?
Adequacy of patient’s airway
Depth of anesthesia
Titrate anesthetic agents to effect
What doesn’t the ECG monitor do?
It is not a measure of heart function. You may have normal ECG complexes on the monitor with no effective cardiac output.
Which type of blockade also impairs thermoregulation?
Regional
What is it harder to do in regards to thermoregulation?
Catch back up
Fasciculations
Succs depolarizes and does not let go = fasciculationd
what are Clinical considerations for evoked potentials?
Evoked potentials are altered by many variables other than neural damage.
General anesthetics
An unexpected increase in end-tidal CO2 is the most sensitive sign of what process?
Malignant Hyperthermia
What type of medications are associated with the highest risk of altering normothermia intraoperatively?
Gas Anesthetics
What is the primary way to avoid hypothermia postoperatively?
Prevention
What are the three main branches of thermoregulation?
Afferent sensing, central regulation, efferent response
What can alter the central regulation threshold the most?
Patients under general anesthesia lose hypothalamus control
If a patients MPAP is 18 mmHg, PAOP is 6 mmHg, and CO is 5 L/min, what is the PVR?
PVR=[(MPAP-PAOP) / CO] x 80
Where is the correct place to draw from for an SVO2 reading?
Distal Port PAC
A patient’s heart rate is 80 bpm and SV is 70ml/ beat. What is their cardiac output?
CO L/min = 80 X 70 → 5,600 ml or 5.6L
A patient has aortic stenosis, what factor does this affect within cardiac output and what are our goals intraoperatively?
Afterload, they do NOT tolerate hypotension well. We must maintain SVR treat with alpha agonist and cardiac output.
All of theses cause decrease in systemic vascular resistance except?
Hypovolemia
