Basics of Anesthesia Exam 2 (monitoring) || All Answers Are
Correct 100%.
Standard ________ of CRNA practice describes monitoring expectations.
What are the 6 categories that must be monitored? correct answers V
1) Oxygenation
2) Ventilation
3) Cardiovascular
4) Thermoregulation
5) Neuromuscular
6) Positioning
_________ should be monitored whenever propofol is given. correct answers ETCO2
What is COVERABCD? correct answers Color
O2 & O2analyzer
Vaporizers & ventilation
ETT (placement/patency)
Review monitors/equipment
Airway
Breathing
Circulation
Drug Effects
What leads monitor for cardiac ischemia?
Which one is the best at detecting this? correct answers V1-V6
V3 detects ischemia earliest and most frequently (86.8%)
Lead II correct answers Large P waves and QRS complexes
Recommended for assessment of narrow QRS complex rhythms
Will detect inferior wall ischemia and arrhythmias
Why would you do a modified V5? correct answers If you only have a 3 lead
You need 5 leads for a true lead V
Modified V5 can be monitored by rearranging the standard 3-lead placement. How?
correct answers Place the left arm lead at the V5 position
,When Lead I is selected, modified V5 is displayed
Lead placement for EASI monitoring: correct answers Derived 12-lead ECG
E at the level of the fifth on the lower sternum
A in the left midaxillary line at the same level as E
S on the manubrium sterni
I in the right midaxillary lines at same level as E
Ground electrode, G, is placed at any convenient location.
The degree of elevation (or depression) on ECG is relative to an isoelectric line, aka the
__________. correct answers PR segment.
P wave
QRS complex
T wave
Q waves correct answers P wave: atrial depolarization generated by SA node.
QRS complex: the ventricle contracts in response to the electrical stimulation.
T wave: commencement of repolarization.
Q waves: myocardial necrosis
How do ECGs help monitor respiratory rate? correct answers Impedance
pneumography
inhaling increases impedance
exhalation decreases impedance
What are gain settings and filters for on ECG? correct answers Gain: changing
amplitude
Filters: lessen artifacts
Important because they can hide ecg changes
What are 3 things a pulse ox tells you? correct answers SaO2
Heart rate
Indication of tissue perfusion (pulse amplitude)
Pulse ox operation is based on what law? correct answers Lambert-Beer aka Beer's law
, What are the 2 light sources used in pulse ox? correct answers 660-nm red light (well
absorbed by oxyhemoglobin)
940-nm infrared light (well absorbed by deoxyhemoglobin)
How does a pulse ox work? correct answers Sensor containing two light sources (red -
660 nm [venous]and infrared - 940 nm [arterial]) and a light detector is placed across a
tissue that can be transilluminated (a spectrophotometer)
A photodetector measures the amount of light that is not absorbed by the tissues
A microprocessor isolates the pulsatile signal to calculate SaO2
Pulse Ox reading 85% could be due to:
What about 65%? correct answers Motion artifact
Dyes (Indocyanine green or indigo carmine)
Methemoglobin toxicity
Methylene blue: falsely low readings of approximately 65%
Normal SaO2 PaO2 correlations: correct answers SaO2 PaO2
90 = 60
80 = 50
70 = 40
6 factors that affect pulse ox accuracy: correct answers Low-blood flow conditions
Prolonged application
Patient movement
Ambient light
Altered relationship between PO2 & SaO2 (curve shifts)
Dysfunctional hgb
Affects of carboxyhemoglobin and methemoglobin on pulse ox readings: correct
answers Carboxyhemoglobin absorbs light the same as oxyhemoglobin so get falsely
high readings
Methemoglobin absorbs red and infrared light equally and corresponds to a saturation
of 85%.
This causes a falsely low reading when saturation is greater than 85% and falsely high
when saturation is less than 85%
What is the gold standard for BP measurement?
What is intraop hypotension for adults?
Correct 100%.
Standard ________ of CRNA practice describes monitoring expectations.
What are the 6 categories that must be monitored? correct answers V
1) Oxygenation
2) Ventilation
3) Cardiovascular
4) Thermoregulation
5) Neuromuscular
6) Positioning
_________ should be monitored whenever propofol is given. correct answers ETCO2
What is COVERABCD? correct answers Color
O2 & O2analyzer
Vaporizers & ventilation
ETT (placement/patency)
Review monitors/equipment
Airway
Breathing
Circulation
Drug Effects
What leads monitor for cardiac ischemia?
Which one is the best at detecting this? correct answers V1-V6
V3 detects ischemia earliest and most frequently (86.8%)
Lead II correct answers Large P waves and QRS complexes
Recommended for assessment of narrow QRS complex rhythms
Will detect inferior wall ischemia and arrhythmias
Why would you do a modified V5? correct answers If you only have a 3 lead
You need 5 leads for a true lead V
Modified V5 can be monitored by rearranging the standard 3-lead placement. How?
correct answers Place the left arm lead at the V5 position
,When Lead I is selected, modified V5 is displayed
Lead placement for EASI monitoring: correct answers Derived 12-lead ECG
E at the level of the fifth on the lower sternum
A in the left midaxillary line at the same level as E
S on the manubrium sterni
I in the right midaxillary lines at same level as E
Ground electrode, G, is placed at any convenient location.
The degree of elevation (or depression) on ECG is relative to an isoelectric line, aka the
__________. correct answers PR segment.
P wave
QRS complex
T wave
Q waves correct answers P wave: atrial depolarization generated by SA node.
QRS complex: the ventricle contracts in response to the electrical stimulation.
T wave: commencement of repolarization.
Q waves: myocardial necrosis
How do ECGs help monitor respiratory rate? correct answers Impedance
pneumography
inhaling increases impedance
exhalation decreases impedance
What are gain settings and filters for on ECG? correct answers Gain: changing
amplitude
Filters: lessen artifacts
Important because they can hide ecg changes
What are 3 things a pulse ox tells you? correct answers SaO2
Heart rate
Indication of tissue perfusion (pulse amplitude)
Pulse ox operation is based on what law? correct answers Lambert-Beer aka Beer's law
, What are the 2 light sources used in pulse ox? correct answers 660-nm red light (well
absorbed by oxyhemoglobin)
940-nm infrared light (well absorbed by deoxyhemoglobin)
How does a pulse ox work? correct answers Sensor containing two light sources (red -
660 nm [venous]and infrared - 940 nm [arterial]) and a light detector is placed across a
tissue that can be transilluminated (a spectrophotometer)
A photodetector measures the amount of light that is not absorbed by the tissues
A microprocessor isolates the pulsatile signal to calculate SaO2
Pulse Ox reading 85% could be due to:
What about 65%? correct answers Motion artifact
Dyes (Indocyanine green or indigo carmine)
Methemoglobin toxicity
Methylene blue: falsely low readings of approximately 65%
Normal SaO2 PaO2 correlations: correct answers SaO2 PaO2
90 = 60
80 = 50
70 = 40
6 factors that affect pulse ox accuracy: correct answers Low-blood flow conditions
Prolonged application
Patient movement
Ambient light
Altered relationship between PO2 & SaO2 (curve shifts)
Dysfunctional hgb
Affects of carboxyhemoglobin and methemoglobin on pulse ox readings: correct
answers Carboxyhemoglobin absorbs light the same as oxyhemoglobin so get falsely
high readings
Methemoglobin absorbs red and infrared light equally and corresponds to a saturation
of 85%.
This causes a falsely low reading when saturation is greater than 85% and falsely high
when saturation is less than 85%
What is the gold standard for BP measurement?
What is intraop hypotension for adults?
