RESP 2200 Unit III Review

100

Your patient’s art line transducer is below the level of their heart. Their monitored systemic blood pressure will be higher or lower than their actual systemic blood pressure?

Higher

100

On a pulmonary artery catheter, what must be done to measure a capillary-wedge pressure?

a. The balloon at the distal tip must be inflated

b. Cold saline must be injected

c. The patient must perform a Valsalva maneuver

d. The pulmonary artery catheter must be replaced with a central venous catheter

a. The balloon at the distal tip must be inflated

100

What method is commonly used to measure cardiac output with a pulmonary artery catheter?

a. Plethysmography

b. Thermodilution

c. Fick Equation

d. Shunt Equation

b. Thermodilution

100

Which line cannot be used to administer medication?

a. Arterial line

b. Central line

c. Swan Ganz

a. Arterial line

100

Use the following parameters to answer determine if the patient is hypoxic or hypoxemic.

Hb 10 gm/dL, SaO2 99%, PaO2 98 mmHg

CaO2 13.56 mg/dL

a. Hypoxic

b. Hypoxemic

c. Hypoxic and Hypoxemic

d. Neither

a. Hypoxic

200

Which intervention may help improve the issue shown here?

CVP 6 mmHg, MPAP 30 mmHg, PCWP 8 mmHg, CO 5 L/min

a. Administration of inhaled pulmonary vasodilator (Nitric Oxide)

b. Administration of IV Heparin

c. Administration of IV Epinephrine

d. A bolus of normal saline

a. Administration of inhaled pulmonary vasodilator (Nitric Oxide)

200

Your patient has a BP of 122/82 mmHg. HR is 80 and SV is 50 mL. CVP is 2 mmHg. Calculate the SVR.

1867 dynes

200

What intervention should be performed when a patient has a large cardiac tamponade?

a. Thoracentesis

b. Pericardiocentesis

c. Escharotomy

d. Bronchoscopy

b. Pericardiocentesis

200

Which patient has the highest PVR?

a. MPAP 18 mmHg, PCWP 10 mmHg, CO 5 L/min

b. MPAP 18 mmHg, PCWP 12 mmHg, CO 5 L/min

c. MPAP 18 mmHg, PCWP 10 mmHg, CO 10 L/min

d. MPAP 18 mmHg, PCWP 10 mmHg, CO 2.5 L/min

200

Calculate the DO2.

SpO2 98%

PaO2 94 mmHg

Hb 14 mg/dL

CO 5.5 L/min

SvO2 76%

PvO2 40 mmHg

1028.5 mL/min

300

Which of the following interventions would help reduce pre-load in a CHF patient?

a. Administer Furosemide

b. Administer Epoprostenol

c. Administer IV fluids

d. Place the patient in the Trendelenburg position

a. Administer Furosemide

300

While inserting a Swan-Ganz catheter, which waveform indicates the catheter is reading pressure from the pulmonary artery?

1 2 3 4

a. 1

b. 2

c. 3

d. 4

c. 3

300

Your patient is recovering from cardiac arrest. Given the following hemodynamics, the RT should recommend the administration of:

CVP 14 mmHg

MPAP 18 mmHg

PCWP 15 mmHg

CO 3.2 L/min

BSA 2 mm2

HR 86 bpm

BP 99/68 mmHg

a. Nitric Oxide (Pulmonary Vasodilator)

b. Nitroprusside (Vasodilator)

c. Dobutamine (inotrope)

d. Lasix (diuretic)

c. Dobutamine (inotrope)

300

Given the patient’s hemodynamics, which possible disease could be present?

CVP 14 mmHg

MPAP 18 mmHg

PCWP 18 mmHg

CO 2.8 L/min

BP 103/76 mmHg

a. COPD

b. High Peep

c. CHF

d. Hypervolemia

c. CHF

300

The patient has an SvO2 of 40%. What does this indicate?

a. Increased O2 delivery to the tissues

b. Decreased O2 delivery to the tissues

c. Increased O2 consumption by the tissues

d. Decreased O2 consumption by the tissues

b. Decreased O2 delivery to the tissues

400

A patient with an arterial blood pressure of 70/41 mmHg has presented with massive hemorrhaging from a farming accident? Staff are stopping the origin of the hemorrhage and a bolus of NS fluid is being administered via IV rapidly. What is the most appropriate next response?

a. Administer NS bolus

b. Administer blood products

c. Administer antibiotics

d. Administer inotrope

b. Administer blood products

400

You notice your patients’ Art line reading shows the following overdamped waveform, while their manual blood pressure reading shows no change from the patients’ previous values. What would you recommend?

a. Administer blood products

b. Check the art line for clots and attempt to flush it with normal saline

c. Hold pressure over the art line insertion site to minimize blood loss

d. Evaluate for a pneumothorax

b. Check the art line for clots and attempt to flush it with normal saline

400

Which patient shows signs of inadequate tissue perfusion?

a. BP 118/90, spo2 92%, lactic 1 mmol/L

b. BP 88/56, spo2 86%, lactic 7 mmol/L

c. BP 90/60, spo2 90%, lactic 0.7 mmol/L

d. BP 110/72, spo2 88%, lactic 0.9 mmol/L

b. BP 88/56, spo2 86%, lactic 7 mmol/L

400

Given the patients’ hemodynamics, which disease could be present?

CVP 2 mmHg

MPAP 6 mmHg

PCWP 3 mmHg

CO 3.4 L/min

BP 66/42 mmHg

a. COPD

b. CHF

c. Hypervolemia

d. Septic Shock

400

Your patient has a PAP of 23/12 mmHg, a PCWP of 6 mmHg, and a cardiac output of 6L/min. Calculate the PVR.

129 dynes

500

Which of the following is a common insertion site for the insertion of a central venous catheter?

a. Subclavian artery

b. Internal jugular vein

c. Radial artery

d. Radial vein

b. Internal jugular vein

500

The Dicrotic notch represents_____

a. Closure of the pulmonary semilunar valve

b. Diastole of the left atrium

c. closure of the aortic semilunar valve

d. Systole of the right atrium

c. closure of the aortic semilunar valve

500

What line is shown in this chest x-ray?

a. Pulmonary Artery Catheter

b. Chest Tube

c. Arterial Line

d. Central Line

500

A patient with chronic kidney failure presents to the emergency department with complaints of food poisoning. 4 hours into his treatment, he has received 3 Liters of normal saline via IV and his measured urine output is 10 mL/hour. Which set of hemodynamics would you expect to see?

CVP MPAP PCWP CO BP

mmHg mmHg mmHg L/min mmHg

a. 2 6 4 4.2 90/54

b. 4 15 10 5 126/84

c. 9 22 16 8 145/98

500

Calculate the C(a-v)O2.

SpO2 93%

PaO2 64 mmHg

Hb 15 mg/dL

CO 9 L/min

SvO2 49 %

PvO2 28 mmHg

9 mL/dL