Fund ch 19 pt 2
After changing the FiO2 of a patient with emphysema, how long should you wait to draw an ABG to monitor the patient's respiratory status?
20-30min
What is the normal gradient between PaCO2 and PETCO2?
3-5mmHg
What is a normal end-tidal PETCO2 range?
35 to 43 mm Hg
Capillary puncture should be performed at or through what location? 1. Edematous tissue 2. Areas with new signs of infection 3. The heal of neonates 4. Previous puncture sites
4 only
What is the normal range for end-tidal CO2 as measured by capnography?
5-6%
Pulse oximeter readings are generally unreliable at saturations below what level?
80%
While monitoring an active infant through a transcutaneous blood gas system, you notice a rapid rise in PtcO2 from 63 to 145 mm Hg. At that same time, the (PtcCO2) drops from 35 to 7 mm Hg. What is the most appropriate action in this case?
Check the sensor for air leaks or dislodgment
How is the accuracy of a blood gas analyzer determined?
Comparing the analyzer's measurements to known values
During a single-breath capnogram, what does the occurrence of a plateau indicate?
Exhalation of mainly alveolar gas
What is the best site for capillary puncture in an infant?
Lateral aspect of the heel's plantar surface
In which of the following patients would transcutaneous blood gas monitoring most likely provide inaccurate or erroneous results?
Patient in hypovolemic shock
Which of the following is false about transcutaneous blood gas monitoring?
Transcutaneous blood gas monitoring is most accurate when used with older adults.
What is the measurement of CO2 in respiratory gases called?
capnometry
Which blood gas analyzer electrode uses a separate reference electrode?
pH
The shape of the expired CO2 tracing of a patient is normal but instead of being zero, the baseline is elevated to approximately 12 mm Hg. Which of the following is the most likely problem?
rebreathing
The advantage that point-of-care testing has over traditional laboratory testing is that point-of-care testing:
reduces turnaround time
The transcutaneous blood gas electrode should not be placed on the:
thigh
At the very beginning of exhalation, the PETCO2 normally should be at what level?
0mmHg
You are monitoring a nurse acquiring a capillary blood sample from an infant. The nurse immediately punctures the infant's heel with a lancet and then squeezes the puncture site to increase the flow of blood. What mistakes has the nurse made while obtaining the capillary blood sample? 1. Inadequate warming of the capillary bed 2. Squeezing of the puncture site 3. Puncture of the infant's heel 4. Use of a lancet.
1,2
Before attaching a transcutaneous blood gas monitor sensor to a patient, what should you do? 1. Provide a specified warm-up time and set the probe temperature. 2. Check the membrane and prepare a sensor with an adhesive ring and gel. 3. Prepare the monitoring site (remove excess hair and clean the skin).
1,2,3
Transcutaneous blood gas monitoring is indicated when what need exists? 1. To continuously analyze gas exchange in infants or children 2. To quantify the real-time responses to bedside interventions 3. To continuously monitor for hyperoxia in newborn infants 4. To monitor CO levels following hyperbaric oxygen treatment
1,2,3
Which of the following are indications for capnography? 1. Evaluating the response to therapies affecting ventilation/perfusion ratio (mc105-1.jpg) relationships 2. Determining the position of an artificial airway (trachea vs. esophagus) 3. Assessing a patient's readiness for weaning from ventilatory support 4. Monitoring the integrity of the ventilatory circuit and artificial airway
1,2,4
Before a sample of capillary blood is taken, what should you do to the site? 1. Warmed to 42° C for 10 min. 2. Squeezed lightly until blanched. 3. Cleaned with an antiseptic solution.
1,3
To avoid thermal injury with transcutaneous blood gas monitor sensors, what should you do? 1. Carefully monitor the sensor temperature. 2. Apply hydrocortisone cream under the sensor. 3. Regularly rotate the sensor site.
1,3
When inspecting an internal quality-control plot for a blood gas analyzer, you notice several data points sporadically appearing outside the 2 standard deviation (SD) range. This represents what type of analytic error? 1. Random error 2. Bias 3. Imprecision 4. Systematic error
1,3
While analyzing a blood gas control sample, you notice a trending of several PCO2 values above the 2 SD range over the last six control samples run. What corrective action would you consider at this time? 1. Check the function of the PCO2 electrode. 2. Rerun the control sample a second time. 3. Repair or replace any failed components
1,3
A patient being monitored by capnography exhibits a sudden rise in end-tidal CO2 levels. Which of the following are possible causes? 1. Sudden release of a tourniquet 2. Massive pulmonary embolism 3. Sudden increase in cardiac output 4. Injection of NaHCO3
1,3,4
Indications for pulse oximetry include which of the following? 1. To assess changes in HbO2 during certain procedures 2. To measure abnormal Hb 3. To comply with external regulations or recommendations 4. To monitor the adequacy of HbO2 saturation
1,3,4
You obtain an SpO2 reading of 100% on a patient receiving O2 through a nonrebreathing mask. What range of PaO2 levels is possible in this patient?
100 to 600mmHg
Warming a capillary bed to 42° C has which of the following effects? 1. It constricts the underlying blood vessels. 2. It increases blood flow well above tissue needs. 3. It "arterializes" the capillary blood.
2,3
A blood gas analyzer measures which of the following? 1. HCO3- 2. PCO2 3. PO2 4. pH
2,3,4
Components of a laboratory blood gas analyzer include which of the following? 1. Two-electrode measuring chamber 2. Reagent containers 3. Calibrating gas tanks 4. Waste container
2,3,4
What is the appropriate interval for changing the site for a transcutaneous blood gas monitor sensor?
2-6hr
When is capillary blood gas sampling indicated?
ABG analysis is needed, but arterial access is not available
To measure PCO2, blood gas analyzers use what electrode?
Severinghaus
