the pressure of mixed venous oxygen and saturation represents tissue oxygenation
Normal Adult Mixed Venous pO2
Normal Adult Mixed Venous O2 Sat
Significance of Arterial-venous O2 Content
calculates oxygen consumption by the body
Normal Adult Arterial-Venous O2 Content value
the amount of blood pumped by the ehart that does not participate in gas exchange
Significance of Shunt
measures ventilation to perfusion mismatch
Normal Adult Shunt level
5% or less of CO
Normal Adult Pulmonary Vascular Resistance
1-3 mm Hg/lpm
Normal Adult Systemic Vascular Resistance
15-20 mm Hg.lpm
The waveform sequence seen during insertion of a PAC is:
When evaluating a patient's SV, which of the following is true?
B) it has a range of 50-120 ml, in the adult
A patient with chronic bronchitis is being monitored with regular measurements of ABG's and capnography. The following data are available: PaCO2 53; PaO2 67; PetCO2 33; PeCO2 20. Calculate the patient's Vd/Vt.
A 40 YO patient recovering from ARDS is receiving mechanical ventilation with a Vt of 650 ml. The patient has an arterial line, a PAC and capnometry for monitoring. THe following information is gathered after a change in PEEP level: PaCO2 43; PaO2 79; PmvO2 32; PetCO2 38; PeCO2 22. Calculate the patient's Vd.
C) 319 ml
A 35 YO patient is in the ICU and has the following hemodynamic data. Which of the following indicates a problem with the patient?
B) SVR of 600 dyn/s/cm-5
A patient with a hx of CHF is inadvertently given IV fluid of 2000 ml instead of 200 ml. Which of the following is most likely to be seen?
A) increased pulmonary capillary wedge pressure
A patient hospitalized with leg vein thrombosis experiences sudden SOB. Which of the following should be recommended to evaluate the patient;s situation?
Capnography will be used to monitor a patient's recovery from anesthesia. What gas should be used for the zero calibration?
C) RA for 0% CO2
Hypovolemia in an adult patient would be indicated by a PCWP of:
D) 2 mm Hg
An adult patient has a PAC inserted. A normal PAP pressure on this patient would be:
Which of the following would describe the principle of operation of a capnometer?
A) absorption of infrared light by CO2
Calculate a patient's pulmonary artery dystolic-PCWP (Pad-PWCP) gradient if the PAP is 30/12 mm Hg and the PCWP is 8 mm Hg.
C) 4 mm Hg
A pateint has an end tidal CO2 pressure of 30 torr and a P(a-er)CO2 gradient of 4 torr. The alveolar to end tidal gradient is in the usual direction. Based on this, the patient's PaCO2 would be estimated as:
A) 34 torr
A patient is known to have advanced COPD. When checking the Vd/Vt ratio, what would be expected?
A patient is being mechanically ventilated and has a reflectance oximetry PAC in place. What mv O2 Sat value would indicate the patient is oxygenating adequately?
The normal range for the p(a-et) CO2 gradient is:
A) <1 torr="" br="">B) 1-5 torr
C) >15 torr
D) -40 torr
B) 1-5 torr
An adult patient has been admitted for observation after suffering a concussion in a fall. The patient's arterial BP is found to be 115/78 mm Hg. How should these results be interpreted?
A patient with advanced emphysema is admitted to the ICU. The patient is placed on a 24% venturi mask and has a PAC inserted. The patient's initial PVR is 9 mm Hg/l/min and his PaO2 is 57. The physician orders an increase to 28% oxygen. The resulting PVR is 5 mm Hg/L/min and the PaO2 is 63 torr. Based on this information, what would you recommend?
A) keep the patient on 28% oxygen
An adult patient is in the ICU and is being monitored with a PAC. The patient has the following parameters: PAP 35/20 mm Hg; PCWP 9 mm Hg; CVP 9 cm H20. The data show that the patient:
D) has increased PVR
A 40 YO patient receiving mechanical ventilation has an arterial line in place. It is noticed that there is a significant difference between the BP taken by the cuff on the L arm and the BP taken by the arterial line on the R arm. What could explain the difference?
B) a clot is at the tip of the catheter and there is an air bubble in the arterial line
An adult patient is receiving mechanical ventilation when the following data are gathered:
9 am 11 am
PaO2 75 53
PVR 120 340
PCWP 8 10
PAP 25/10 42/21
How should these results be interpreted?
A) pulmonary embolism
A patient is receiving mechanical ventilation with a mandatory rate of 10/min. End tidal CO2 monitoring is being done and the following data are recorded:
4 pm 6 pm
Set Vt 700 ml 700 ml
Set Rate 10 10
PetCO2 33 41
PaCO2 42 43
How can this data be explained?
D) alveolar ventilation has decreased
A patient has an arterial line inserted. What should be done to ensure accurate BP readings are obtained?
A) open the stopcock to RA to zero the transducer & have the patient lie flat & fill the pressure tubing with saline solution
An unconscious 25 TO patient is admitted with viral pneumonia, vomiting & diarrhea. Mechanical ventilation is initiated and a flow directed PAC is inserted. The following data are gathered: PAP 22/8; PCWP 3 mm Hg; CVP 0 mm Hg; BP 90/60; Pulse 142. What is the most likely cause of these findings?
A 3-day post op open heart patient has an arterial catheter in the R radial artery for continuous BP measurements. Because of retained secretions, the therapist places the patient in a head down position for PD. The nurse notices that the patient's BP is less than before being placed in this position. After the patient is returned to the original position, the BP is the same as it was originally. How can the therapist explain the BP change?
D) the patient's body was below the level of the pressure transducer
A 65 YO patient has been sick with vomiting and diarrhea for several days. Arterial and PA catheters are placed for monitoring ABGs and hemodynamic parameters. ABG values on 30% O2 show the following: pH 7.44 PaCO2 41 PaO2 80 HCO3 27. PAC parameters show the following: PAP 22/8 PCWP 3 torr. In addition electrolytes show the following:
potassium 4.5 chlorine 120 sodium 156. Based on these data, what should be recommended?
B) administer IV fluids
A pateint with HF and pulmonary edema has an initial PmvO2 of 35 torr. After the patient is mechanically ventilated and given digitalis, the PmvO2 is 41 torr. How should this be interpreted?
C) improved tissue oxygenation
A neonatal patient is suspected of having a CSD. What could be done to confirm or R/O this condition?
B) Check the PmvO2 from the R atrium and R Ventricle
An adult patient with CHF needs to have his fluid management and O2 consumption monitored. What type of catheter should be used for these measurements?
D) a triple lumen ScvO2 CVP catheter
As the therapist assigned to ICU, you are caring for the following 4 persons: Mr. Boone is a 28 YO male being observed after an appendectomy. Mrs. Decker is a 74 YO female with sepsis. Mrs. Dylan is a 48 YO female with gastritis who is receiving IV fluids for dehydration. Mr. Zawinal is a 42 male with diabetes. The following BP measurements were taken:
10am 12pm 2 am
Boone 125/80 122/82 120/78
Decker 96/60 105/40 85/45
Dylan 88/70 94/75 105/78
Zawinal 135/98 129/94 125/89
In which of these patients should an arterial line be placed?
B) Mrs. Decker
A patient with HF had an ScvO2 of 65% an hour ago. The patient is now showing an ScvO2 level of 60%. How should these results be interpreted?