EXAM 2 Reading (N.Ch17) Flashcards Preview

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Flashcards in EXAM 2 Reading (N.Ch17) Deck (46)
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1
Q

2 associated with a loss of “a wave” on a CVP waveform?

A

atrial fibrillation

Ventricular pacing

2
Q

Which of the following in an overestimation of the actual BP?

A

Placing a BP cuff on an extremity below the level of the heart.

3
Q

You are inserting a pulmonary artery catheter via the right internal jugular vein. At what distance would you expect to reach the right atrium?

A

15-25cm

4
Q

The distances from the right internal jugular vein to the cardiac and pulmonary structures are as follows: pulmonary artery:

A

35-45 cm,

5
Q

distances from the right internal jugular vein to the right ventricle:

A

25-35cm

6
Q

Distance to pulmonary artery wedge position:

A

40-50 cm

7
Q

When the balloon of a PA catheter is not inflated, what pressures are reflected during diastole?

A

pulmonary artery diastolic pressure

8
Q

Transduced during systole

A

Right ventricular systolic pressure

9
Q

Transduced during diastole.

A

PA diastolic pressure

10
Q

The PA diastolic pressure is also a representation of

A

left atrial (LA) pressure

11
Q

What does the y descent on a central venous pressure waveform represent?

A

Opening of the tricuspid valve

12
Q

The x descent follows the a wave and represents the

A

relaxation of the atria.

13
Q

The x1 descent occurs as a result of the

A

downward pull of the ventricular septum during systole.

14
Q

The y descent represents the

A

opening of the tricuspid valve.

15
Q

Which of the following are associated with an increased central venous pressure reading? (select two)

A

Pulmonary hypertension

Heart failure

16
Q

Mechanical ventilation, PEEP on CVP

A

Increase

17
Q

Tension pneumothorax, and pulmonary embolism on CVP

A

Increase

18
Q

Chronic LV failure on CVP

A

Increase

19
Q

Tricuspid stenosis and TR on CVP

A

increase

20
Q

How will an arterial pressure transducer that is placed below the level of the heart affect the estimate of the actual blood pressure?

A

Overestimates

21
Q

What factors result in decreased mixed venous oxygen (SVO2) measurements? (select three)

A

Shivering
Decreased CO
Hemorrhage

22
Q

Factors that result in an increased SVO2 include:

A
Cyanide toxicity, 
Hypothermia.  
A wedged pulmonary artery 
    catheter
Left-to-right shunts,
Sepsis
23
Q

Factors that result in a decreased SVO2 include:

A

hyperthermia
shivering,
hemorrhage,
decreased cardiac output, and a decrease in the pulmonary transport of oxygen.

24
Q

Which of the following would you expect to produce a large V wave on a CVP waveform?

A

Tricuspid regurgitation, mitral regurgitation, or a sudden, dramatic increase in intravascular volume

25
Q

Which of the following are associated with cannon ‘a’ waves on the central venous pressure waveform? (select two)

A

Diatolic dysfunction

Compleve AV block

26
Q

Tricuspid and mitral stenosis will show on CVP

A

Cannon a waves.

27
Q

When calculating the mean arterial pressure, the diastolic pressure is doubled

A

because diastole accounts for two-thirds of the cardiac cycle duration

28
Q

TEE: Complete absence of wall motion is

A

Akinesia

29
Q

TEE; Decreased wall motion is

A

HYPOKINESIA

30
Q

TEE: Paradoxical wall motion

A

Dyskinesia

31
Q

What is the hallmark of myocardial infarction with ventricular aneurysm?

A

Dyskinesia (paradoxical motion)

32
Q

When the balloon of a pulmonary artery catheter is inflated, what pressure can be obtained indirectly during ventricular systole?

A

left atrial filling pressure

33
Q

The most significant expected alteration from a cracked stopcock in an arterial pressure monitoring system would be

A

acute blood loss

34
Q

Potential complications due to intra-arterial monitoring include:

A

acute blood loss from a leak or crack in the transducer system, thrombosis, vasospasm, infection, hematoma, nerve damage, and loss of digits.

35
Q

Which of the following would result in an underestimation of the aortic pressure? (select two)

A

Radial artery monitoring during hypothermic cardiopulmonary bypass
Air in the transducer tubin g

36
Q

Hypothermic conditions reduce the vascular resistance in the hand compared to the aorta, and the radial arterial line will

A

underestimate the aortic pressure.

37
Q

Placing a blood pressure cuff that is too loose, too small, or positioned below the level of the heart will result in a blood pressure that

A

overestimates the actual blood pressure.

38
Q

The presence of air in the transducer tubing and the addition of stopcocks and longer tubing can

A

decrease the frequency of the monitoring system and lead to overdamping which will tend to underestimate the systolic blood pressure.

39
Q

The degree of ST elevation or depression on an ECG is measured between the isoelectric line and the

A

J point

40
Q

ATrial repolarization occur at

A

S

41
Q

Isoelectric line after t wave is

A

Ventricular repolarization complete.

42
Q

T wave is the

A

Ventricular repolarization is beginning

43
Q

QT interval indicates

A

Ventricular depolarization is complete.

44
Q

End of QRS complex at the last downward deflection is

A

Ventricular depolarization begins

Atria are repolarizing

45
Q

PR interval is

A

Atrial depolarization is complete.

46
Q

P wave is

A

Atrial depolarization begins