Ch. 5 - Critical Care Monitoring

Front 1

Definitions:

1. PaO2

2. PaCO2

3. SpO2

4. ETCO2

Back 1

1. Partial Pressure of oxygen in blood

2. Partial Pressure of CO2 in blood

3. Oxygen saturation

4. end tidal CO2

Front 2

Cellular health throughout the body depends on normal ______________ of ______________ to organs.

Back 2

perfusion

blood

Front 3

_______________ blood is comprised primarily of O2 bound to hgb.

Back 3

Arterial blood

Front 4

Hgb - bound O2 depends on the _________________ of hgb as well as the ________________ of hgb with __________.

Back 4

concentration

saturation

Oxygen

Front 5

PaO2 depends on 3 things:

1. the amount of O2 in the ___________ air.

2. ability of animal to .........

3. absorption of O2 from ____________ into _______.

Back 5

1. inspired

2. ...move air in and out of pulmonary tree (ventilation.)

3. pulmonary tree / blood

Front 6

Removal of CO2 from body depends on _________________.

Back 6

Ventilation

Front 7

Respiratory acidosis:

1. aka

2. what happens to CO2 in body?

Back 7

1. hypoventilation

2. accumulates / increases in body

Front 8

Respiratory alkalosis:

1. aka

2. what happens to CO2 in body?

Back 8

1. hyperventilation

2. decreases / excessive loss of CO2

Front 9

What monitor reading / measurement can tell you if patient is experiencing respiratory acidosis or alkalosis?

Back 9

ETCO2 (end tidal CO2)

Front 10

What does an arterial blood gas analysis test measure?

Back 10

absolute concentration of oxygen

Front 11

Where do you perform an arterial stick for a cat? For a dog?

Back 11

cat - femoral

dog - dorsal/pedal

Front 12

What is the most common blood gas parameter measured for respiratory function?

Back 12

PaO2

Front 13

What is normal PaO2 in a patient breathing room air (21% O2)

Back 13

100mmHg

Front 14

Ventilation is assessed by measuring ___________.

Back 14

PCO2

Front 15

HYPOventilation =

increased ________

decreased __________

>________mmHg requires TX

>________mmHg is life threatening

Back 15

increased PaCO2

decreased PaO2

>50mmHg requires TX

>70mmHg = life threatening

Front 16

PulseOx - what is normal? (good)

Back 16

98%

Front 17

Advantages of the pulse ox:

Back 17

• inexpensive
• continuous info about pulse rate & hgb sat.
• useful for patents at risk of hypoxia

Front 18

Disadvantages of the pulse ox:

Back 18

• affected by motion
• affected by pigment of skin
• cannot distinguish between normal and abnormal hgb
• provides little info on gas exchange

Front 19

Where to place pulse ox?

(6 possible places)

Back 19

1. tongue

2. pinna

3. interdigital web

4. prepuce

5. inguinal fold

6. shaved skin over lip

Front 20

Capnograph provides information about the amount of ________ exhaled and inhaled.

This allows evaluation of _____________ _______________.

Back 20

CO2

respiratory depression

Front 21

ETCO2 = amount of CO2 at the ____________ of exhalation.

Back 21

END

Front 22

Capnograph can provide what information?

(list 4 things)

Back 22

1. confirmation of ET tube placement

2. measure of ventilation

3. measure of cardiac output

4. measure of cellular metabolism

Front 23

Delivery of CO2 to lungs requires _________ ___________.

Back 23

blood flow

Front 24

*** One of the earliest and most sensitive signs of cardiovascular collapse or cardiac arrest is: ________________________________.

Back 24

an abrupt decrease in end tidal CO2

Front 25

an abrupt decrease in CTCO2 means there is no _____________.

Back 25

perfusion

Front 26

ETCO2 reflects _____________

Back 26

PaCO2

Front 27

Advantages of the capnograph: (3)

Back 27

1. continuous

2. non-invasive

3. BEST WAY TO DETERMINE EFFICIENT VENILATION

Front 28

Disadvantages of the capnograph (2)

Back 28

1. dead space w/insertion of sampling connector

2. INCREASED POTENTIAL FOR LEAKS IN THE BREATHING SYSTEM

Front 29

Blood pressure is important for __________ _______________.

Back 29

tissue perfusion

Front 30

________________________ increases vascular resistance and BP, decreased perfusion

Back 30

vasoconstriction

Front 31

TRUE or FALSE:

Low BP manes inadequate perfusion

Back 31

FALSE - not always

Front 32

Lis 6 instances where we monitor a patient's blood pressure?:

Back 32

1. during any anesthetic procedure

2. during induction / recovery

3. any ER / critical care situation

4. CPR

5. routine monitoring / checks

6. when underlying disease may lead to secondary BP abnormalities (ex. renal disease, heart disease, hyperthyroidism)

Front 33

SBP =

dbp

Back 33

Systolic blood pressure

Diastolic blood pressure

Front 34

Systolic blood pressure corresponds to _____________ _______________. (systole)

Back 34

ventricular ejection (contraction)

Front 35

Diastolic BP corresponds to ______________ ___________________ (diastole)

Back 35

ventricular relaxation

Front 36

Normal SBP for:

dogs =

cats =

Back 36

Normal SBP for:

dogs = 110-170mmHg

cats = 120-170mmHg

Front 37

Normal dbp for:

dogs =

cats =

Back 37

Normal dbp for:

dogs = 55 - 110mmHg

cats = 70 - 110mmHg

Front 38

MAP = __________ ____________ _____________

Back 38

mean arterial pressure

Front 39

_______mmHg = hypotension

Back 39

60mmHg

Front 40

Factors Affecting BP: (3)

Back 40

1. Blood volume

2. Cardiac output

3. Vascular resistance

Front 41

Blood volume refers to the amount of blood in the _______________ _______________.

Back 41

vascular space

Front 42

Cardiac output:

_____________ ___________ is the number of timers per minute the heart contracts or beats

Back 42

Heart rate

Front 43

Vascular resistance: what is it (2 options), and what can affect it?

Back 43

vasodilation or vasoconstriction

medications

Front 44

Indirect Method of monitoring BP:

Back 44

Doppler ultrasound

Front 45

Doppler ultrasound only measures this type of BP:

Back 45

systole

Front 46

What is extremely important with regard to performing a Doppler ultrasound BP?

Back 46

cuff size

Front 47

Common sites to place BP cuff (3)

Back 47

metacarpus

metatarsus

tail

Front 48

If performing routine BP checks on an animal, what special consideration do you need to keep in mind?

Back 48

put cuff in same place / position every time

Front 49

Oscillometric method of measuring BP measures what type of BP?

Back 49

MAP

Front 50

Oscillometric BP test is usually in association with what two other measurements / pieces of equipment?

Back 50

ECG, pulse ox

Front 51

What is the advantage of the oscillometric BP test over the Doppler?

Back 51

it measures the MAP (Doppler only measures systolic)

Front 52

If both the femoral AND the dorsal pedal pulse can be palpated on the SAME LEG, the systolic pressure is at least _________mmHg

Back 52

80mmHG

Front 53

If femoral pulse is palpable but metatarsal pulse is absent, BP is probably between ______ to _______mmHg.

Back 53

60 - 80 mmHg

Front 54

If femoral pulse is weak or absent, BP is likely below ____________mmHg

Back 54

60 mmHg (critically low)

Front 55

Arterial blood pressure measures ______ __________

Back 55

gas exchange

Front 56

Never do an arterial blood pressure / arterial catheter on a patient with _______________ _____________.

Back 56

bleeding disorder

Front 57

Most common site for an arterial blood pressure test on a DOG is the _________________ artery.

Back 57

dorsal pedal

Front 58

For an arterial catheter, choose a needle one size __________ than you would for use on a peripheral vein.

Back 58

smaller

Front 59

Arterial catheters should not be left in more than ________________________ due to high incidence of ____________ ___________.

Back 59

a few hours

arterial spasm

Front 60

Concern with arterial blood tests / cath placement:

Back 60

if patient connections are not secured, large volumes of blood can be lost in a short period of time.

Front 61

TRUE or FALSE:

Medications and fluids can be given via an arterial catheter.

Back 61

FALSE