Intraoperative Procedures & Patient Monitoring Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Intraoperative Procedures & Patient Monitoring flashcards as text
During cardiopulmonary bypass, a mixed venous oxygen saturation (SvO2) of 55% most likely indicates:
Answer: Inadequate oxygen delivery relative to metabolic demand
SvO2 below 65–70% indicates that tissues are extracting more oxygen than normal, suggesting oxygen delivery is insufficient to meet metabolic demand.
Which type of cardioplegia delivery route is preferred when there is severe proximal coronary artery disease preventing antegrade flow?
Answer: Retrograde via coronary sinus
Retrograde cardioplegia delivered via the coronary sinus bypasses proximal coronary obstructions, ensuring adequate distribution to myocardium distal to the stenosis.
A patient on CPB receiving tranexamic acid (TXA) is at increased risk for which adverse event?
Answer: Thrombotic complications including seizures
Tranexamic acid, an antifibrinolytic agent, increases thrombotic risk, and high doses have been associated with postoperative seizures, particularly in high-risk patients.
When protamine is administered to reverse heparin after CPB, which hemodynamic response is most commonly observed?
Answer: Transient hypotension
Protamine administration commonly causes transient hypotension due to histamine release and complement activation; severe anaphylactic reactions can also occur.
During CPB, the hematocrit is noted to drop to 18%. The most appropriate immediate action is to:
Answer: Administer packed red blood cells to restore oxygen-carrying capacity
A hematocrit of 18% during CPB is below safe thresholds for adequate oxygen delivery, and packed red blood cells should be transfused to restore oxygen-carrying capacity.
Which intraoperative monitor is the gold standard for detecting myocardial ischemia during cardiac surgery?
Answer: Transesophageal echocardiography (TEE)
TEE is considered the gold standard for intraoperative detection of myocardial ischemia because it identifies new regional wall motion abnormalities before ECG changes appear.
The purpose of performing a de-airing maneuver before removing the aortic cross-clamp at the conclusion of CPB is to:
Answer: Prevent systemic air embolism when cardiac ejection resumes
De-airing removes air accumulated in cardiac chambers and the aortic root to prevent air embolism—particularly to the coronary and cerebral circulation—when the heart begins ejecting again.