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WorksheetsPost test one lung ventilation
Total questions: 10
Worksheet time: 10mins
A patient undergoing right upper lobectomy for lung cancer in the left lateral decubitus position is experiencing hypoxemia while receiving an FIO2 of 1.0 during one-lung anesthesia with a double-lumen tube. Which one of the following options is the most appropriate next step in the treatment of hypoxemia?
Application of continues positive airway pressure (CPAP) to the nondependent lung
Application of PEEP to the dependent lung
Intermittent reinflation of the nondependent lung
Reinstitute two-lung ventilation
Administration of oxygen via suction catheter to the collapsed lung
In comparing patients undergoing esophagectomy against those undergoing pulmonary resection, it is generally TRUE that esophagectomy patients
Have better nutritional status
Have less risk of aspiration
Have better pulmonary function
Are less likely to be hypoxic d u ring single lung ventilation
Are less likely to need postoperative Ventilation
A patient with esophageal obstruction is to have a general anesthetic for sophagoscopy. He has had a barium swallow on the previous day. One of the greatest dangers of the planned procedure is
Bleeding
Difficult intubation
Aspiration
Arrhythmia
Hypotension
The first step recommended to improve oxygenation if a patient is exhibiting drop in Oxygen saturation during one-lung ventilation is
Apply continuous positive-airway pressure (CPAP) to the collapsed lung
Apply positive end–expiratory pressure (PEEP) to the dependent lung
Periodic inflation of the collapsed lung
Continuous inflation of oxygen into collapsed lung
During apneic oxygenation
Adequate oxygenation can be maintained only for short periods
Arterial PCO2 rises 3 to 4 mm Hg in the first minute
Arterial PCO2 rises 1 to 2 mm Hg each subsequent minute after the first minute
Progressive respiratory acidosis limits the use of this technique to 10 to 20 minutes in most patients
Anesthetic considerations for esophageal surgery include
Very low risk of pulmonary aspiration
Mandatory pulmonary artery catheter monitoring
Diaphragmatic retractors interfering with cardiac function
Always performed with a double-lumen tube (DLT)
The most appropriate method for improving oxygenation during one lung anesthesia, after institution of an FiO2 of 1.0, is application of
5cm H2O CPAP to the non-dependent lung
10cm H2O CPAP to the non-dependent lung
5cm H2O PEEP to the dependent lung
5cm H2O CPAP to the non-dependent and 5cm H2O PEEP to the dependent lung
intermittent re-inflation to the non-dependent lung
The patient most likely to desaturate significantly during one lung anesthesia is one who is having
A left sided thoracotomy, has reasonable PaO2 values during two-lung ventilation, but poor pre-operative spirometry
A right-sided thoracotomy, has relatively poor PaO2 values during two-lung ventilation but good pre-operative spirometry
A left-sided thoracotomy and has diminished perfusion but not ventilation to the operative lung on a V/Q scan
A right-sided thoracotomy, has relatively poor PaO2 values during two-lung ventilation and poor pre-operative spirometry
Following one-lung ventilation there is an increased risk of lung injury if plateau airway pressure (during one-lung ventilation) exceeds
30 cm wate
40 cm water
50 cm water
lung injury is not related to ventilation pressure
20 cm water
In preparation for a posterior-lateral incision for a thoracotomy, a patient is placed in the left lateral decubitus position. In this position the
axillary roll is placed under the chest to aid surgical exposure
nondependant leg should be extended and the superior leg flexed
neck should be extended to allow access to the airway
radial nerve is the most commonly injured nerve
right brachial plexus is at risk of injury if the right arm is flexed at the shoulder to more than 90deg
