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WorksheetsILP Quiz
Total questions: 111
Worksheet time: 4hrs 42mins
Name
Class
Date
1.
Who devised the concept of Isolated Limb Perfusion (ILP) and in what year
a)
Creech and associates in 1956
b)
Johnson and Miller in 1962
c)
Kaye and Spencer in 1954
d)
Lee and Carter in 1958
e)
Harkins and Roberts in 1960
2.
What was the original purpose of Isolated Limb Perfusion (ILP)
a)
To treat bone marrow cancer
b)
To treat patients with extremity skin cancer
c)
To treat metastatic lung tumors
d)
To prevent systemic spread of infection
e)
To reduce limb swelling after trauma
3.
What is the cancer most often treated with Isolated Limb Perfusion (ILP)
a)
Sarcoma
b)
Basal cell carcinoma
c)
Melanoma
d)
Kaposi’s sarcoma
e)
Squamous cell carcinoma
4.
What types of malignancies can be treated with Isolated Limb Perfusion (ILP)
a)
Only melanoma
b)
Melanoma, sarcomas, and other limb-confined cancers
c)
Breast cancer and melanoma
d)
Sarcomas and lung cancer
e)
Lymphomas and sarcomas
5.
What are the three primary goals of ILP
a)
Reduce systemic BP, improve oxygenation, shrink tumor
b)
Isolate extremity, use hyperthermia, prevent systemic chemo spread
c)
Isolate lung function, use cooling, deliver antibiotics
d)
Increase heart output, reduce swelling, limit pain
e)
Increase renal filtration, lower heart rate, reduce blood volume
6.
What role does the oxygenator play in ILP
a)
Supplies blood to the systemic circulation
b)
Provides respiratory support to isolated limb
c)
Filters chemotherapy drugs
d)
Maintains constant temperature
e)
Removes excess carbon dioxide from whole body
7.
What does the heat exchanger and heater-cooler in ILP do
a)
Induce cooling for nerve protection
b)
Maintain room temperature
c)
Induce hyperthermia for chemo efficacy
d)
Warm the whole body
e)
Maintain limb oxygenation
8.
Why can chemotherapy doses in ILP be 10 times stronger than systemic treatments
a)
Because metabolism is faster in limbs
b)
Because vital organs are bypassed
c)
Because the drugs are injected directly into tumors
d)
Because blood pressure is higher in extremities
e)
Because chemo binds better to limb tissue
9.
How are chemotherapy drugs removed before tourniquet release in ILP
a)
By ultrafiltration
b)
By lymphatic drainage
c)
By complete limb blood volume drainage
d)
By systemic dialysis
e)
By topical cooling
10.
What circuit components are ideal for ILP procedures
a)
Adult-sized components
b)
Pediatric-sized circuit with reservoir and oxygenator
c)
Neonatal-sized components
d)
Large-volume ECMO circuit
e)
Portable bypass unit
11.
If the oxygenator does not have an integrated filter, what should be used in ILP?
a)
Adult arterial filter
b)
External pediatric filter
c)
Microbubble trap
d)
Centrifugal separator
e)
Activated charcoal filter
12.
Why is it important to use pediatric-sized components for ILP
a)
To reduce turbulence
b)
To fit smaller machines
c)
To minimize hemodilution in small tissue area
d)
To speed priming
e)
To increase drug potency
13.
What tubing sizes are commonly used for arm perfusion in ILP circuits
a)
3/8 in. arterial, 3/8 in. venous
b)
1/4 in. arterial, 1/4 in. venous
c)
1/4 in. arterial, 3/8 in. venous
d)
3/16 in. arterial, 1/4 in. venous
e)
1/4 in. arterial, 3/16 in. venous
14.
What tubing sizes are commonly used for leg perfusion in ILP circuits
a)
1/4 in. arterial, 3/8 in. venous
b)
3/8 in. arterial, 3/8 in. venous
c)
1/4 in. arterial, 1/4 in. venous
d)
1/4 in. arterial, 1/2 in. venous
e)
3/16 in. arterial, 1/4 in. venous
15.
What circuit feature allows removal of blood volume containing chemotherapy in ILP
a)
Side arm filter
b)
Y-connector to waste bag
c)
Roller pump with bypass
d)
Inline suction filter
e)
Centrifugal waste pump
16.
Besides removal of chemotherapy-laden blood, what is another purpose of the Y-connector setup in ILP
a)
To oxygenate the limb
b)
To flush and transfuse if needed
c)
To monitor venous pressure
d)
To measure temperature
e)
To sample gases
17.
What types of pumps can be used in ILP procedures
a)
Centrifugal or roller pump
b)
Only centrifugal pump
c)
Only roller pump
d)
Peristaltic pump
e)
Micro-roller pump
18.
What must be considered when choosing the type of pump for ILP
a)
Limb size
b)
Perfusionist’s experience
c)
Cost of the pump
d)
Drug compatibility
e)
Patient age
19.
Why should circuit pressures be monitored in ILP
a)
To check for air embolism
b)
To detect limb resistance
c)
To monitor temperature
d)
To detect drug leaks
e)
To assess venous return
20.
What temperature control components are essential in the ILP circuit
a)
Inline warmer only
b)
Intra-oxygenator heat exchanger and heater-cooler
c)
Cooling blanket
d)
Warm saline flush
e)
Heated oxygen supply
21.
What common perfusion circuit safety mechanisms should be used in ILP
a)
Level detector, bubble detector, and circuit pressure servo-regulation
b)
Air filter with reservoir scale
c)
Bubble detector with arterial filter only
d)
Heater-cooler and backup battery
e)
Flow sensor and drug infusion pump
22.
What method is used to determine the percentage and volume of limb perfusion in priming solutions
a)
BMI-based surface estimate
b)
The Rule of Nines method
c)
Limb circumference chart
d)
Square-area approximation
e)
Doppler surface mapping
23.
What percentage of total body surface area does the Rule of Nines assign to an arm
a)
0.09 percent
b)
0.12 percent
c)
0.15 percent
d)
0.06 percent
e)
0.18 percent
24.
What percentage of total body surface area does the Rule of Nines assign to a leg
a)
0.12 percent
b)
0.18 percent
c)
0.24 percent
d)
0.15 percent
e)
0.09 percent
25.
How is the circulating volume of a limb calculated for perfusion
a)
By limb density tables
b)
By limb’s %TBSA applied to total blood volume
c)
By limb circumference × length
d)
By BMI and height
e)
By ultrasound blood pool
26.
What type of solution is commonly used as the priming solution in isolated limb perfusion
a)
0.9% saline only
b)
Lactated Ringer’s
c)
Balanced electrolyte (PlasmaLyte/Normosol)
d)
D5W
e)
Hypertonic saline
27.
What is the recommended concentration of sodium bicarbonate added to the priming solution
a)
10 mEq/L
b)
15 mEq/L
c)
20 mEq/L
d)
25 mEq/L
e)
30 mEq/L
28.
Why is sodium bicarbonate added to the priming solution
a)
To enhance drug binding
b)
To increase pH and prevent acidosis in the limb
c)
To raise oncotic pressure
d)
To reduce potassium levels
e)
To improve oxygen solubility
29.
How many International Units of heparin are added to the prime to prevent coagulation
a)
3,000 IU
b)
4,000 IU
c)
Approximately 5,000 IU
d)
7,500 IU
e)
10,000 IU
30.
What optional drug may be added to the prime to help decrease extremity edema
a)
Albumin
b)
Mannitol
c)
Furosemide
d)
Dextran
e)
Hetastarch
31.
What factors should be considered when deciding on drugs to include in the priming solution
a)
Pharmacy stock and cost
b)
Patient intra-op values and etiologies
c)
Pump manufacturer recommendation
d)
Nursing preference
e)
Case duration only
32.
What type of calculations are used to determine the limb hematocrit after prime dilution
a)
Oxygen extraction fraction
b)
Fick cardiac output
c)
Standard volume–concentration calculations
d)
Mass-balance by flow
e)
Hemoglobin index
33.
What type of calculations are used to determine the whole body hematocrit after limb blood is removed
a)
Pressure-volume loop
b)
Standard volume–concentration calculations
c)
Mean corpuscular indices
d)
Stroke volume index
e)
Hemodilution factor only
34.
Why should the hematocrit of the limb be kept at physiologically ideal conditions during the case?
a)
To optimize heat transfer
b)
To prevent dilutional ischemia
c)
To speed drug metabolism
d)
To limit venous pooling
e)
To reduce vasodilation
35.
What is the formula to calculate a patient's red blood cell volume (RBCV)
a)
RBCV = CBV × hematocrit (decimal)
b)
RBCV = weight × 70 mL
c)
RBCV = CBV ÷ hematocrit
d)
RBCV = TBSA × CBV
e)
RBCV = MAP ÷ SVR
36.
What is the formula to calculate a patient's circulating blood volume (CBV)
a)
CBV = 65 mL × kg
b)
CBV = 80 mL × kg
c)
CBV = BSA × 50 mL
d)
CBV = 70 mL × kg
e)
CBV = height × 10 mL
37.
What is the recommended heparin dose before initiating isolated limb perfusion (ILP)
a)
200 IU/kg
b)
250 IU/kg
c)
300 IU/kg
d)
350 IU/kg
e)
150 IU/kg
38.
What is the formula to calculate the circulating blood volume (CBV) of a limb
a)
Limb CBV = CBV × limb % (decimal)
b)
Limb CBV = CBV ÷ limb %
c)
Limb CBV = CBV × BMI
d)
Limb CBV = CBV × weight %
e)
Limb CBV = CBV − limb %
39.
What is the formula to calculate the red blood cell volume (RBCV) of a limb
a)
Limb RBCV = RBCV ÷ limb %
b)
Limb RBCV = CBV × Hct
c)
Limb RBCV = RBCV × limb % (decimal)
d)
Limb RBCV = limb CBV × weight
e)
Limb RBCV = RBCV − limb %
40.
What is the formula to calculate the total circulating volume (TCV) of the limb after prime is added
a)
TCV = limb CBV + prime volume
b)
TCV = CBV + RBCV
c)
TCV = CBV × limb %
d)
TCV = limb CBV × 2
e)
TCV = prime volume − limb CBV
41.
What is the formula to calculate the hematocrit of the total circulating volume (TCV)
a)
Hematocrit of TCV = limb RBCV ÷ TCV
b)
Hematocrit of TCV = limb CBV × TCV
c)
Hematocrit of TCV = RBCs added ÷ TCV
d)
Hematocrit of TCV = total RBCV ÷ CBV
e)
Hematocrit of TCV = limb Hct × TCV
42.
What is the formula to calculate the total RBCs required if red blood cells are needed in the prime
a)
RBCs required = prime volume × desired Hct
b)
RBCs required = TCV × desired hematocrit in decimal form
c)
RBCs required = limb CBV × Hct
d)
RBCs required = CBV × desired Hct
e)
RBCs required = limb RBCV + desired Hct
43.
What is the formula to calculate how many RBCs to add to the prime
a)
RBCs to add = RBCs required − limb RBCV
b)
RBCs to add = limb CBV − RBCs required
c)
RBCs to add = limb RBCV × desired Hct
d)
RBCs to add = RBCs required + prime volume
e)
RBCs to add = limb Hct ÷ desired Hct
44.
What is the formula to calculate the milliliters of packed RBCs to add to the prime
a)
mL of PRBCs = RBCs to add × 0.70
b)
mL of PRBCs = RBCs to add ÷ 0.70
c)
mL of PRBCs = RBCs required × Hct
d)
mL of PRBCs = RBCV ÷ 0.70
e)
mL of PRBCs = limb CBV × 0.70
45.
What is the approximate hematocrit of packed red blood cells?
a)
0.6 percent
b)
0.65 percent
c)
0.7 percent
d)
0.75 percent
e)
0.8 percent
46.
What is the target Activated Clotting Time (ACT) for ILP before starting the circuit
a)
400 seconds
b)
450 seconds
c)
460 seconds
d)
480 seconds
e)
500 seconds
47.
Why must systemic blood be fully heparinized before ILP despite it being a localized procedure
a)
To prevent tourniquet displacement
b)
A leak across the tourniquet could allow non-heparinized blood into the circuit, causing clotting
c)
To speed up cannulation
d)
To allow higher flow rates
e)
To prevent hemolysis
48.
What is done after achieving target ACT and surgically isolating the limb vessels
a)
The limb is flushed with saline
b)
The artery and vein of the limb are cannulated
c)
The oxygenator is connected
d)
The limb is wrapped in a warming blanket
e)
Blood gases are drawn
49.
Why might test transfusions be performed after cannulation during ILP
a)
To ensure proper cannula placement
b)
To evaluate limb swelling
c)
To confirm drug compatibility
d)
To preheat the circuit
e)
To prime the tubing
50.
How is desired ILP flow determined
a)
As a fraction of patient’s cardiac index based on limb percentage (Rule of Nines)
b)
Based on limb temperature
c)
Using vessel diameter
d)
Using total blood volume only
e)
By doubling cardiac output
51.
Why are smaller arterial and venous cannulas used in ILP
a)
To reduce turbulence
b)
Because lower flow is needed and for vessel size/ease of placement
c)
To reduce prime volume
d)
To prevent air entrainment
e)
To increase pressure
52.
What factors should be considered when selecting ILP cannulas
a)
Inventory, ease of placement, pressure drop values, vessel size, and flow characteristics
b)
Manufacturer preference only
c)
Lowest cost option
d)
Sterility packaging
e)
Cannula color coding
53.
Why might an arterial cannula be used for venous drainage in ILP
a)
To reduce heat loss
b)
Due to lower required venous flows, ease of placement, and shorter length
c)
To increase prime volume
d)
To reduce hemodilution
e)
To increase resistance
54.
What tool is used to stop circulation to the limb before initiating ILP perfusion
a)
Blood pressure cuff
b)
An Esmarch tourniquet with a Steinman pin or similar
c)
Surgical clip
d)
Hemostatic clamp
e)
Compression stocking
55.
What monitoring should be used during ILP
a)
Arterial pressure lines, EKG, O₂ saturation, and CVP line
b)
Pulse oximeter only
c)
CVP line only
d)
Arterial line only
e)
EKG only
56.
Why might arterial flow be started before opening the venous line during ILP
a)
To improve drug mixing
b)
To promote forward flow and enhance venous drainage
c)
To increase pressure in the circuit
d)
To cool the extremity
e)
To avoid hemodilution
57.
How should ventilation parameters be set during ILP
a)
Based on gas-to-blood ratios per oxygenator manufacturer and clinical judgment
b)
Standard adult settings only
c)
High PEEP and low FiO₂
d)
Hyperventilation with 100% O₂
e)
Using fixed sweep gas flow
58.
Why are blood gases obtained during ILP
a)
To check for infection
b)
To ensure proper ventilation and assess patient status
c)
To monitor electrolytes only
d)
To measure lactate clearance
e)
To track drug metabolism
59.
How is ILP pump flow rate (PFR) calculated
a)
Cardiac output × limb percentage in decimal form
b)
Limb CBV × Hct
c)
Cardiac index × limb %
d)
CBV × limb %
e)
Stroke volume × limb %
60.
What is the calculated pump flow rate for an arm if the cardiac output is 4.5 L/min
a)
350 mL/min
b)
405 mL/min
c)
450 mL/min
d)
375 mL/min
e)
500 mL/min
61.
What is the calculated pump flow rate for a leg if the cardiac output is 4.5 L/min
a)
810 mL/min
b)
750 mL/min
c)
900 mL/min
d)
700 mL/min
e)
600 mL/min
62.
What is the equation to calculate Pump Flow Rate (PFR) in ILP
a)
PFR = Cardiac Index × Limb %
b)
PFR = Limb % × Cardiac Output
c)
PFR = Limb % ÷ Cardiac Output
d)
PFR = (Limb Pressure × 80) ÷ CO
e)
PFR = Limb CBV × 80
63.
What is one of the key beneficial aspects of the ILP procedure?
a)
Lower anticoagulation requirement
b)
Short cannulas
c)
Temperature control and manipulation
d)
Single-venous access
e)
No oxygenator needed
64.
What is the equation to calculate Pump Resistance (PR) in ILP
a)
PR = Pressure ÷ Flow
b)
PR = CO × Limb %
c)
PR = Limb Perfusion Pressure ÷ PFR
d)
PR = (Limb Perfusion Pressure × 80) ÷ PFR
e)
PR = Pressure × Flow
65.
Why is it necessary to check for leaks across the tourniquet before administering chemotherapy during ILP
a)
To maintain ACT
b)
To avoid limb cooling
c)
To keep reservoir level constant
d)
To optimize pulse pressure
e)
Leaks let chemotherapy reach systemic circulation
66.
Do pump flows during ILP affect systemic pressures
a)
No—ILP is an isolated system
b)
Only during warming
c)
Yes, they raise MAP
d)
Yes, with high prime volume
e)
Only in lower limbs
67.
What are two common methods used to check for leaks across the tourniquet in ILP
a)
ACT rise and temperature drop
b)
Venous color change and CVP rise
c)
Thermal probe variance and ultrasound
d)
Doppler flow and blood gases
e)
Reservoir level changes and radiopharmaceutical with external detectors
68.
What should be done to the limb and circuit fluid prior to chemotherapy administration during ILP
a)
Cool to 32 °C
b)
Warm to the desired temperature
c)
Keep at room temperature
d)
Flush with cold saline
e)
Remove prime first
69.
What is the common target temperature range for the limb during ILP
a)
36–37 °C
b)
37–38 °C
c)
38–40 °C
d)
40–42 °C
e)
35–36 °C
70.
What components are used to achieve the target ILP limb temperature
a)
Warm blankets only
b)
Heat lamp and pads
c)
Warm saline bags
d)
Oxygenator heat exchanger + heater-cooler
e)
Roller pump heat only
71.
Why is leak detection important before administering chemotherapy during ILP?
a)
To prevent systemic exposure to high-dose chemo
b)
To avoid hemodilution
c)
To keep pressure steady
d)
To improve oxygenation
e)
To reduce prime volume
72.
What devices can help maintain limb temperature before ILP initiation
a)
Hot water immersion
b)
Heat lamp
c)
Warming blanket or sterile forced-air warmer
d)
Electric heating pad
e)
Humidified air
73.
Why is it important to ensure the heater-cooler used for ILP is capable of hyperthermic temperature control
a)
Some units can’t reach/hold hyperthermia
b)
To prevent condensation
c)
To speed priming
d)
To maintain MAP
e)
To remove bubbles
74.
What is a viable heater-cooler option if hyperthermic control is needed for ILP
a)
Portable immersion heater
b)
Warm water bath
c)
HIPEC heater-cooler
d)
Standard CPB unit only
e)
Radiant warmer
75.
What types of temperature probes are necessary during ILP
a)
Tympanic + rectal
b)
Single central probe
c)
Arterial/venous circuit + proximal/distal limb probes
d)
Skin-only probes
e)
Core probe only
76.
Why are flows maintained for a specified amount of time after chemotherapy agent is added during ILP
a)
To keep ACT stable
b)
To cool the limb
c)
To ensure perfusion and drug distribution
d)
To reduce prime
e)
To prevent bubbles
77.
What is usually the first indication of a leak during ILP
a)
Significant reservoir volume change
b)
Limb temperature drop
c)
Oxygen saturation change
d)
Venous color change
e)
Pressure spike
78.
Why might a leak diagnosis be difficult even if one is present during ILP
a)
Tourniquet pressure too high
b)
Limb too small
c)
High flows
d)
Arterial and venous leaks can offset reservoir changes
e)
Heater-cooler masking
79.
What tools can aid in detecting systemic leaks during ILP
a)
pH indicator
b)
Near-infrared camera
c)
Fluorescein dyes or radioactive tracers
d)
CO₂ contrast
e)
Gas analyzer
80.
What does a decreasing reservoir level during ILP indicate
a)
An arterial leak
b)
Venous collapse
c)
Over-priming
d)
Temperature imbalance
e)
Oxygenator failure
81.
Why are arterial leaks during ILP the most detrimental
a)
They cause chemotherapy to enter systemic circulation
b)
They lower limb temperature
c)
They decrease venous return
d)
They cause prime loss
e)
They reduce ACT
82.
How can the clinician reduce the chance of arterial leaks during ILP
a)
Using a smaller cannula
b)
Increasing tourniquet pressure
c)
Keeping circuit pressures below diastolic
d)
Lowering ACT
e)
Avoiding heat exchanger use
83.
How can circuit pressure be lowered to prevent arterial leaks during ILP
a)
Flow rate changes and/or drug intervention
b)
Switching cannula position
c)
Using a higher tourniquet
d)
Reducing prime volume
e)
Adding albumin
84.
What should be done if an arterial leak is detected during ILP
a)
Increase ACT
b)
Add volume
c)
Adjust the tourniquet
d)
Lower limb temperature
e)
Replace oxygenator
85.
What does an increasing reservoir level during ILP indicate
a)
Arterial leak
b)
Venous leak
c)
Tourniquet malfunction
d)
Low ACT
e)
Oxygenator rupture
86.
Why are venous leaks less serious during ILP
a)
They avoid chemo entering systemic circulation
b)
They keep limb warm
c)
They increase venous return
d)
They improve perfusion
e)
They increase prime volume
87.
What are the two categories of chemotherapy drugs used for ILP?
a)
Alkylating and natural agents
b)
Synthetic and biologics
c)
Alkylating and antimetabolites
d)
Antibiotics and antifungals
e)
Natural and hormonal agents
88.
What is the main concern with venous system leaks during ILP
a)
Loss of prime
b)
Dilution of chemo concentration
c)
Lower limb temperature
d)
Increased ACT
e)
Cannula dislodgement
89.
How can venous leaks be managed during ILP
a)
Increase flows and/or adjust tourniquet
b)
Replace cannula
c)
Cool the limb
d)
Reduce prime
e)
Change patient position
90.
Why is collaboration with the oncology team important during ILP
a)
To adjust ACT
b)
To select correct drug and dose
c)
To manage temperature
d)
To set circuit pressures
e)
To place cannulas
91.
Why is it important to follow PPE standards during ILP
a)
Chemo drugs are highly toxic
b)
To keep limb sterile
c)
To avoid heat burns
d)
To prevent air emboli
e)
To avoid prime leaks
92.
Why must proper disposal standards be followed during ILP
a)
To avoid environmental contamination
b)
To comply with hospital waste policy
c)
To manage hazardous chemotherapy safely
d)
To keep circuit sterile
e)
To reduce prime cost
93.
What should clinicians understand before handling chemotherapy drugs during ILP
a)
Manufacturer dosing
b)
PPE requirements only
c)
Local spill and exposure policies
d)
Cannulation technique
e)
Drug storage temps
94.
When is the chemotherapy drug administered during ILP
a)
After temperature and leak checks
b)
Immediately after cannulation
c)
Before warming
d)
After tourniquet removal
e)
After heparin reversal
95.
What is an example of a chemotherapy drug used for ILP
a)
Cisplatin + high-dose TNF-alpha
b)
Melphalan ± low-dose TNF-alpha
c)
5-FU
d)
Cyclophosphamide
e)
Doxorubicin
96.
Why can dosing based on actual body weight be problematic during ILP
a)
Obesity can cause overdosing
b)
It underestimates in underweight patients
c)
It overestimates in children
d)
It increases prime volume
e)
It lowers ACT
97.
What are the three dosing strategies used for chemotherapy drugs in ILP
a)
Actual body weight, lean body mass, BSA
b)
Ideal body weight, BSA, limb circumference
c)
Actual body weight, ideal body weight, total limb volume
d)
Total body volume, ideal body weight, BMI
e)
Lean body weight, BMI, surface area
98.
What must be done before the tourniquet is removed to complete the ILP procedure?
a)
Prime removal
b)
All chemo-containing blood removed
c)
Administer protamine
d)
Lower limb temperature
e)
Flush with saline
99.
What is the typical hematocrit reduction from ILP if no RBCs are added or used in the prime
a)
3–5%
b)
9–18%
c)
20–25%
d)
5–8%
e)
12–15%
100.
What perfusion technique helps drain chemotherapy-contaminated blood during ILP
a)
Dual reservoir
b)
Venous Y-connector to waste
c)
Roller pump bypass
d)
Venous occluder
e)
Alternate arterial line
101.
During the ILP procedure, how is venous drainage directed toward the reservoir
a)
Waste line is clamped
b)
Reservoir line is clamped
c)
Both lines left open
d)
Reduce pump flow
e)
Adjust tourniquet
102.
How is venous drainage redirected toward the waste container after chemotherapy circulation is completed
a)
Clamp both lines briefly
b)
Open both lines to gravity
c)
Increase pump speed
d)
Remove the clamp from the waste line and apply it to the reservoir line
e)
Switch tubing connectors
103.
How is the system flushed of chemotherapy blood during ILP termination
a)
Add albumin while raising MAP
b)
Add crystalloid as the reservoir volume falls
c)
Open only the waste line fully
d)
Run the pump in reverse
e)
Stop flow and wait 10 minutes
104.
What volume of normal saline is typically sufficient to flush the system during ILP
a)
250–500 mL
b)
0.5–1.0 L
c)
1–3 L
d)
3–5 L
e)
5–7 L
105.
How is perfusion flow terminated after the flush in ILP
a)
Stop venous flow and keep arterial open
b)
Clamp the waste line only
c)
Occlude the arterial line first
d)
Turn down arterial flow while occluding the venous line
e)
Shut off heater-cooler then oxygenator
106.
What should be monitored to guard against overfilling the circuit during ILP termination
a)
Central venous pressure
b)
Venous line pressure
c)
Limb temperature
d)
Pulse oximetry
e)
Circuit arterial line pressures
107.
What happens after the pump is stopped and the venous line is occluded during ILP termination
a)
Administer protamine
b)
Open the waste line
c)
Draw post-ILP labs
d)
Loosen the tourniquet slightly
e)
Remove the tourniquet
108.
What is a common hemodynamic effect after ILP tourniquet removal
a)
Blood pressure may drop
b)
ACT spikes sharply
c)
Hematocrit rises
d)
Core temperature increases
e)
Oxygen saturation increases
109.
What must be done after ILP to reverse systemic heparin
a)
Lower ACT below 120
b)
Start low-dose heparin
c)
Give protamine per standard protamine/heparin ratio
d)
Clamp the reservoir line
e)
Increase flows
110.
What labs are necessary after ILP termination
a)
CBC and electrolytes
b)
Post-procedure blood gas and post-protamine ACT
c)
INR only
d)
Serum lactate only
e)
LFTs and bilirubin
111.
Why is proper disposal of circuit components and fluids important after ILP
a)
To avoid environmental and personal exposure to hazardous drugs
b)
To reduce OR costs
c)
To free up equipment quickly
d)
To comply with inventory policy
e)
To minimize staff workload
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