Critical Care (Final)
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187 terms
Terms | Definitions |
|---|---|
 What are the three forms of dead space inside the lungs? | 1. Anatomic: gas does not participate in gas exchange. Perfusion problem. Large Airway 2. Alveolar: part of alveolar that does not participate in gas exchange. 3. Physiologic: combination of both of them. Makes up 1/3 of it. |
| Physiologic deadspace = ? | Physiologic = Anatomic + Alveolar |
| Physiologic deadspace makes up: a. 1/2 of all deadspace b. 3/4 of all deadspace c. 2/3 of all deadspace d. 1/3 of all deadspace e. none of the above | d. 1/3 of all deadspace |
| The list below represents causes of deadspace. Fill in the missing numbers. 1) Rapid Shallow Breathing 2) Airway Extension 3) Pathology with Alveolar Distention 4) 5) 6) Excessive PEEP | 4) Pulmonary Embolus 5) Decreased in Cardiac Output |
| The list below represents causes of deadspace. Fill in the missing numbers. 1) 2) Airway Extension 3) 4) Pulmonary Embolus 5) Decreased in Cardiac Output 6) Excessive PEEP | 1) Rapid Shallow Breathing 3) Pathology with Alveolar Distention |
| The list below represents causes of deadspace. Fill in the missing numbers. 1) Rapid Shallow Breathing 2) 3) Pathology with Alveolar Distention 4) Pulmonary Embolus 5) Decreased in Cardiac Output 6) | 2) Airway Extension 6) Excessive PEEP |
| What are the the six causes of deadspace? | RAP PED 1) Rapid Shallow Breathing 2) Airway Extension 3) Pathology with Alveolar Distention 4) Pulmonary Embolus 5) Excessive PEEP 6) Decreased in Cardiac Output |
| You are just exchanging upper airway, conducting upper airway, exchanging deadspace. 1) Rapid Shallow Breathing 2) Airway Extension 3) Pathology with Alveolar Distention 4) Pulmonary Embolus 5) Excessive PEEP 6) Decreased in Cardiac Output | 1) Rapid Shallow Breathing |
| Causes NO perfusion. Alveoli not participating in gas exchange creating deadspace. 1) Rapid Shallow Breathing 2) Airway Extension 3) Pathology with Alveolar Distention 4) Pulmonary Embolus 5) Excessive PEEP 6) Decreased in Cardiac Output | 4) Pulmonary Embolus |
| Emphysema 1) Rapid Shallow Breathing 2) Airway Extension 3) Pathology with Alveolar Distention 4) Pulmonary Embolus 5) Excessive PEEP 6) Decreased in Cardiac Output | 3) Pathology with Alveolar Distention |
| Lung will drop in perfusion, alveoli less gas exchange, creating some deadspace. Inadequate perfusion. 1) Rapid Shallow Breathing 2) Airway Extension 3) Pathology with Alveolar Distention 4) Pulmonary Embolus 5) Excessive PEEP 6) Decreased in Cardiac Output | 6) Decreased in Cardiac Output |
| Causes over-distention of alveoli, creating more deadspace. 1) Rapid Shallow Breathing 2) Airway Extension 3) Pathology with Alveolar Distention 4) Pulmonary Embolus 5) Excessive PEEP 6) Decreased in Cardiac Output | 5) Excessive PEEP |
| What is the difference between capnography and capnometry? | Capnometry: Measurement with numeric display Capnography: Graphic display of the capnometry |
| What are the causes for decrease deadspace? | 1) Artificial Airway: Most Common 2) Atelectasis: Collapse down the lung tissue |
| The following list represents factors that affect CO₂. Fill in the missing numbers. 1. Metabolism 2. Cardiac Output 3. 4. 5. | 3. Ventilator Settings 4. Intubation Tube Leaks 5. Equipment Function |
| The following list represents factors that affect CO₂. Fill in the missing numbers. 1. 2. 3. 4. Intubation Tube Leaks 5. Equipment Function | 1. Metabolism 2. Cardiac Output 3. Ventilator Settings |
| Name the two types of capnographs and their typical analyzer systems? | Diverting (Double Beam Analyzer) Non-diverting (Single Beam Analyzer) |
| Name the analyzer: Tends to be seen more on Non-Diverting Type. Has wire with infared light on left side, passes thru sample thru a receptor, the information if transmitted thru the wire. Sample is the pt inhaling or exhaling. With goes to the analyzer which will show you a display. Connected to the pt's tube. |  Single Beam Analyzer or Solid State |
| Name the analyzer: Has sample chamber, the beam uses a infrared light (on right side) which goes thru sample to an analyzer. A certain amt of infared is absorbed in the sample. A second light goes thru a Known Sample which goes to another analyzer. The Known Sample usually is 100% O2 or CO2. These 2 system is comparted to each other and is shown onto you analyzer display |  Doublel Beam Analyzer |
| What are normal values for ETCO₂? | Normal value is about 1-5 torr < PaCO2 • 35-45 torr • 5-6% Baseline should return to 0 (referring to graphic) |
| Describe a capnograph indicative of obstruction. |  - obstruction in the exp. limb of the breathing circuit - presence of a foreign body in upper airway - partially kinked or occluded artificial airway - bronchospasm The worse the obstruction the more diagonal the wave is. |
| Describe a capnograph where ETCO₂ is increasing. |  - ↓ respiratory rate (hypoventilation) - ↓ VT - ↑ metabolic rate - rapid rise in body temperature (malignant hyperthermia) |
| What would you do if you saw that the capnograph had decreasing ETCO₂? |  - ↑ respiratory rate (hyperventilation) - ↑ VT - ↓ metabolic rate - ↓ body temp |
| Describe a capnograph where patient is rebreathing their ETCO₂. |  - faulty expiratory valve - inadequate respiratory flow - malfunction of CO₂absorber system - partial rebreathing circuits - insufficient expiratory time |
| Describe a capnograph where the ET tube is in the patient's stomach. |  No more CO2 in the stomach. This will not happen because auscultate first so see if the ETT is placed in the right spot. |
| Describe the capnograph where there is an inadequate seal around the ET tube. |  - a leaky or deflated ET or Trach cuff - an artificial airway that is too small for patient |
| Describe the capnograph where there is a faulty ventilator circuit valve. |  - baseline elevated - abnormal descending limb of capnogram - allows patient to rebreathe exhaled gas |
| Describe the capnograph where there is cardiogenic oscillations. |  When heart is beating really hard, it is beating a/g the esophagus and trachea. Heat beating off the esophagus and trachea so it is measuring it so that is why the graph looks that way. |
| Describe the capnograph where there is muscle relaxants involved. |  Bump is a wearing off of the anesthesia gas that was that were given to pt. - depth pf cleft is inversely proportional to the degree of drug activity - position is fairly constant on the same patient but not necessarily present with every breath |
| Factors related to ETCO₂ may be minute production and equipment but it may be caused by another category. Name it. | Minute Ventilation (non-ventilator pt) due to change in pathology: Swelling & Edema Muscle spasm Secretion Drugs (CNS Depressants) Head Trauma Neuromuscular Conditions (seizures) |
| Factors related to ETCO₂ may be minute ventilation and equipment but it may be caused by another category. Name it. | Production (ventilator pt) Fever Metabolic Change Neuromuscular Condition |
| Factors related to ETCO₂ may be minute ventilation and production but it may be caused by another category. Name it. | Equipment |
| Name the three categories that may DECREASE ETCO₂ and the pathologies related to them. | 1. Production: - Hypothermia - Change in cardiovascular conditions 2. Ve: - Coming off the CNS Depressants (pt will start breathing faster) - Head Trauma - Diabetic Condition 3. Equipment - Leaks in system, in connectors → can give false reading of what's going on. |
| What is a normal value for volumetric carbon dioxide? | 5-6% VCO₂ L/Ve |
| Saturation is directly reflective of ___________. | Saturation is directly reflective of Cardiac Output (QT). |
| What is the arterial content equation? | CaO₂ = (1.34 x Hb x SaO₂) + (.003 + PaO₂) |
| What is the normal for SṽO₂? Give answer as percent, content, and pressure. | 70-75% 12-15 ml/dL 35-45 torr |
| What is the Fick Equation? | VO₂ = QT (CaO₂-CṽO₂) |
| What are the four main causes for a ↓ in SṽO₂ (decreased supply)? | 1. QT 2. Hb 3. Lung Dysfunction 4. ↑ O₂ Consumption |
| QT is a cause for ↓ in SṽO₂ Why? | Generally it involves pathologies of the heart such as: CHF, Cor Pulmonale, Shock, CAD, Hypovolemia. |
| Hb is a cause for ↓ in SṽO₂ Why? | Hemorrhage, internal/external blood cancers, CO poisoning, and Abnormal Hb |
| ↑O₂ consumption is a cause for ↓ in SṽO₂. Give one good example of this. | Hyperthermia Seizure Disorder Metabolic Status Agitation/Pain |
| What is a normal level for SṽO₂ ? | 70-75% |
| SṽO₂ > 75% 1. Patient is on O₂ 2. Impending Cardiac Failure 3. Anaerobic Metabolism 4. Tissue Damage 5. Permanent Brain Damage | 1. Patient is on O₂ |
| SṽO₂ < 60% 1. Patient is on O₂ 2. Impending Cardiac Failure 3. Anaerobic Metabolism 4. Tissue Damage 5. Permanent Brain Damage | 2. Impending Cardiac Failure |
| SṽO₂ < 40% 1. Patient is on O₂ 2. Impending Cardiac Failure 3. Anaerobic Metabolism 4. Tissue Damage 5. Permanent Brain Damage | 3. Anaerobic Metabolism |
| SṽO₂ < 30% 1. Patient is on O₂ 2. Impending Cardiac Failure 3. Anaerobic Metabolism 4. Tissue Damage 5. Permanent Brain Damage | 4. Tissue Damage |
| SṽO₂ < 20% 1. Patient is on O₂ 2. Impending Cardiac Failure 3. Anaerobic Metabolism 4. Tissue Damage 5. Permanent Brain Damage | 5. Permanent Brain Damage |
| What two pathologies would give an abnormal increase in SṽO₂? | Polycythemia Hypothermia |
| What is a PO₂ electrode called? | Clark Electrode |
| What is a PCO₂ electrode called? | Severinghaus Electrode |
| With transcutaneous monitoring, O↑ is released through the skin. In what direction does this shift the oxy-hemoglobin curve? | Right |
| What are two negative aspects of heat in transcutaneous monitoring? | 1. ↑ metabolism = ↑ consumption (slight) 2. ↑ CO₂ production |
| True / False Transcutaneous monitoring is tied to Cardiac Index. | True |
| What is a normal cardiac index? | 3-5 L/min at 97 mmHg |
| What level of SṽO₂creates lactic acidosis? | SṽO₂< 40% |
| What are the heat ranges in transcutaneous monitoring? Give answer for both neonates and infants. | neonate: 41-43° C infant: 44° C adult: 45° C |
| How often is TCM changed and why? | Q4H because of probability of skin burning. |
| Why is PTCO₂> PCO₂? | Heat ↑ CO₂to stay as a gas. |
| When cardiac index (CI) > ___ then PTCO₂ = PCO₂+ ____ | When cardiac index (CI) > 1.5then PTCO₂ = PCO₂+ 23 |
| When is TCM at its greatest accuracy? | When cardiac index (CI) > 2.2. This is when TCM is 79% accurate +/- 12% |
| What are the barriers of the skin that affect transcutaneous monitoring? | Nonvascular layers: stratum corneum and epidermis. Remember the dermis and the hypodermis are the vascular layers. |
| Define cardiac index (CI). | A cardiodynamic measure based on the cardiac output, which is the amount of blood the left ventricle ejects into the systemic circulation in one minute, measured in liters per minute (l/min). Cardiac output can be indexed to a patient's body size by dividing by the body surface area (called the BSA) to yield the cardiac index. |
| The cardiac cycle is made up of what two major components? | Ventricular Systole (1/3) Ventricular Diastole (2/3) |
| When does atrial filling occur? a. ventricular systole b. ventricular diastole c. atrial systole | a. ventricular systole |
| Ventricular pressure drops a. ventricular systole b. ventricular diastole c. atrial systole | b. ventricular diastole |
| A small amount of regurgitation occurs. a. ventricular systole b. ventricular diastole c. atrial systole | b. ventricular diastole |
| 80% of volume drains from the atria into the ventricles. a. ventricular systole b. ventricular diastole c. atrial systole | b. ventricular diastole |
| Bulging of mitral/tricuspid valves into atria a. ventricular systole b. ventricular diastole c. atrial systole | a. ventricular systole |
| This is 1/3 of the cardiac cycle. a. ventricular systole b. ventricular diastole c. atrial systole | a. ventricular systole |
| This is 2/3 of the cardiac cycle. a. ventricular systole b. ventricular diastole c. atrial systole | b. ventricular diastole |
| What is the equation for cardiac output (QT)? | QT = Stroke Volume x Rate |
| What does sympathetic stimulation do to cardiac rate and cardiac output? Describe how this affects the patient with cardiovascular disease. | ↑ Heart Rate ↑ QT In the patient with cardiovascular disease, if there is too great of an increase in heart rate there may be insufficient filling time to decrease cardiac output. |
| What does parasympathetic stimulation do to cardiac rate? | ↓ Heart Rate |
| Preload factor is also known as ________________. | Preload factor is also known as STROKE VOLUME PRELOAD. |
| __________________ is the amount of blood in the ventricles at the onset of ventricular contraction (or end-systole). | STROKE PRELOAD VOLUME is the amount of blood in the ventricles at the onset of ventricular contraction (or end-systole). This is also known as the Frank-Starling Law. This law states that the greater the amont of stretch to the muscle fibers (myocardial stretch), the greater the force of contraction. |
| What are the optimal and normal pressures of stroke volume preload? | Optimal: 15-20 mmHg Normal: 8-12 mmHg |
| Give two physiologic reactions related to DECREASED myocardial preload. | 1. ↓ venous return (e.g. volume loss, shock) 2. loss of atrial systole (e.g. Afib) |
| Give two physiologic reactions related to INCREASED myocardial preload. | 1. incomplete ejection of ventricle volume (e.g. early CHF) 2. ↑ fluid volume (e.g. hypervolemia, renal failure) 3. valve damage 4. overstretch of ventricle |
| _______________ is the amount of blood in the ventricle following ventricular contraction. This is based on vascular resistance. | AFTERLOAD is the amount of blood in the ventricle following ventricular contraction. This is based on vascular resistance. |
| Give two physiologic reactions related to INCREASED afterload. | 1. ↑ pulmonary/vascular resistance (pulm. disease) 2. valve stenosis (aortic or pulmonic) |
| Give two causes related to DECREASED afterload. | 1. vasodilators (e.g. nitrates) 2. excercise |
| A decrease in contractility may be the result of three causes. Name two of them. | 1. mycocardial disease (e.g. MI, CAD) 2. inotropic drugs (e.g. beta-blockers, some anti-arrhythmic drugs) 3. metabolic concerns |
| A increase in contractility may be the result of three causes. Name two of them. | 1. sympathetic stimulation (e.g. exercise, stress) 2. sympathomimetic drugs (e.g. epinephrine) 3. cardiotonic drugs (e.g. digitalis, digoxin digitoxin) |
| How many lumens does a Swan-Ganz catheter have? Name them. | 3-4 lumens 1. distal port 2. proximal port 3. balloon port 4. thermister port |
| This port fits in the right atrium and measures RAP. a. distal port b. proximal port c. balloon port d. thermister port | b. proximal port |
| This port obtains mixed venous samples and creates waveforms seen on the monitor. a. distal port b. proximal port c. balloon port d. thermister port | a. distal port |
| This port is the temperature sensor and is used in cardiac output studies. a. distal port b. proximal port c. balloon port d. thermister port | d. thermister port |
| Where is the balloon inflated for the Swan-Ganz catheter? | right ventricle |
| Where is the Swan-Ganz catheter inserted? | superior vena cava |
| What is a normal right atrial pressure (RAP)? | 0-6 mmHg |
| What is a normal right ventricle pressure (RVP)? (give your answer in systolic and diastolic) | normal systolic: 15-25 mmHg normal diastolic: < 5mmHg |
| What is a normal central venous pressure (CVP)? What is its application? | 2-6 mmHg (no waveform) It is used to monitor fluid volume |
| A high CVP would indicate what? | 1. back pressure in venous system (right ventricle failure) |
| A low CVP would indicate what? | low volume (hemorrhage, renal dysfunction) |
| A decrease in RAP would indicate what? | 1. low volume 2. shock |
| An increase in RAP would indicate what? | 1. ↑ in preload 2. valve stenosis 3. ↑ valve regurgitation 4. hypervolemia (rare) |
| This is typically not monitored because other pressures provide enough information. a. RAP b. RVP c. LAP d. LVP | b. RVP |
| What is normal pulmonary artery pressure PAP? Give your answer in systolic and diastolic, and explain what each represents. | normal systolic: 15-25 mmHg (work of RIGHT ventricle) normal diastolic: 8-15 mmHg (work of LEFT ventricular end diastolic pressure) |
| What is a normal MEAN PAP? | 10-15 mmHg |
| What would an increase in PAP (systolic) mean? | ↑ in Pulmonary Vascular Resistance This could be pulmonary disease or embolism. |
| What would an increase in PAP (diastolic) mean? (hint: 4) | 1. left ventricular dysfunction or failure 2. mitral valve dysfunction (e.g. stenosis) 3. hypervolemia (rare) 4. ↑ pressure from outside the heart (pericarditis, tamponade) |
| What would a decrease in PAP (systolic/diastolic) mean? | hypervolemia (due to burns, shock) |
| When viewing the waveform created by the Swan-Ganz catheter, what would the 'A' portion of the wave form represent: a. atrial systole b. atrial diastole c. ventricular systole d. ventricular diastole (left) | a. atrial systole |
| When viewing the waveform created by the Swan-Ganz catheter, what would the 'X' portion of the wave form represent: a. atrial systole b. atrial diastole c. ventricular systole d. ventricular diastole (left) | b. atrial diastole or atrial relaxation |
| When viewing the waveform created by the Swan-Ganz catheter, what would the 'V' portion of the wave form represent: a. atrial systole b. atrial diastole c. ventricular systole d. ventricular diastole (left) | c. ventricular systole |
| When viewing the waveform created by the Swan-Ganz catheter, what would the 'Y' portion of the wave form represent: a. atrial systole b. atrial diastole c. ventricular systole d. ventricular diastole (left) | d. ventricular diastole (left ventricular pressure and diastolic pressure) |
| What is a normal Pulmonary Artery Wedge Pressure? | Normal PAWP 4-12 mmHg |
| Which is dynamic? a. PAEDP b. PWP | a. PAEDP pulmonary artery end-diastolic pressure |
| Which is static? | b. PWP pulmonary wedge pressure remember: wedge is static |
| If PAEDP is ______ mmHg greater than PWP then __________________ is present. | If PAEDP is 4 mmHg greater than PWP then pulmonary hypertension is present. |
| When a patient has high PWP what happens to PWP and PAEDP? | PWP ↑ RAP ↑ Also remember that blood backs up into the right atrium causing mitral regurgitation. |
| When a patient has HYPOvolemia, what happens to RAP, PWP, and PAP? How is HPOvolemia treated? | ↓ RAP ↓ PWP → PAP (drops but not significantly) Tx: fluids, plasma, blood (depends) |
| When a patient has HYPERvolemia, what happens to RAP, PWP, and PAP? How is HYPERvolemia treated? | ↑ RAP ↑ PWP ↑ PAP (drops but not significantly) Tx: diuretics |
| The onset of interstitial edema may be seen in the PWP. What is the PWP range that would indicate ONSET of interstitial edema? | PWP between 20 - 30 mmHg |
| The presence of interstitial edema may be seen in the PWP. What is the PWP range that would indicate PRESENCE of interstitial edema? | PWP > 30 mmHg |
| Left ventricular failure (LVF) is due to an _____________ in afterload. | Left ventricular failure (LVF) is due to an INCREASE in afterload. REMEMBER: This backs up into left atrium and eventually the whole system. |
| What happens to PWP and QT during mild LVF (left ventricular failure)? | ↑ PWP → Normal QT |
| What happens to PWP and QT during severe LVF (left ventricular failure)? | ↑↑ PWP ↓ Normal QT |
| What is the treatment for left ventricular failure (LVF)? 1. fluids 2. blood 3. cardiotonics 4. diuretics 5. vasodilators a. 1, 2 b. 2, 3 c. 4, 5 d. 3, 4 e. 1, 5 | c. 4, 5 |
| How are PAP, PWP, and QT affected by excessive PEEP? | ↑ PAP ↑ PWP ↓ QT (over time) |
| How are PAP and PWP affected during pulmonary vascular resistance (PVR)? | ↑ PAP → PWP (initially because no blood pressure) |
| Name two of the four causes for pulmonary vascular resistance (PVR). | 1. ARDS 2. Emphysema 3. Pulmonary Emboli 4. Hypoxia (profound) |
| In the case of long term (chronic) right ventricular failure (RVF), what pressures increase? | ALL PRESSURE INCREASE |
| How are RAP, PWP, and PAP affected by RVF (right ventricular failure)? | ↑ RAP (initially) then ↓ RAP (venous distendability) ↓ PWP ↓ PAP (initially) then vasoconstriction then normal. |
| Waveform Artifacts: seen in PAP and PWP a. respiratory variation b. damping c. over-wedging d. catheter whip | a. respiratory variation |
| Waveform Artifacts: seen in mechanical ventilation a. respiratory variation b. damping c. over-wedging d. catheter whip | a. respiratory variation |
| Waveform Artifacts: may happen with a blood clot in catheter. a. respiratory variation b. damping c. over-wedging d. catheter whip | b. damping |
| Waveform Artifacts: catheter impinged against the heart wall or a kink in catheter. a. respiratory variation b. damping c. over-wedging d. catheter whip | b. damping |
| Waveform Artifacts: air bubble (rare) a. respiratory variation b. damping c. over-wedging d. catheter whip | b. damping |
| Waveform Artifacts: artery squishes the catheter. a. respiratory variation b. damping c. over-wedging d. catheter whip | over-wedging |
| Waveform Artifacts: excessive, irregular oscillations of the waveform a. respiratory variation b. damping c. over-wedging d. catheter whip | d. catheter whip |
| Waveform Artifacts: catheter has backed into the right ventricle and is next to the pulmonic valve or coiled inside right ventricle. a. respiratory variation b. damping c. over-wedging d. catheter whip | d. catheter whip |
| The following list represents uses for cardiac output (QT) studies. Fill in the missing pieces. 1. 2. cardiogenic pump failure 3. 4. post myocardial infarction | 1. true hypovolemia 2. cardiogenic pump failure 3. effect of therapeutic treatment 4. post myocardial infarction |
| The following list represents uses for cardiac output (QT) studies. Fill in the missing pieces. 1. true hypovolemia 2. 3. effect of therapeutic treatment 4. post myocardial infarction | 1. true hypovolemia 2. cardiogenic pump failure 3. effect of therapeutic treatment 4. post myocardial infarction |
| The following list represents uses for cardiac output (QT) studies. Fill in the missing pieces. 1. true hypovolemia 2. cardiogenic pump failure 3. effect of therapeutic treatment 4. | 1. true hypovolemia 2. cardiogenic pump failure 3. effect of therapeutic treatment 4. post myocardial infarction |
| Certain factors affect cardiac output studies. Name three of them. | 1. stroke volume 2. cardiac rate (at rest) 3. age 4. body age 5. physical condition 6. pathology (cardiac, vascular, renal) |
| What is the one special procedure that a clinician is likely to see only in the cardiac catheterization lab? a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | b. indicator dye method |
| Uses a Swan-Ganz catheter a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | a. thermodilution method |
| Temperature change is recorded at thermister. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | a. thermodilution method |
| The injectate is D5W solution and it is injected into the right atrium of heart then measurement is taken in the pulmonary artery. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | a. thermodilution method |
| This procedure is based on resistance and electricity. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | c. thoracic bioimpedance |
| The idea is that electrical current will follow blood and QT can be calculated. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | c. thoracic bioimpedance |
| Using this special procedure, you an measure the size of a chamber and determine volume. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | d. echocardiography |
| The main argument against this special procedure is that whether a consistent measurement can be made between patients. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | d. echocardiography |
| This special procedure beings in the descending aorta. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | e. IABP (intra-aortic balloon pump) |
| This procedure involves counter pulsation, doing the exact opposite of what the heart is doing. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | e. IABP (intra-aortic balloon pump) |
| This special procured is comprised both of an anatomic basis and physiologic basis. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | e. IABP (intra-aortic balloon pump) |
| The dicrotic notch is focused on in this special procedure. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | e. IABP (intra-aortic balloon pump) |
| With IABP when does the balloon inflate and deflate? | inflation @ diastole deflation @ systole |
| This special procedure has the ability to improve the immune system and contributes to neovascularization. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | f. Hyperbaric Therapy (HBO) |
| This special procedure may be either monochamber or multiplace. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | f. Hyperbaric Therapy HBO |
| The typical time for this treatment is 90 minutes, BID for 10-20 days. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | f. Hyperbaric Therapy (HBO) |
| The factors of IABP may be either anatomic or physiologic. What is the anatomic comprised of? | The anatomic assumes that the body is divided into two compartments. Proximal Compartment = above heart Distal Compartment = below heart |
| The factors of IABP may be either anatomic or physiologic. What is the physiologic comprised of? | The physiologic basis is comprised of the diastole and systole of the cardiac cycle. THESE TWO PARTS WHEN USED WITH IABP IMPROVE QT. |
| Name one of the three indications for IABP. | 1. cardiogenic shock (when other interventions don't work) 2. used to wean off bypass post surgery 3. severe MI when other interventions don't work |
| How would a clinician wean a patient from IABP? | 1. decrease volume of balloon 2. decrease rate |
| Two of the hazards of this special procedure are barotrauma and CNS toxicity. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | f. Hyperbaric Therapy (HBO) |
| Complications of this special procedure may involve: vascular damage, emboli, and hemolysis. a. thermodilution method b. indicator dye method c. thoracic bioimpedance d. echocardiography e. IABP f. Hyperbaric Therapy (HBO) | e. IABP |
| Sound is expressed in _______ or _______ per second. | Sound is expressed in HERTZ (Hz) or CYCLES per second. |
| True / False Sound travels through a vacuum. | True |
| How much tissue must be present for ultrasound to work? | Two different tissue textures. |
| imaging showing echoes in varying levels a. gray scale b. amplitude c. attenuation | a. gray scale |
| strength of sound wave a. gray scale b. amplitude c. attenuation | b. amplitude |
| the progressive weakening of the sound beam as it travels through the body a. gray scale b. amplitude c. attentuation | c. attenuation |
| As the sound wave travels through the body (attenuation), it goes through three distinct phases. Can you name them? | 1. reflection 2. scattering 3. absorption |
| the degree to which loss is created from the sound beam as it passes through the tissue a. gain b. depth c. artifact d. time-gain compensation | d. time-gain compensation |
| overall echo amplification a. gain b. depth c. artifact d. time-gain compensation | a. gain |
| shows the degree at which echoes are displayed. a. gain b. depth c. artifact d. time-gain compensation | b. depth |
| error in image a. gain b. depth c. artifact d. time-gain compensation | c. artifact |
| These two combined make all the echoes the same. They compensate for loss of sound beam as it passes through tissue. a. gain b. depth c. artifact d. time-gain compensation | a. gain d. time-gain compensation |
| This type of artifact is when sound is reflected off a strong reflector and is redirected toward a second structure, causing a __________. a. mirror image b. shadowing c. enhancement d. reverberation | a. mirror image |
| This type of artifact appears as an anechoic region posterior from a very strong attenuating medium. a. mirror image b. shadowing c. enhancement d. reverberation | b. shadowing |
| This type of artifact appears as a hyperemic region beneath tissues with low attenuation. a. mirror image b. shadowing c. enhancement d. reverberation | c. enhancement |
| This type of sound artifact appears on the display as multiple equally spaced echoes. a. mirror image b. shadowing c. enhancement d. reverberation | d. reverberation |
| What is the audible level of sound? What is the speed of sound in soft tissue? | Audibility: 20-20,000 Hz Speed: 1540 m/sec |
| without echoes, black on image a. anechoic, sonolucent b. echogenic c. hyperechoic d. hypoechoic e. internal echoes | a. anechoic, sonolucent |
| describes a structure that produces echoes a. anechoic, sonolucent b. echogenic c. hyperechoic d. hypoechoic e. internal echoes | b. echogenic |
| increased (very bright) a. anechoic, sonolucent b. echogenic c. hyperechoic d. hypoechoic e. internal echoes | c. hyperechoic diaphragm is a good example |
| decreased (dull) a. anechoic, sonolucent b. echogenic c. hyperechoic d. hypoechoic e. internal echoes | d. hypoechoic |
| low-level a. anechoic, sonolucent b. echogenic c. hyperechoic d. hypoechoic e. internal echoes | internal echoes |
| right and left a. sagittal b. coronal c. axial | a. sagittal |
| anterior and posterior a. sagittal b. coronal c. axial | b. coronal |
| superior and inferior a. sagittal b. coronal c. axial | c. axial |
| seen in RUQ and LUQ a. diaphragm b liver c. kidney d. spleen e. lung | a. diaphragm b. kidney e. lung |
| seen predominately in RUQ a. diaphragm b liver c. kidney d. spleen e. lung | b. liver |
| seen predominately in LUQ a. diaphragm b liver c. kidney d. spleen e. lung | d. spleen |
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