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26 Cards in this Set
- Front
- Back
What four things do you need to monitor during concious sedation
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-CNS
-respiratory system -CV system -temperature |
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Characteristic of an ideal monitoring device
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-safe, reliable, noninvasive, easily interpreted design, easily calibrate, stable, portable, easily integrated, no technical aid required, inexpensive
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Pre-op monitoring should include what vital signs:
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-BP
-HR and rhythm -respiratory rate -temp -height and weigth |
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What should you do before procedure
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-get baseline vital levels
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During sedation how often should you monitor pulse
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-continuously
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Where are some arteries for pulse determination
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-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 |
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Palpable pulse means there is a minimum systolic BP where:
radial brachial carotid |
radial - 80 mmHg
brachial - 70 mmHg carotid - 60 mmHg |
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What BPs are a red flag for concious sedation
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-systolic > 150
-diastolic > 100 |
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How to take a manual BP
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-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 |
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How does cuff size affect BP
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-a small cuff will elevate BP, a large cuff will decrease BP
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How often should you monitor BP during a procedure
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-every 5 minutes
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Do we need direct BP monitoring
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-no, requires arterial line
-only for high risk GA |
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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 |
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Most drugs used depress which system the most
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-respiratory (more than CV)
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T/F - breathing alterations are usually observed long before CV changes
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-true
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Which changes are seen first, breathing or cardiovascular
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-breathing
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What conditions are associated with M&M
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-unrecognized respiratory depression, hypoxia, hypercarbia
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T/F - movement of the chest guarantees air exchange
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-false
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What is the primary cause of cardiac arrest during sedation
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-ischemia of the heart secondary to respiratory arrest or obstruction
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T/F - observing mucous membrane color is reliable to monitor hypoxia
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-false, hypoxia precedes cyanosis
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What are three types of respiratory monitors
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-precordial/pretracheal stethoscope
-esophagela stethoscope -pulse oximetry |
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What does the pulse oximeter measure
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-oxygen saturation of arterial blood as a percentage
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What is the assumption of pulse oximetry
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-that hemoglobin exists in two state - oxygenated and reduced
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How is arterial oxygen saturation defined
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-ratio of HbO2 to total hemoglobin (HbO2 + Hb)
- |
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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 |
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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 |