Review deck 3

Question 1

Joules to shock an open heart is at

Answer 1

10-30 J

Question 2

HPV works to

Answer 2

divert blood away from hypoxic regions of the lung, decreased blood flow to the non-ventilated lung, helps improve arterial oxygen content–>
improving hypoxemia, decreases shunt

Question 3

Blood flow distribution in two lung ventilation is

Answer 3

40% in nondependent and 60% in dependent

Question 4

Isoflurane shifts blood flow in the lungs to

Answer 4

20% in the upper lung & 80% in the lower lung

Question 5

_________ can inhibit HPV which is why you may see a drop in SPO2

Answer 5

nitroglycerin

Question 6

Describe which double lumen tube is more difficult to place.

Answer 6

a right tube

Question 7

With inhalation anesthestics, 1 MAC leads to a ____ in shunt

Answer 7

4% increase

Question 8

If you have placed a left tube & you clamp the tracheal cuff, you should hear breath sounds on

Answer 8

the left but not the right

Question 9

The most common problem encountered when positioning a right endobronchial tube is

Answer 9

excluding the right upper lobe from ventilation

Question 10

The minimal predicted postoperative FEV1 necessary for long-term survival is

Answer 10

800-1000 mL

Question 11

The systemic syndromes of mediastinal tumors can be related to

Answer 11

hypertension, myasthenia gravis, myasthenic syndrome, ectopic parathyroid hormone, hypercalcemia

Question 12

Prior to instituting OLV, it is important to

Answer 12

always get baseline ABG

Question 13

The greatest risk with OLV management is

Answer 13

hypoxemia

Question 14

If you have high peak inspiratory pressures,

Answer 14

check ETT position
reduce VT
increase RR to maintain minute ventilation

Question 15

If hypoxemia is occurring during OLV, then you can

Answer 15

add CPAP to collapsed lung

Question 16

If you are going to keep a patient intubated after a OLV procedure, then you must

Answer 16

exchange the tube to a single lumen tube

Question 17

The most likely intraoperative complications of thoracoscopic procedures is

Answer 17

gas embolism into venous circulation

Question 18

For a mediastinoscopy, it is important to

Answer 18

keep pulse ox & a-line on the right arm and ask surgeon to reposition mediatinoscope if absent waveform due to poor cerebral perfusion

Question 19

For a patient presenting for mediastinoscopy who lays down and has respiratory distress,

Answer 19

sit them up

Question 20

The most common complication of mediastinoscopy is

Answer 20

mediastinal hemorrhage

Question 21

ECG leads to monitor are

Answer 21

II & V5

Question 22

Vagally- mediated reflex bradycardia from compression of trachea or great vessels may occur and you should

Answer 22

tell the surgeon to stop & give glyco

Question 23

Cardiac oxygen utilization can be decreased by

Answer 23

anesthesia
hypothermia
cardioplegia

Question 24

Cardioplegia can cause issues with

Answer 24

renal patients due to high K

Question 25

Contraindications for TEE include

Answer 25

esophageal pathology like varices or tumors

Question 26

TEE can be used to help diagnose underlying problems like

Answer 26

valvular pathology
evaluation of ventricles
when to give volume
when there is air in the heart

Question 27

You know when the swan enters the PA when the waveform shows _______ diastolic pressure in the PA versus RV

Answer 27

INCREASED

Question 28

Complications of a swan include

Answer 28

arrhythmias, heart block, pneumothorax, valve damage, PA rupture

Question 29

To go on cardiac bypass, ACT must be

Answer 29

> 400

Question 30

The weight based dose of heparin is

Answer 30

300-400 units/kg

Question 31

Heparin binds to

Answer 31

ATIII

Question 32

Heparin should be administered

Answer 32

via CVP or directly into RA

Question 33

Pts with _______ are unresponsive to heparin

Answer 33

ATIII deficiency and FFP can be given

Question 34

When cannulating the aorta, systolic BP should be

Answer 34

<90

Question 35

Heparin should be given

Answer 35

before any cannulas are placed

Question 36

Retrograde cardioplegia occurs into

Answer 36

the coronary sinus

Question 37

Problems with bypass include

Answer 37

bleeding, arrhythmias, hypertension, hypotension

Question 38

When transitioning to CPB-

Answer 38

look at head/pupils
pull back PAC 2-3 cm
stop the ventilator once the heart is empty

Question 39

When a patient is on bypass, a hematocrit of ____ is accepted

Answer 39

20%

Question 40

Hemodilution is associated with

Answer 40

decreased viscosity
decreased SVR
promotes blood flow to tissues