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Mar: prep for clinicals > Stanford CA-1 Prep (Basic Monitoring) > Flashcards

Stanford CA-1 Prep (Basic Monitoring) Flashcards

1
Q

Oxygen probes emit light at ______ nanometers to detect unoxygenated blood.

A

660 (red, for Hgb)

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2
Q

Oxygen probes emit light at 940 nanometer for ___________ blood.

A

oxygenated (infrared)

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3
Q

In the presence of methemoglobinemia, when true SpO₂ is > 85% you will get a falsely _____ reading.

A

Low

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4
Q

In the presence of methemoglobinemia, when true SpO₂ is < 85% you will get a falsely _____ reading.

A

High

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5
Q

What is the typical treatment for methemoglobinemia?
What if the patient has a G6PD deficiency?

A
  • Typical: Methylene Blue
  • G6PD Deficiency? → Vitamin C
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6
Q

What are common causes of elevated carboyxhemoglobin levels?

A
  • Smoke inhalation
  • VAA degradation
  • Dessicated soda lime
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7
Q

What is the treatment for excessive carboxyhemoglobin?

A
  • 100% FiO₂
  • Hyberbaric O₂
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8
Q

The cardinal sign of cyanide toxicity is….

A

Clinical cyanosis despite high SpO₂.

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9
Q

What are two common causes of cyanide toxicity?

A
  • Nitroprusside
  • Smoke Inhalation
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10
Q

What is the treatment for cyanide toxicity?

A

Hydroxycobalamin

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11
Q

Which leads in a 5 lead EKG system are 98% sensitive for the detection of ischemic events?

A

II, V4, V5

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12
Q

Which lead(s) is/are most sensitive to atrial dysrhythmias?

A
  1. Lead II
  2. V1
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13
Q

How is MAP calculated?

A

(SBP + 2*DBP) ÷ 3

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14
Q

Where would one want to level the transducer for a neurosurgical case?

A

At the tragus of the ear to assess cerebral perfusion

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15
Q

Whats the mnemonic for assessing the difference in blood pressure between two different sites?

A

pH 7.410

pressure of 7.4 mmHg occurs with every height change of 10 cm away from the heart

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16
Q

In the beach chair position the BP cuff in the leg reads 120/80 but you note that the brain is 60 cm above than the cuff. What would you anticipate the pressure in the brain to be?

A

~ 75/35

17
Q

What would occur with your arterial waveform as you move away from the proximal aorta?

A

Systolic amplification

18
Q

What are the phases in a capnographic waveform?

A
  1. VD gas exhaled
  2. VD and alveolar gas transition
  3. Alveolar plateua
  4. Inspiration
19
Q

Pulse Pressure will increase with _________ stroke volume and ________ vessel compliance.

A

increased ; decreased

20
Q

When would PPV be at its apex? How about its lowest?

A
21
Q

What aspect of the capnography waveform denotes the change from deadspace gas to alveolar gas?

A

Phase II: expiratory upstroke (remember, there is no CO2 in the dead space the first part of the exhalation)

22
Q

Significant hypotension can be associated with a ______ in EtCO₂ .

A

drop
- (a low ETCO2 can indirectly contribute to hypotension by indicating a reduced CO, leading to decreased blood pressure; essentially, a low ETCO2 can be a sign of poor circulation that could manifest as hypotension in certain situations)
- but remember, a high PCO2 can cause vasodialation - just be sure to look at the whole picture

23
Q

What type of capnography waveform would be anticipated in a patient undergoing bronchospasm?

A
24
Q

Treating a Bronchospasm

A
  • 100% 02
  • Deepen the anesthetic
  • Give B2 agonist (albuterol or ipratropium via neb)
  • If severe, consider IV Epi
  • Add corticosteriods later
  • Change vent to increase expiratory time (decreases air trapping)
25
Q

What are the three overarching causes for a drop in EtCO₂?

A
  1. increased CO₂ elimination (hypervenitilation)
  2. ↓ CO₂ production
  3. Circuit problems
26
Q

What are the four most common causes related to decreased CO₂ elimination?

A
  • CV collapse (↓CI)
  • Venous air embolism
  • Large PE
  • Kinked, dislodge, or esophageal ETT
27
Q

What are the three greatest reasons for decreased CO₂ production?

A

↓ CO₂ production = ↓ metabolism

  • Hypothermia
  • Hypothyroidism
  • Neuromuscular blockade
28
Q

During a diagnostic laparascopy, an intubated and anesthetized patient is placed in trendelenburg. Over the next 20 minutes SpO₂ decreases from 100% to 95%, and EtCO₂ increases from 35 to 40 with no concurrent ventilator setting changes. The most likely reason is:

A. Decreased diaphragmatic excursion
B. Compression of the Vena Cava
C. Carbon Dioxide Embolism
D. Pneumothorax

A

A. Decreased Diaphragmatic Excursion

29
Q

What type of capnogram is depicted below?

A

Normal capnogram

30
Q

What would you anticipate is the issue based on the capnography below?

A

Bronchospasm/asthma

  • Obstruction
  • Kinked ETT or expiratory circuit
31
Q

What would you anticipate is the issue based on the capnography below?

A

Hypoventilation likely (increasing CO₂)

  • ↓ RR or VT
  • ↑ metabolism
  • Hyperthermia
32
Q

What would you anticipate is the issue based on the capnography below?

A

Hyperventilation likely (decreasing CO₂)

  • ↑ resp rate
  • ↑ VT
  • Metabolic acidosis
  • ↓ body temp
33
Q

What would you anticipate is the issue based on the capnography below?

A

Rebreathing CO₂

34
Q

What would you anticipate is the issue based on the capnography below?

A

Curare Cleft

Indication of neuromuscular blockade wearing off (2-3 minutes until patient movement typically).

Mar: prep for clinicals (16 decks)

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