Vascular

Question 1

What does pitting edema look like?

Answer 1

when you press down on the skin and the indentation remains indented

Question 2

What is skin turgor?

Answer 2

when you pinch the skin and the skin remains bunched up

Question 3

K+ of >5.5mEq/L is associated with what EKG abnormalities? What happens in the heart at this time?

Answer 3

peaked T waves; repolarization abnormalities in heart

Question 4

K+ of >6.5mEq/L is associated with what EKG abnormalities? What happens in the heart at this time?

Answer 4

P wave widens and flattens, PR segment lenthens, P waves eventually disappear; progressive paralysis of the atria

Question 5

K+ of >7.0mEq/L is associated with what EKG abnormalities?

Answer 5

prolonged or bizarre QRS, AV block w/ slow junctional and vent escape rhythms, sinus brady or slow AF, development of sine wave

Question 6

Delayed gastric emptying in diabetics is an effect of what?

Answer 6

neuropathy in the GI tract

Question 7

What blocks would be used for an AV fistula?

Answer 7

brachial, axillary, supraclavicular

Question 8

Why might high dose Nimbex be a good choice for rapid sequence to an AV fistula patient?

Answer 8

they may be hyperkalemic (no sux), they may have renal failure (caution roc & vec)

Question 9

What fluid should likely be given to an AV fistula patient?

Answer 9

NS because they may have high electrolyte levels already

Question 10

What opioids are contraindicated in renal failure patients?

Answer 10

morphine and demerol

Question 11

Ketamine and propofol are sometimes used in what ratio?

Answer 11

1:10

Question 12

How many units of heparin are typically given for an AV fistula?

Answer 12

5000

Question 13

What procedure involves massive amounts of radiation?

Answer 13

TAAA

Question 14

How often does heparin need to be re-checked?

Answer 14

hourly

Question 15

How long after giving heparin should you wait before clamping?

Answer 15

3 min

Question 16

What is the #1 morbidity of aorto bi-femoral bypass?

Answer 16

MI

Question 17

What are some physiological changes that arise when the tournequit is released? How do you treat these?

Answer 17

BP drop - treat w/ phenylephrine, ETCO2 increase - give 1/2 amp HCO3 or hyperventilate, temp decreases

Question 18

Where should you never place a Bairhugger? Why?

Answer 18

in an area of decreased perfusion such as a limb with significant PVD or an area distal to a tournequit or strap (where blood is pooling); it will “boil” the pooled blood and significantly burn the patient

Question 19

Why may acidotic patients not respond to HCO3?

Answer 19

Their vessels are maximally dilated because they do not have enough O2

Question 20

How many cc and mg protamine do you give per unit of heparin?

Answer 20

1cc (10mg) protamine per 1000 units heparin

Question 21

How does protamine deactivate heparin?

Answer 21

it binds and creates a salt