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13 Cards in this Set
- Front
- Back
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Pt with a deviated trachea on CXR is for thoracic surgery, which of the following is not an anesthetic concern?
a. Tumor in airway b. neuroendocrine involvement c. phrenic nerve involvement d. heart failure |
d. heart failure is not a general concern
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Which is not a type of DLT?
a. Carlens b. White c. Mendels d. robertshaw |
c Mendels
(Carlens is a Left-side tube, White is a Right side tube, Robertshaw is right or left and has no carina hook) |
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What is the size range of a DLT for a 45 year old woman, 72kg?
a. 35- 39 fr b. 39 - 41 fr c. 30 -35 fr d. 8.0 |
a. 35- 39 fr
-- although the nminimal size for the use of a 4.9 bronchoscope is a 37fr. andything smaller, must use a pediatric scope |
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What should the trachea look like during fiberoscope to indicate a posterior view?
a. flat at the top b. flat at the bottom c. flat on the right d. round with cartilage rings |
b. flat at the bottom (D shaped) indicates the posterior view
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When checking placement of a DLT, the first thing to do is to listen bilaterally, what does it mean if BS are heard on one side?
a. the tube is in too far and both lumens are in the right b.. the tube is out too far and both lumens are in the trachea c. neither d. both e. a only |
e. or a. the tube is in too far and both lumens are either right or left
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You listen bilaterally while clamping each side of a DLT, and breath sounds are heard on each side. What has happened?
a. the tube is in too far b. the tube is out too far c. the cuffs are inflated d. none of the above |
b the tube is out too far and needs to be advanced
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You listen bilaterally while checking placement of a left- DLT and when you clamp the bronchial tube you hear breath sounds on right and when you clamp the tracheal tube you hear breath sounds on the left. What has happened?
a. the tube is in too far b. the tube is in the right bronchus c. the tube is correctly placed d. none of the above |
c the tube is corectly placed
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What happens to closing volume in the chronic smoker compared to nonsmokers?
a. decreased b. increased c. no change d. shifts to the left |
b. increased--
closing vol is the closing capcity + the residual volume = air trapping is greater in the smoker. |
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What are the steps in OLV? place the following in the correct order....
a. clamp tubing to NDL b. Baseline ABG c. Go to 100% O2 d. Leave lumen of NDL open to air or attach to suction e. ABG on one lung after 15 min |
c. Go to 100% O2
b. Baseline ABG a. clamp tubing to NDL d. Leave lumen of NDL open to air or attach to suction e. ABG on one lung after 15 min |
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Which is not considered a consistently effective measure to treat hypoxemia during OLV?
a. periodic inflation of collapsed lung b. PEEP to the ventilated lung c. early ligation or clamping of the ipsilateral PA during pneumonectomy d. CPAP to collapsed lung |
b. PEEP to ventilated lung is considered to be a marginally effective measure (Morgan p598)
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The surgeon wants to use two lung ventilation with apneic oxygenation-- you know that this is possible, keeping which in mind? pick three
a. this is usually limited to 10-20 min before hypoxemia occurs b. this is limited to 3-7 min before hypoxemia occurs c. Arterial PCO2 rises 6mmHg in the first minute d. Arterial PCO2 continues to rise 3-4mmHg/min after the first min a. |
a, c, and d are correct
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Your patients PCO2 is 40mmHg, you predict it to be what after 10 min of apneic oxygenation during a wedge resection?
a. 46 b. 55 c 64 d. 73 |
d. approx 73
Arterial PCO2 rises 6mmHg in the first minute, and continues to rise 3-4mmHg/min |
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During OLV your pt becomes hypoxic, what steps should be done to try and correct this? place in the correct order...
a. Apply CPAP to the collapsed lung b. Apply PEEP to the ventilated lung c. reexpansion of the collapsed lung d. check tube placement |
d, a, b, c
(morgan p599) |
