stud
bud
Sign up
Log in
Home
Library
Explore
SAT
More
RPT 233 Module B Flashcards | StudBud
Explore
/
RPT 233 Module B
RPT 233 Module B
90 terms
·
StudBud Administration
·
150 plays
IABP, Arterial lines, & ECLS/ECMO
Flashcards
90 cards
F
Practice quiz
P
Host live
L
Questions
90
Answers
1
During the 1980's newborns had a better survival rate than adults did on ECMO
True
False
2
ECMO support for newborns has decreased to an average of 800 cases annually due to improved strategies
False
True
3
General indications for initiating VA and VV ECMO support in Adult patients
All of the above
Acute hypoxic or hypercarbic respiratory failure
Murray score > 3
Normal RV/LV function
4
Which of the following should cover the insertion site when dressing A-line?
Tape
Clear dressing
Gauze
Armboard
5
All of the following are indications for IABP except...
Dissecting Aortic Aneurysm
Intraoperative Injury
Cardiac Failure
Myocardial Infarction
6
It is not necessary to always have a doctor's order on the patient's chart prior to A-line insertion.
True
False
7
Mean arterial pressure is average between systolic and diastolic pressure during one cardiac cycle
True
False
8
VV provides support for which system?
Pulmonary
None of the above
Cardiac and Pulmonary
Cardiac
9
When pulling waste off of a UAC, it is ok to discard it
False
True
10
Where should you see the radiopaque tip of the IABP on x-ray?
3 cm above the carina
2 cm above the carina
2 cm below the carina
3 cm below the carina
11
AV provides support to which system?
None of the above
Cardiac
Cardiac and Pulmonary
Pulmonary
12
What type of waveform is heightened with a very large dicrotic notch?
Normal
Underdamped
Flatline
Overdamped
13
During A-line insertion it is okay to push the catheter in further if resistance is met?
False
True
14
All of the following are absolute contraindications to IABP except...
Severe Aortic Regurgitation
Large A-V shunt
Myocardial Infarction
Severe Coagulopathy
15
There are no clear set of ECMO guidelines for pediatric and adult patients
False
True
16
Which of the following is not true concerning A-Line insertion?
Insert catheter at 30 degree angle to the radial artery
Once blood flow is observed, advance catheter further
If resistance is met, advance catheter further
Advance catheter while removing needle
17
Which vessel is an IABP inserted into?
Femoral Vein
Radial Artery
Femoral Artery
Brachial Artery
18
All of the following are relative contraindications to IABP except...
Coagulopathy
Severe peripheral vascular disease
Recent Thrombolytic Therapy
Dissecting Aortic Aneurysm
19
Which of the following is not a primary diagnosis of newborns when initiating ECMO...
Sepsis
Congenital Diaphragmatic Hernia (CDH)
Premature birth
Meconium aspiration syndrome (MAS)
20
Removing cap from stop-cock opens the transducer to atmospheric pressure
True
False
21
Radial A-Lines must be inserted under completely sterile conditions
False
True
22
ECMO support only requires monitoring every 3-4 hours
False
True
23
All of the following are absolute contraindications to ECMO in peds and adults except...
BMI > 40
Mechanical ventilation > 14 days
Acute ICH or stroke
In hospital CPR > 60 minutes
24
The absolute amount of blood pumped from the heart is cardiac output
True
False
25
Support is partial cardiopulmonary bypass, providing both cardiac and pulmonary support
VV ECMO
VA ECMO
AV ECMO
VAV ECMO
26
Also known as the "bladder"
Heater/Cooler
Pump
Oxygenator
Venous Reservoir
27
Which of the following is an arterial line useful for?
Monitoring heart rate
Answers 1 & 2 are correct
Continuous arterial pressure monitoring
Frequent ABG sampling
28
Which of the following arteries does not have good collateral circulation?
Radial Artery
Carotid artery
Brachial Artery
Femoral Artery
29
Flushing the line causes the arterial waveform to appear
Normal
Heightened
Square
Flattened
30
It is not necessary to flush bubbles out of A-line pressure monitoring tubing
False
True
31
Essential education for role of ECMO specialist follows ELSO
True
False
32
Which of the following is not a cause of a damped waveform?
Air in line
Kink in line
Inflated pressure bag
Clot at tip of catheter
33
Which of the following arteries is the most common for A-Line insertion in adults?
Brachial Artery
Femoral Artery
Radial Artery
Carotid Artery
34
It is ok if tiny air bubbles are present in the arterial line
False
True
35
Which of the following should you do to prevent bubbles in tubing during A-Line insertion?
Make sure tubing isn't connected too tightly at hub
Flush tubing after connecting to hub
Flush hub continuously while connecting tubing
Pull the pig-tail at the transducer
36
You need to remove the cap to the stop-cock to zero the line
True
False
37
Relative contraindications of newborns to ECMO include all of the following except...
Gestational age < 34 weeks
Irreversible organ damage (unless a transplant candidate)
Mechanical ventilation with 100% oxygen for >13 days
No Coagulopathies
38
What is the most common site for A-Line in neonatal patients?
Umbilical Artery
Femoral Artery
Radial Artery
Dorsalis Pedis Artery
39
What is true concerning counterpulsation?
All of the above are true
Reduces workload of the heart
Raises systolic blood pressure
Lowers diastolic pressure
40
If arterial waveform on monitor is damped or abnormal, flush catheter first and then reposition catheter
False
True
41
All of the following are indications for the initiation of ECMO in newborns except...
Failure of maximum mechanical ventilation and INO
Birthweight < 2 kg
Lung disease considered reversible
Gestational age ≥ 34 weeks
42
Condition in which your heart suddenly can't pump enough blood to meet your body's needs.
Cardiac Output
Cardioversion
Myocardial Infarction
Cardiogenic Shock
43
You must always allow Betadine or CHG to dry before Sticking for an A-line.
True
False
44
It is not necessary to obtain consent prior to A-line insertion...
False
True
45
VA ECMO provides support to which system?
Cardiac
None of the above
Pulmonary
Cardiac and Pulmonary
46
Primarily for CO
2
removal at low pump flows and requires the patient's own hemodynamics to pump blood
VA ECMO
VV ECMO
AV ECMO
VAV ECMO
47
What pressure should a pressure bag be inflated to for an A-line?
250 cmH2O
350 cmH2O
250 mmHg
300 mmHg
48
Another name for aortic valves is semilunar valves?
False
True
49
All of the following are absolute contraindications to arterial line insertion except...
Thromboangiitisobliterans
Traumatic injury proximal to the insertion site
Robert's Syndrome
Absentradial and ulnar pulse
50
What part of the Aorta is an IABP advanced to?
Thoracic Aorta
Ascending Aorta
Abdominal Aorta
Descending Aorta
51
RT's are good candidates for ECMO specialists because...
RT's are not good candidates for ECMO specialists
Strong knowledge of cardiopulmonary physiology
Both A & B
Good critical thinking skills and technical adeptness
52
What gas is an IABP normally filled with?
Helium
Hydrogen
Oxygen
Nitrogen
53
Where should transducer be positioned in relation to the patient?
At the level of the patient's heart
Lying on the patient's side when the patient is sitting up
At the patient's head
Above the patient's head
54
Pump flow is not dependent on the patient's pre-load and after-load.
True
False
55
Which of the following are possible complications of A-Line insertion?
Hematoma
Damage to artery
All of the following are possible complications
Thrombus formation and artery occlusion
56
Development of what therapies have reduced the number of newborns placed on ECMO?
All of the above
Improved ventilator strategies
Surfactants
Nitric Oxide
57
Which of the following is not a relative contraindication to A-line insertion?
Infection at insertion site
Coagulopathy
Anticoagulation
Raynaud's Syndrome
58
ECMO provides what kind of support?
Both Cardiac and Pulmonary
Pulmonary
Cardiac
None of the above
59
Which of the following are risks associated with the use of IABP?
Infection
Aortic dissection
All of the above
Thrombosis
60
Absolute contraindications of newborns to ECMO include...
Severe irreversible brain damage
All of the above are correct
Grade III or higher intracranial hemorrhage (ICH)
Lethal congenital anomalies
61
Which of the following is not a step for zeroing a transducer?
Pressing the zero button
Turning stop-cock off to patient and open to atmospheric pressure
Silencing the alarms
Turning stop-cock off to transducer and open to atmospheric pressure
62
If an IABP is placed to high, which of the following can occur?
Occlude the branch aortic vessels
All of the above
Decreased blood flow to the upper extremities
Decreased blood flow to the neck
63
Which of the following is not true about IABP?
Increases perfusion of coronary arteries
Assists with circulation
Decreases cardiac output
Decreases workload on the heart
64
What sort of waveform ensures that the A-line is properly zeroed?
Flattened line
Square waveform
Arterial waveform
Damped waveform
65
When using an IABP, the balloon is inflated during systole and deflated during diastole.
False
True
66
Sweep flow is the same thing as gas flow from a flow meter.
True
False
67
The primary goal(s) of ECMO are...
Provide adequate oxygen delivery
All of the above
Allows lungs and/or heart to rest and recover
Remove CO2 from the body
68
Which is the correct equation for MAP?
SBP + 3(DBP)/2
SBP x DBP/3
SBP + DBP/2
SBP + 2(DBP)/3
69
Which type of waveform is flattened with a small or absent dicrotic notch?
Underdamped
Normal
Flatline
Overdamped
70
Transducer converts electrical pressure into mechanical energy which is then displayed on monitor.
False
True
71
When using an IABP, the balloon is deflated during systole and inflated during diastole.
False
True
72
It is not necessary to draw waste off of an A-line when obtaining a sample
True
False
73
Which of the following steps must be performed first for A-Line insertion?
Prep the area for insertion
Palpate the radial artery
Perform an Allen's Test
Perform a time-out
74
Which A-Line insertion site requires absolutely sterile conditions?
Posterior Tibial Artery
Femoral Artery
Dorsalis Pedis Artery
Radial Artery
75
The largest increase in ECMO usage for pediatric and adult patients are in one of two categories
ECMO for heart transplant and pulmonary support
ECMO as a bridge for lung support or transplant and cardiac support
ECMO for heart and lung transplant
ECMO for heart and pulmonary support
76
The primary test for anticoagulation at the bedside?
ABG
CBC
ACT
PTT
77
What part of the arterial waveform represents the closure of the semilunar valves?
Lowest part of arterial waveform
Highest part of arterial waveform
The average between the highest and lowest points
Dicrotic Notch
78
Which of the following are relative contraindications to initiating ECMO in peds and adults?
Age > 70 years
Active cancer
Chronic kidney disease
ALL of the above
79
What does the lowest part of the arterial waveform indicate?
Diastolic Pressure
Systolic Pressure
Dicrotic Notch
Mean Arterial Pressure
80
Only provides Pulmonary support
VA ECMO
VV ECMO
AV ECMO
VAV ECMO
81
How long should you wait for A-line insertion site to dry after prepping?
30 seconds
90 seconds
20 seconds
60 seconds
82
Which of the following can occur if the IABP is placed too low?
Occlude renal arteries
Occlude blood flow to the upper extremities
Occlude branch aortic vessels
Cause an MI
83
What does the highest point of an arterial waveform represent?
Dicrotic Notch
Mean Arterial Pressure
Diastolic Pressure
Systolic Pressure
84
The amount of oxygen contained in blood leaving the heart is the arterial oxygen content
True
False
85
Oxygen content times cardiac output equals the amount of oxygen delivered to the tissues
True
False
86
Arterial Line Placement has a low rate of major complications
False
True
87
Mean arterial pressure is a better indicator of perfusion than systolic pressure.
False
True
88
What is the best angle for A-Line catheter insertion on radial artery?
45 degrees
35 degrees
25 degrees
30 degrees
89
Item that converts mechanical pressure into electrical energy
Catheter
Monitor
Transformer
Transducer
90
You need to check for causes of damped waveform before re-zeroing the line
True
False
