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CCP Semester 1 > Skill Station Prep > Flashcards

Skill Station Prep Flashcards

1
Q

D of the DOPE mnemonic (4)

A

Dislodged ETT
Disconnected circuit
Demand
Deflated ETT cuff pressure

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2
Q

O of the DOPE mnemonic (5)

A

Obstruction:
change in compliance,
bronchospasm,
requires deep/oral suctioning,
kinked ETT circuit,
under-sedated/dysynchrony

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3
Q

P of the DOPE mnemonic (1)

A

Pneumothorax

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4
Q

E of the DOPE mnemonic (3)

A

Equipment:
loose connections,
ventilator settings (PEEP vs nonPEEP compensated), tight alarm settings

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5
Q

Risks of recruitment maneuver (6)

A
  1. Tachy-brady arrhythmia
  2. Hypotension due to preload reduction
  3. Desaturation due to shunt physiology
  4. Pneumothorax
  5. Increased ICP
  6. Cardiac arrest
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6
Q

Equipment and drugs for recruitment maneuver

A

BVM, PEEP, O2
Patent IV with charged IV line
Phenylephrine
ACLS meds
Defib pads
Chest decompression equipment
Paralytics
Sedation drugs

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7
Q

Measured EPOC parameters (11)

A

pH
pCO2
pO2
Na+
K+
Ca++
Lactate
Glucose
Hematocrit
Creatinine
Cl-

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8
Q

Calculated EPOC parameters (10)

A

Hemoglobin
Actual bicarbonate (cHCO3-)
Total CO2 (cTCO2)
Base excess of extra cellular fluid (BEecf)
Base excess of blood (BEb)
Oxygen saturation
Estimated GFR
Estimated GFR if African American
Anion Gap
Anion Gap, K+

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9
Q

Equipment for arterial line insertion

A

PPE
Secure surface/arm board
Roller gauze, sterile 4x4, tape
clorohexadine swab
500 mL NS, pressure infuser
pressure monitoring set with VAMP
radial artery catheterization set
securing device/Tegaderm/suture set
1% lidocaine solution % SQ needle/syringe
ultrasound, gel

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10
Q

Indications for arterial line insertion (3)

A
  1. requires continuous monitoring of arterial blood pressure
  2. evaluation of arterial waveform patterns to predict fluid responsiveness
  3. need for frequent blood sampling
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11
Q

Contraindications for arterial line insertion (7)

A
  1. localized infection
  2. thrombus at insertion site
  3. distorted anatomy
  4. burns
  5. severe PVD of selected artery
  6. active Reynaud’s syndrome
  7. known thrombocytopenia with platelet count <50
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12
Q

Complications of arterial line insertion (8)

A
  1. bruising, pain, swelling
  2. hematoma
  3. bleeding, iatrogenic blood loss
  4. vasospasm
  5. thrombus formation
  6. embolism
  7. dissection/psueudoaneurysm
  8. infection
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13
Q

Characteristics of overdamped waveform (6)

A
  1. low amplitude waveform
  2. loss of dichrotic notch
  3. falsely low SBP reading
  4. falsely high DBP reading
  5. falsely high MAP reading
  6. no oscillations after square waveform test
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14
Q

Causes of overdamped waveform

A
  1. Anything that absorbs the pulse wave: overcompliant tubing, long tubing, air bubbles in line
  2. Anything that reduces the magnitude of the pulse wave: fluid leaks from the connections, low pressure in the transducer line, catheter tip resting against the arterial inner wall, blood clots, kinked tubing.
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15
Q

Troubleshooting measures to correct overdamping (5)

A
  1. modify wrist position to reduce kinking and catheter occlusion
  2. remove air or clots from the system
  3. ensure appropriate back pressure exists (300 mmHg)
  4. ensure connections are tight and transducer stopcock is fully off to the vent cap
  5. change the catheter and/or site of arterial monitoring
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16
Q

Characteristics of an underdamped waveform (5)

A
  1. over-estimated SBP
  2. falsely reduced DBP
  3. deep dichrotic notch
  4. non-physiological oscillations during diastolic phase
  5. multiple post-oscillations after square waveform test
17
Q

Causes of an underdamped waveform (3)

A
  1. Artifact
  2. Stiff, non-compliant pressure tubing (frozen lines or too many stopcocks)
  3. Catheter whip (excessive movement of catheter within the artery causing resonance, increased heart rates)
18
Q

Troubleshooting measures to correct underdamping (3)

A
  1. reduce catheter movement
  2. keep lines at normal temperatures when transitioning patient through colder environments
  3. eliminate number of stopcocks in the line
19
Q

Name 2 locations other than the phlebostatic axis where a transducer may need to be secured and for what purpose

A
  1. tragus of the ear to measure ICP via an EVD (correlates to the Foramen of Munroe)
  2. Intersect of the iliac cres and mid-axillary line to measure IAP (approximately the level of the bladder)
20
Q

What change do you anticipate in the IBP reading if the transducer is too low or falls to the ground?

A

Abnormally high reading. For every 10 cm below phlebostatic axis, IBP reading will increase by 7.4 mmHg.

21
Q

What change do you anticipate in the IBP reading if the transducer is too high above the phlebostatic axis?

A

Abnormally low BP reading.

22
Q

Equipment required to conduct a blood draw from a radial arterial line

A

PPE
Arterial blood sampling kit
VAMP needleless shielded cannula
EPOC blood analysis system
10 cc syringe
alcohol or clorohexadine swabs
sharps container

23
Q

Indications for obtaining an arterial blood sample (3)

A

Need to assess:
1. arterial oxygenation
2. arterial acid-base status
3. electrolyte levels

24
Q

Troubleshooting and recognizing potential test failures for EPOC (6)

A
  1. Test card out of date
  2. Test card damaged
  3. Too fast or too slow insertion of test card into reader
  4. Test cards and Reader must be at similar temperature
  5. Reader contains heater that maintains sensor temperature at 37 C +/- 0.15 degrees C
  6. Battery failure. Reader must be charged

CCP Semester 1 (10 decks)

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