I&M final spring

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218636
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I&M final spring
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2013-05-08 18:08:30
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  1. Does ART digital display need to read zero when checking zero reference?
    No- signal interrupted for less than 1 second and not required
  2. CDC recommends using _____ technique when inserting ART lines, and replacing catheters, transducers and flush tubing every ___ hours.
    • sterile
    • 96
  3. More peripheral Art lines display what 3 changes? (aorta vs femoral)
    • 1) wider pulse pressure (taller)
    • 2) delayed upstroke
    • 3) slurred dicrotic notch
  4. general changes in BP waveform as you move peripherally
    • systolic increase
    • diastolic decrease
    • mean pressure decrease
    • dP/dT increase
    • waveform more peaked
  5. What does HHb stand for?
    deoxygenated hemoglobin
  6. What wavelengths does an O2 spectrophotometer measure?
    660 and 940 nm (red and infrared)
  7. what is the diff between Fractional SaO2 and Functional O2
    • fractional accounts for all types of Hgb, regardless of carrying capacity
    • Functional includes only OHbg and total Hgb
  8. Why does carboxyhemoglobin read 90?
    oxy and carboxy absorb equally at 660 nm
  9. at SaO2 of 85% the ration of 660 to 940 nm is what?
    1.0!
  10. What causes right shift of OHDC?
    • RIGHT- increased H+
    • Co2
    • Temp
    • 23DpG

    decerased O2 affinity and increased offloading
  11. What causes left shift of OHDC?
    • fHgb
    • opposite of everything listed for right shift
  12. De oxygenated Hgb shows higher amplitude with what wavelength?
    660nm
  13. Venous pulse effect?
    double notch before major dip
  14. What does a massimo SET do?
    • Signal Extraction technology.
    • separates noise from wanted signal
  15. List dyes in order of descending effect on pulse ox: (most to least)
    • Methylene blue
    • Lymphazurine Blue
    • Indocyanine Green
    • Indigo Carmine
    • Fluer = no fx
    • my LIIF
  16. With pulse ox reading, which placement will have a LONGER delay... Ear or Finger?
    Finger
  17. What are the measurement errors fro pulse ox:
    70-100
    50-70
    • +/- 2
    • +/- 3
    • *95% data will fall within +- 4-6 w/ standard devation
  18. What is perfusion index? (PULSE OX)
    Is it relative?
    • numerical value indication strength of IR signal returning from monitoring site (PULSE OX)
    • yes- varies according to site of monitor/physiology
  19. is transmission pulse accurate when used as reflectance pulse ox?
    NO
  20. ASA standards require _____ ______ tones must be audible when using the PULSE OX.
    variable pitch
  21. IV infusion may cause poor function of ____ ___ due to hypothermia and edema if used on same limb.
    pulse ox
  22. Probe (Pulse ox) should not be on what finger during wake-up?
    • index
    • may cause corneal abrasion if pt rubs eyes
  23. two ways to confirm pulse ox placement accuracy:
    • waveform
    • synchronous with pulse rate of ECG
  24. Cerebral Oximetry is NIRS, what does this stand for?
    Natrual Human Tissue window is ____ - ____ nm.
    • Near-infrared spectrometry
    • 690-880
    • *710 and 830 are commonly used
    • *short from tissue and skull, long for brain
  25. rSO2
    cerebral
  26. What are the problems with cerebral oximetry?
    • intra/extracranial blood dependence
    • dependence on venous and arterial pressure
    •     - pt position
    •     - PaCO2, hypoxia, pH
    •     - cerebral edema
  27. Ways to improve rSO2:
    • mechanical (head position, cannula position)
    • decrease metabolic demand (increase anesthetic, decr temp)
    • increase supply (O2 delivery) (incr FiO2, cerebral blood flow, CO2, BP, hematocrit)
  28. StO2 of ____ indicates adequate perfusion?
    75
  29. SvO2 is ______ ____________ _________ ____________.
    How is it measured?
    • mixed Venous O2 Saturation
    • fiber optic pulmonary artery or venous catheter
  30. Name the parts of PAC waveform: A, C, X, V, Y
    • A- artrial contraction
    • C- ventricular contraction (tricuspid protrusion0
    • X- ventricular ejection (late)
    • V- venous return
    • Y- opening of tricuspid valve
  31. CVP measurement:
    spontaneous ventilation causes-
    positive-pressure ventilation causes-
    BOTH are measure at ___-__________
    • reduction in intrathoracic pressure
    • increase in intrathoracic pressure
    • End-expiration
  32. CVP content kit first letters to answers:
    JSL-35W-C2S-18D-NTS
  33. Distal port has opening fartherst away from the ____ ____ ___________.
    point of insertion
  34. CVP cannula- with a wire OD of 0.028", what is the smallest cannula wire will fit through?
    18G
  35. What is the distance from the RIJV insertion site (CVP) to the right atrium?
    20cm
    • 1- thermistor
    • 2- pace port, venous infusion
    • 3- balloon, 1cm back
    • 4- pulmonary artery, connects with end
    • 5- proximal port - 30 cm
    • 6- air injection for balloon
  36. Imp swan Ganz distances (PACEPORT):
    thermistor
    RV port
    proximal injectate port
    • 3cm from end
    • 19 cm
    • 30 cm
  37. When insering swan ganz- use an introducer that is ____ F larger than the catheter
    0.5
  38. PA catheter must be in what lung zone to get an accurate wedge pressure?
    ZONE 3
  39. average PAEDP:
    8 mmHg
  40. SVR (RU)=
    (MBP-RAP)/CO
  41. PVR=
    (PAP-PAWP)/CO
  42. convert RU to ARU:
    multiply by 80

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