PRACTICUM 2 TEST 1 – COMPLETE
EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS | ALREADY
VERIFIED
Hemodynamic effects of minimally invasive surgery - CORRECT
ANSWER>>>>Increased
SVR & MAP (> SNS output)
Variable changes in cardiac filling volumes
Dysrhythmias
*Increased CBF, ICP*
*Decreased splanchnic, renal, and hepatic BF*
Decreased UOP
Usually well tolerated if healthy
Not well tolerated if significant heart/lung disease
Trendelenburg, intra-abd organ compression, and IVC compression have what
effect on BP (via changes in preload)? - CORRECT ANSWER>>>>Increase or no
change in BP
pg. 1
,Peripheral vasoconstriction during laparoscopic procedures can have what effect
on BP -
CORRECT ANSWER>>>>Increase or no change in BP
Peritoneal irritation can cause arrhythmias, and what changes to BP? - CORRECT
ANSWER>>>>Up, down, or no change in BP
Hypercapnia/acidosis can cause arrhythmias, and alter afterload/MAP. How will
this affect BP? - CORRECT ANSWER>>>>Increase, decrease, or no change
What effect does hypoxia have on BP? - CORRECT ANSWER>>>>Decrease or
no change in BP
What things affect the magnitude of circulatory changes that occur during
laparoscopic surgery? - CORRECT ANSWER>>>>Pts' pre-existing
cardiopulmonary status
Amount of IAP
Degree of CO2 absorption
Pt position
Type of surgery
Pneumoperitoneum SVR, MAP, and filling pressures - CORRECT
ANSWER>>>>Increases
pg. 2
,Sudden stretching of the peritoneum during insertion of ports or during insufflation
an cause -
CORRECT ANSWER>>>>Arrhythmias and asystole
*Slow insufflation of CO2 decreases risk*
Advantages of laparoscopic/minimally invasive surgery - CORRECT
ANSWER>>>>Improved cosmetic results
Shorter recovery/earlier return to work & ADLs
Lower costs
Lower medical risk, better clinical outcomes
Earlier return of bowel functions
Less postop complications
*Less incisional stress response, opioid reqs, postop pain, fluid shifting, and postop
resp dysfunction*
Disadvantages of laparoscopic/minimally invasive surgery - CORRECT
ANSWER>>>>*Higher risk PONV*
*Referred pain from CO2 insufflation (to shoulder)*
Highly specialized training required; longer OR times
Complex equipment/set up
May be more challenging if scar tissue present (re-operation)
*Pneumoperitoneum-induced stress response*
pg. 3
, *Steep trendelenburg, jackknife, lithotomy*
Mech vent challenges
Extraperitoneal CO2 related complication
Limited CRNA access to pt in robotic surgery
Conventional laparoscopy vs robotic - CORRECT ANSWER>>>>*laparoscopic*:
reduced ROM, dexterity, and 2D view of field
*robotic*: better depth perception (3D view), intuitive instrument control, mimics
natural hand/wrist mints, improves outcomes, reduces complications, shorter LOS,
and better surgeon ergonomics
Contraindications to laparoscopic/robotic surgery - CORRECT
ANSWER>>>>Poor pulmonary function
Poor cardiac function
HX stroke, aneurysm, >ICP (prolonged trendelenburg is relatively contraindicated
in these patients)
T/F: Patient position cannot be changed by CRNA once robot is docked -
CORRECT
ANSWER>>>>True
Thoracic procedures are usually done in the position with trendeleburg or reverse
trendelenburg - CORRECT ANSWER>>>>Lateral
pg. 4
EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS | ALREADY
VERIFIED
Hemodynamic effects of minimally invasive surgery - CORRECT
ANSWER>>>>Increased
SVR & MAP (> SNS output)
Variable changes in cardiac filling volumes
Dysrhythmias
*Increased CBF, ICP*
*Decreased splanchnic, renal, and hepatic BF*
Decreased UOP
Usually well tolerated if healthy
Not well tolerated if significant heart/lung disease
Trendelenburg, intra-abd organ compression, and IVC compression have what
effect on BP (via changes in preload)? - CORRECT ANSWER>>>>Increase or no
change in BP
pg. 1
,Peripheral vasoconstriction during laparoscopic procedures can have what effect
on BP -
CORRECT ANSWER>>>>Increase or no change in BP
Peritoneal irritation can cause arrhythmias, and what changes to BP? - CORRECT
ANSWER>>>>Up, down, or no change in BP
Hypercapnia/acidosis can cause arrhythmias, and alter afterload/MAP. How will
this affect BP? - CORRECT ANSWER>>>>Increase, decrease, or no change
What effect does hypoxia have on BP? - CORRECT ANSWER>>>>Decrease or
no change in BP
What things affect the magnitude of circulatory changes that occur during
laparoscopic surgery? - CORRECT ANSWER>>>>Pts' pre-existing
cardiopulmonary status
Amount of IAP
Degree of CO2 absorption
Pt position
Type of surgery
Pneumoperitoneum SVR, MAP, and filling pressures - CORRECT
ANSWER>>>>Increases
pg. 2
,Sudden stretching of the peritoneum during insertion of ports or during insufflation
an cause -
CORRECT ANSWER>>>>Arrhythmias and asystole
*Slow insufflation of CO2 decreases risk*
Advantages of laparoscopic/minimally invasive surgery - CORRECT
ANSWER>>>>Improved cosmetic results
Shorter recovery/earlier return to work & ADLs
Lower costs
Lower medical risk, better clinical outcomes
Earlier return of bowel functions
Less postop complications
*Less incisional stress response, opioid reqs, postop pain, fluid shifting, and postop
resp dysfunction*
Disadvantages of laparoscopic/minimally invasive surgery - CORRECT
ANSWER>>>>*Higher risk PONV*
*Referred pain from CO2 insufflation (to shoulder)*
Highly specialized training required; longer OR times
Complex equipment/set up
May be more challenging if scar tissue present (re-operation)
*Pneumoperitoneum-induced stress response*
pg. 3
, *Steep trendelenburg, jackknife, lithotomy*
Mech vent challenges
Extraperitoneal CO2 related complication
Limited CRNA access to pt in robotic surgery
Conventional laparoscopy vs robotic - CORRECT ANSWER>>>>*laparoscopic*:
reduced ROM, dexterity, and 2D view of field
*robotic*: better depth perception (3D view), intuitive instrument control, mimics
natural hand/wrist mints, improves outcomes, reduces complications, shorter LOS,
and better surgeon ergonomics
Contraindications to laparoscopic/robotic surgery - CORRECT
ANSWER>>>>Poor pulmonary function
Poor cardiac function
HX stroke, aneurysm, >ICP (prolonged trendelenburg is relatively contraindicated
in these patients)
T/F: Patient position cannot be changed by CRNA once robot is docked -
CORRECT
ANSWER>>>>True
Thoracic procedures are usually done in the position with trendeleburg or reverse
trendelenburg - CORRECT ANSWER>>>>Lateral
pg. 4
