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26 Cards in this Set

  • Front
  • Back
What four things do you need to monitor during concious sedation
-CNS
-respiratory system
-CV system
-temperature
Characteristic of an ideal monitoring device
-safe, reliable, noninvasive, easily interpreted design, easily calibrate, stable, portable, easily integrated, no technical aid required, inexpensive
Pre-op monitoring should include what vital signs:
-BP
-HR and rhythm
-respiratory rate
-temp
-height and weigth
What should you do before procedure
-get baseline vital levels
During sedation how often should you monitor pulse
-continuously
Where are some arteries for pulse determination
-radial (wrist)
-brachial (antecubital fossa)
-carotid (b/t SCM and trachea)
-labial (upper lip)
-facial (notch of mandible)
-superficial temporal (ant to tragus of ear)
**radial and brachial most common
Palpable pulse means there is a minimum systolic BP where:
radial
brachial
carotid
radial - 80 mmHg
brachial - 70 mmHg
carotid - 60 mmHg
What BPs are a red flag for concious sedation
-systolic > 150
-diastolic > 100
How to take a manual BP
-apply cuff to upper arm proximal to antecubital fossa, palpate radial pulse, inflate until radial pulse dissappears and then go 20-30 mmHg more
-auscultate brachial artery, deflate slowly, first sounds represent systolic, loss of sounds represents diastolic pressure
How does cuff size affect BP
-a small cuff will elevate BP, a large cuff will decrease BP
How often should you monitor BP during a procedure
-every 5 minutes
Do we need direct BP monitoring
-no, requires arterial line
-only for high risk GA
EKG
-provides
-which lead is used
-used for
-means of monitoring HR and rhythm and recognizing dysrhythmias
-lead II
-GA or high cardiac risk ppl with concious sedation
Most drugs used depress which system the most
-respiratory (more than CV)
T/F - breathing alterations are usually observed long before CV changes
-true
Which changes are seen first, breathing or cardiovascular
-breathing
What conditions are associated with M&M
-unrecognized respiratory depression, hypoxia, hypercarbia
T/F - movement of the chest guarantees air exchange
-false
What is the primary cause of cardiac arrest during sedation
-ischemia of the heart secondary to respiratory arrest or obstruction
T/F - observing mucous membrane color is reliable to monitor hypoxia
-false, hypoxia precedes cyanosis
What are three types of respiratory monitors
-precordial/pretracheal stethoscope
-esophagela stethoscope
-pulse oximetry
What does the pulse oximeter measure
-oxygen saturation of arterial blood as a percentage
What is the assumption of pulse oximetry
-that hemoglobin exists in two state - oxygenated and reduced
How is arterial oxygen saturation defined
-ratio of HbO2 to total hemoglobin (HbO2 + Hb)
-
Carbon dioxide
-type of monitor
-work how
-monitor what
-accurate
-non-invasive to monitor CO2 levels
-use infrared absorption principles
-levels of inspired and end tidal CO2, provides display as percent or in mmHg
-not very in a non-intubated pt
Temperature:
-necessary
-what is important
-why is monitoring important
-not critical
-detecting a elevated temp pre-op
-to detect hypothermia (b/c OR is cold) and hyperthermia