ch. 19 / 14

53問 • 2年前

問題一覧

Which of the following are true about invasive versus noninvasive monitoring? 1. Invasive procedures require insertion of a device into the body. 2. Laboratory analysis of gas exchange is usually noninvasive in nature. 3. Physiologic monitoring can be either invasive or noninvasive. 4. Invasive procedures provide more accurate data but carry greater risks.

1, 3, and 4 only

Under ideal conditions, electrochemical oxygen (O2) analyzers have approximately what degree of accuracy?

How does the Clark polarographic O2 electrode function?

It uses O2 to produce a reduction-oxidation reaction.

Which of the following is false about the galvanic fuel cell O2 analyzer?

It requires an external power source (alternating current line or batteries).

While checking a polarographic (Clark) electrode, you determine that the device fails to read 100% when exposed to pure O2. Which of the following actions would be the proper first step?

Replace the analyzer’s batteries.

During calibration of a Clark polarographic O2 analyzer, you cannot get the sensor to read 100% when exposed to 100% O2, even after adjusting its calibration control. The unit has new batteries. Which of the following actions would be correct?

Change the sensor or electrode.

You are asked to provide continuous monitoring of the FiO2 provided by a humidified O2 delivery system using a galvanic cell analyzer. Where would you install the analyzer’s sensor?

Proximal to the heated humidifier

Which of the following sites are used for arterial blood sampling by percutaneous needle puncture? 1. Femoral 2. Radial 3. Brachial 4. Carotid

1, 2, and 3 only

Why is the radial artery the preferred site for arterial blood sampling? 1. It is near the surface and easy to palpate and stabilize. 2. The ulnar artery normally provides good collateral circulation. 3. The radial artery is not near any large veins. 4. It is the largest artery located in the upper extremities.

1, 2, and 3 only

Clinical indications for arterial blood analysis include which of the following? 1. Sudden, unexplained dyspnea 2. Cardiopulmonary resuscitation 3. Changes in ventilator settings 4. Chest pain

1, 2, and 3 only

Which of the following are reasons for finding an alternative site for arterial puncture? 1. Failed Allen test 2. History of peripheral vascular disease 3. Anticoagulation therapy 4. Presence of a surgical shunt

1, 2, and 4 only

Precautions and/or possible complications of arterial puncture include which of the following? 1. Arteriospasm 2. Embolization 3. Infection 4. Hemorrhage

1, 2, 3, and 4

Which of the following should be monitored during the sampling of arterial blood? 1. Blood pressure proximal to puncture site 2. Presence of pulsatile blood return 3. Presence of air bubbles or clots in sample 4. Appearance of puncture site

2, 3, and 4 only

Which of the following patient parameters does not need to be assessed as part of arterial blood sampling?

Blood pressure

Purposes of a needle-capping device include which of the following? 1. To isolate the sample from air exposure 2. To help prevent needlestick injuries 3. To hold the excess anticoagulant

1 and 2 only

After obtaining an arterial blood sample through percutaneous puncture using a syringe that does not have a capping safety device, what should you do?

“Scoop” the needle cap up with one hand, then plug the syringe.

Which of the following Centers for Disease Control and Prevention (CDC) barrier precautions would you use when obtaining an arterial blood gas (ABG) through percutaneous puncture? 1. Gloves 2. Protective eyewear 3. Gown or apron

1 and 2 only

What size needle would you recommend to obtain an ABG sample through percutaneous puncture of an infant?

25 gauge

Required equipment and supplies for percutaneous arterial blood sampling of an adult include all of the following except:

local anesthetic.

What chart information should be checked before performing artery puncture? 1. Patient’s primary diagnosis and history 2. Presence of bleeding disorders or blood-borne infections 3. Anticoagulant or thrombolytic drug prescriptions 4. Respiratory care orders (e.g., O2 therapy)

1, 2, 3, and 4

Which of the following describes the correct procedure for an Allen test?

Compress both the radial and ulnar arteries, and then release the ulnar artery.

After obtaining an arterial blood sample, what should you do? 1. Apply pressure to the puncture site until bleeding stops. 2. Place the sample in a transport container with ice slush. 3. Check to see if the patient is getting anticoagulant therapy. 4. Mix the sample by rolling and inverting the syringe.

1, 2, and 4 only

How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FiO2 has just been changed?

20 to 30 min

Before performing puncture or cannulation of the radial artery, what should you do?

Perform the Allen test to ensure collateral circulation.

You return to a patient’s room 20 min after drawing an ABG. Which of the following should you check at this time? 1. Puncture site for hematoma 2. Adequacy of distal circulation 3. Prothrombin or partial thromboplastin times

1 and 2 only

When performing an Allen test on the left hand of a patient, you notice that the palm, fingers, and thumb remain blanched for more than 15 sec after pressure on the ulnar artery is released. What should you do?

Perform the Allen test on the right hand.

You are asked to calibrate an O2 analyzer. Which of the following gases would you use for this procedure? 1. 100% oxygen 2. 50% oxygen 3. 21% oxygen (room air)

1 and 3 only

A patient suffering from traumatic brain injury in the ICU has a PtO2 (tissue oxygen) value of 10 to 15 mm Hg, what does this indicate?

Ischemic brain damage

When performing a percutaneous needle puncture of the radial artery, you get only a small spurt of blood. Which of the following is the best action at this time?

Slowly withdraw the needle until a pulsatile flow fills the syringe.

Which of the following indicates venous admixture during arterial puncture? 1. Need to use syringe suction. 2. Dark-colored blood. 3. Small sample volumes.

1 & 3 only

If patient pain or anxiety occurs during arterial puncture, which of the following will probably occur?

Hyperventilation

Most pre-analytical ABG errors can be avoided by ensuring that the sample is which of the following? 1. Properly anticoagulated. 2. Obtained anaerobically. 3. Analyzed within 15 to 30 min.

1, 2, and 3

Which of the following would you expect to occur if too much heparin was used in gathering an ABG sample from a patient breathing room air?

Decrease in PCO2

To avoid the dilution effects caused by too much sodium heparin during ABG sampling of an adult, what should you do? 1. Ensure a sample volume greater than 2 ml. 2. Use dry heparin instead. 3. Fill the needle dead space only. 4. Use saline if dry heparin is not available.

1, 2, and 3 only

A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 min. Which of the following parameters can you predict will increase in this sample during that period? 1. PCO2 2. pH 3. PO2

1 only

When analyzing an ABG sample from a patient with acute respiratory distress syndrome and refractory hypoxemia, you notice a PaO2 of 141 mm Hg and a PaCO2 of 14 mm Hg. Which of the following analytic errors should you suspect?

Exposure of the blood sample to air

Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble? 1. Decreased PCO2 2. Decreased pH 3. Increased PO2

1 and 3 only

Which of the following can help avoid the problem of arterial blood sample contamination with air? 1. Discarding frothy samples 2. Fully expelling any bubbles 3. Mixing before expelling air 4. Capping syringe quickly

1, 2, and 4 only

Analysis of an arterial blood sample taken from a healthy athlete reveals a pH of 7.36, a PCO2 of 45 mm Hg, and a PO2 of 43 mm Hg. Which of the following analytic errors should you suspect?

Sample admixture with venous blood

Because of an extremely low PO2, you suspect that an arterial blood sample taken from a patient’s brachial artery might have been contaminated with venous blood. Which of the following might help to confirm your suspicion?

Cross-check the sample with an SpO2 reading.

You determine that a blood gas sample that requires analysis has been sitting in ice slush for 90 min. What should you do?

Discard the sample and notify the appropriate clinician.

An outpatient scheduled for an arterial blood sample enters the pulmonary lab 20 min late and out of breath, having run up four flights of stairs. What should you do?

Wait 5 min before taking the sample.

A PaO2 below what value would be considered moderate hypoxemia?

55 mm Hg

What is a normal level for CaO2?

18 to 20 ml/100 ml

To assess gas exchange at the tissues, you would obtain a blood sample from which of the following?

Pulmonary artery (balloon-inflated)

Before connecting the sample syringe to an adult’s arterial line stopcock, what would you do?

Aspirate 1 to 2 ml of fluid or blood using a waste syringe.

After obtaining an arterial blood sample from an arterial line, you would do all of the following except:

aspirate at least 5 ml of fluid or blood (dead space or waste).

A physician requests that you obtain and set up an arterial line system for invasive monitoring of blood pressure. Which of the following equipment would you gather? 1. Pressurized intravenous bag 2. Continuous flush device 3. Arterial catheter 4. Volume transducer

1, 2, and 3 only

Through which pulmonary artery catheter port would you obtain a mixed venous blood sample?

Distal (catheter tip) port

A mixed venous blood sample obtained from a pulmonary artery catheter sample has a PO2 of 85 mm Hg and a hemoglobin saturation of 95%. Which of the following is likely? 1. The pulmonary artery catheter balloon was not deflated. 2. The sample was drawn from the proximal, not distal port. 3. The blood sample was withdrawn too quickly.

1 and 3 only

All of the following are true about capillary blood gas sampling except:

a capillary sample PO2 provides a fairly close estimate of actual arterial oxygenation.

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 and 3 only

When is capillary blood gas sampling indicated?

ABG analysis is needed, but arterial access is not available.

ch. 2

Darya Rose · 83問 · 2年前

ch. 2