IABP TEST 2 QUESTIONS WITH 100% CORRECT ANSWERS

IABP TEST 2 QUESTIONS WITH 100% CORRECT ANSWERS. The fundamental hemodynamic objective of IABP therapy: a. Increase CBF and increase preload b. Increase MVO2 supply and decrease MVO2 demand c. Increase CBF and increase MVO2 demand d. Increase MVO2 supply and increase contractility b. Increase MVO2 supply and decrease MVO2 demand The resting phase of the cardiac cycle: a. cardiac systole b. cardiac diastole c. cardiac repolarization d. two the above e. all of the above d. two the above (B & C) The coronary arteries receive the majority of blood supply during: a. diastole b. systole c. isovolumetric relaxation d. two of the above e. all the above a. diastole Inflation of the balloon occurs during: a. cardiac systole b. cardiac diastole c. QRS interval d. isovolumetic contraction e. cardiac depolarization c. QRS interval Which of the following is a hemodynamic effect of aortic balloon inflation: a. decreased left ventricular workload b. decreased renal perfusion c. increased coronary perfusion pressure d. increased cardiac output e. decreased diastolic blood pressure c. increased coronary perfusion pressure Reduction of afterload counterpulsation: a. balloon inflation b. increased diastolic pressure c. increased augmentation d. deflation pre-systolic ejection e. deflation aortic valve closure d. deflation pre-systolic ejection The most common insertion site of IAB catheter: a. left subclavian artery b. right axillary artery c. left femoral artery d. right brachial artery e. right femoral artery e. right femoral artery Identify the correct position of the tip of the balloon as reflected on a chest xray: a. fourth/fifth intercostal space b. renal bifurcation c. left clavicular junction d. second/third intercostal space e. proximal left subclavian d. second/third intercostal space A trigger is defined as: a. adjustment of balloon inflation and deflation b. pressure exerted to inflate IAB c. event that purges console gas volume d. signal of the next cardiac cycle e. indication for balloon inflation e. indication for balloon inflation The cardiac event determining balloon inflation: A. Dicrotic aortic notch B. Systolic peak pressure C. Second heart sound D. Two of the above E. None of the above D. Two of the above (A, C) Balloon standstill for an extended period may cause: A. Leg ischemia B. Thromboemboli C. Thrombocytopenia D. Renal failure E. Cardiomyopathy B. Thromboemboli An arterial pressure waveform characteristic of late inflation: A. Inflation precedes the dicrotic notch B. Diastolic augmentation is early in systole C. Assisted systole is significantly prolonged D. Inflation follows diastolic run off E. Inflation corresponds to isovolumetric contraction D. Inflation follows diastolic run off Coronary artery perfusion occurs predominantly during: A. Ventricular systole B. Isovolumetric ventricular contraction C. Ventricular ejection D. Isometric ventricular relaxation E. Ventricular peak pressure D. Isometric ventricular relaxation Isovolumetric contraction: A. Determines coronary artery perfusion B. Determines myocardial oxygen consumption C. Comprises 90% of MVO2 D. two of the above E. All of the above D. Determines two of the above: (B,C) The assist interval used for timing of the intra-aortic balloon pump: A. 1:1 B. 1:2 C. 1:4 D. 1:8 E. None of the above B. 1:2 The width of the balloon pressure waveform should correspond to: A. Heart rate B. Diastole C. Systole D. Arterial pressure E. Cardiac cycle A. Heart rate In ECG trigger, the R wave is used to: A. Establish balloon deflation period B. Identify next cardiac cycle C. Initiate balloon inflation period D. Two of the above E. All of the above D. Two of the above (B, C) 18. Weaning a patient from IABP support can be facilitated by: A. Decreasing IABP frequency B. Placing the IABP on standby C. Decreasing IABP augmentation D. Two of the above E. All of the above E. All of the above All of the following are correct regarding the effects of IABC on myocardial oxygen supply and demand except: A. Balloon inflation increases DPTI B. IABC decreases end diastolic pressure C. DPTI to TTI estimates adequacy of oxygen delivery D. Balloon inflation decreases myocardial oxygen delivery E. TTI decreases with balloon deflation D. Balloon inflation decreases myocardial oxygen delivery The following are correct regarding the endocardial viability ratio: A. IABC increases EVR B. EVR of 1.0 signifies normal supply/demand balance C. EVR less than 0.7 is indicative of ischemia D. Two of the above E. All of the above D. Two of the above (A, C) Preload is the: A. Impedance against which the LV must pump B. Pressure of vol. in the ventricle at the end of diastole C. AO root pressure D. PVR B. Pressure of vol. in the ventricle at the end of diastole Afterload is the: A. Impedance against which the LV must pump B. Pressure of vol. in the ventricle at the end of diastole C. AO root pressure D. PVR A. Impedance against which the LV must pump The major physiological effects of counter pulsation include: A. Increase coronary artery perfusion, increased preload, decreased afterload, decreased myocardial oxygen consumption B. Increase coronary artery perfusion, increased preload, increase afterload, decreased myocardial oxygen consumption C. Increase coronary artery perfusion, decreased preload, decreased afterload, increased myocardial oxygen consumption D. Increase coronary artery perfusion, decreased preload, decreased afterload, decreased myocardial oxygen consumption D. Increase coronary artery perfusion, decreased preload, decreased afterload, decreased myocardial oxygen consumption Coronary artery perfusion occurs predominately during: A. Ventricular systole B. Isovolumetric ventricular contraction C. Reduced ventricular ejection D. Ventricular diastole D. Ventricular diastole During isovolumetric contraction: A. MV is open B. Coronary artery perfusion occurs C. 90% of myocardial O2 consumption occurs D. AO valve opens C. 90% of myocardial O2 consumption occurs Contraindication of IABP include (possible multiple answers): A. AO insufficiency B. MV incompetent C. Dissecting aortic aneurysm D. AO wall disease E. Pre-infraction Angina F. Coronary artery disease A. AO insufficiency C. Dissecting aortic aneurysm D. AO wall disease List 3 indications of using IABP: acute coronary syndrome, complications of heart failure, and cardiac or non-cardiac surgery 2 Possible complications of IAB insertion or pumping Complications: dissection of AO. limb ischemia, emboli Insertion of IAB should be halted immediately if the pt. complains of: A. Numbness in affected leg B. Back pain C. Pressure at insertion site D. Chest pain B. Back pain The IABP _______________ at the onset of diastole A. Inflates B. Deflates A. Inflates The IABP _______________ at the onset of systole A. Inflates B. Deflates B. Deflates The most commonly used tracing for triggering the balloon pump to inflate and deflate is the ______________: A. ECG or R wave B. Pulse C. TEE D. Pressure A. ECG or R wave The only tracing representing the mechanical events in the heart used to accurately time balloon inflation and deflation is the __________: Arterial waveform The dicrotic notch of the arterial waveform reflects: A. Systolic ejection B. Isovolumetric contraction C. Aortic valve opening D. Aortic valve closure D. Aortic valve closure Some of the desirable effects that can be expected from proper timing of IABP are: A. Decrease afterload B. Decrease PCWP C. Increase Preload D. Increase LV size E. Increase CO F. Increase HR G. Increase systemic pulsatile pressure A. Decrease afterload B. Decrease PCWP E. Increase CO G. Increase systemic pulsatile pressure Identify timing alterations in the arterial pressure tracing below and indicate their detrimental hemodynamic effects. Timing: Hemodynamic effect: Timing: Early inflation Hemodynamic: Decreased CO, premature closure of aortic valve Identify timing alterations in the arterial pressure tracing below and indicate their detrimental hemodynamic effects. Timing: Hemodynamic effect: Timing: Late deflation Hemodynamic: Increased MVO2, increased afterload Late inflation of the balloon can result in: a. premature augmentation b. increased augmentation c. decreased augmentation d. increased coronary perfusion c. decreased augmentation Late deflation of the balloon can result in: a. increased myocardial oxygen consumption b. premature closure of the aortic valve c. decreased afterload d. increased afterload a. increased myocardial oxygen consumption or d. increased afterload A squared off balloon pressure waveform can indicate: a. helium leak b. high pressure c. balloon occluding the aorta d. hypovolemia b. high pressure or c. balloon occluding the aorta Which of the following is most likely to cause a high pressure alarm: a. hypertension b. increased ectopy c. kinked balloon catheter d. hypotension c. kinked balloon catheter The width of the balloon pressure waveform should correspond to: a. heart rate b. length of diastole c. length of systole d. arterial pressure a. heart rate or b. length of diastole True or False The diacrotic notch is the landmark used to set balloon deflation false True or False Deflation is timed to occur during the period of isovolumetric contraction true True or False The balloon should be large enough to occlude the aorta, when fully inflated false True or False The most commonly used trigger mode is the arterial pressure mode false True or False The internal trigger mode is acceptable to use for a patient in normal sinus rhythm false True or False Pacing spikes are automatically rejected in ECG trigger modes true True or False The pacing trigger modes can be used for a patient in 50% paced rhythm false True or False After percutaneous balloon removal, firm pressure is held at the femoral site for 15 minutes false True or False The patient on the IABP is allowed to have the head of the bed no more than 90 degress and can flex the leg of insertion false True or False Blood in the clear plastic tubing of the balloon catheter indicates a hole in the balloon itself true True or False When the console alarms for "high pressure" or "kinked line" the balloon continues to inflate and deflate false