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MM Flash Cards
Surgical Procedures-Lithotripsy
| Question | Answer |
|---|---|
| Identify a procedure on the genitourinary system that is associated with a high incidence of cardiac dysrhythmias? | During extracorporeal shock wave lithotripsy. Shock wave-induced cardiac arrhythmia's occur in 10-14% of pt's undergoing lithotripsy despite the shock waves being synchronized w the pt's ECG & delivered in the refractory period of the cardiac cycle |
| Arrhythmia's during lithotripsy are believed to be caused from what? | Mechanical stresses on the conduction system exerted by the shock waves. |
| What pt's are at risk of developing arrhythmias induced by shock waves during extracorporeal shock wave lithotripsy? | Pt's w a hx of dysrhythmias & pt's w pacemakers. |
| What what is the delivery of shock waves timed during extracorporeal shock wave lithotripsy for pt's w a hx of dysrhythmias or w a pacemaker? | Shock waves are usually timed to occur 20 milliseconds after the R wave, a time that corresponds to the ventricular absolute refractory period. |
| What are the most frequent dysrhythmias during extracorporeal shock wave lithotripsy? | Premature atrial and premature ventricular contractions are the most frequent dysrhythmias noted during extracorporeal shock wave lithotripsy. |
| What cardiovascular changes occur upon immersion into a heated water bath for extracorporeal shock wave lithotripsy? | Increased venous return due to the increased venous pressure on the legs and abdomen generally raises blood pressure, possibly to hypertensive levels. Some pt's experience low BP bc vasodilation bc of the warm water. |
| What two problems may occur after immersion in a heated water bath during extracorporeal shock wave lithotripsy? | 1)The sudden increase in venous return can precipitate CHF in pt's w marginal cardiac reserve, & 2)Hypoxemia may develop secondary to a decrease in functional residual capacity. |
| LIGHTNING BOLT-During extracorporeal shockwave lithotripsy (ESWL), which organs may be directly damaged, especially by first-generation lithotripter? | BC lungs are filled w air, they present differ acoustic impedance to the shock waves;if not protected they may be injured. The GI tract or pancreas may also be damaged directly by the shock waves, owing to their proximity to the kidneys. |
| LIGHTNING BOLT (cont)- What type of pt's are more susceptible to pulmonary contusions from direct shock waves? | Children and adults of small stature. |
| LIGHTNING BOLT (cont)- What should be placed between the shock waves and the ling tissue to prevent damage from occurring? | A thick sheet of styrofoam |
Created by:
ngawlik
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