2 Hemodynamic Monitoring Part 2

Question 1

What does SVR vs PVR tell us

Answer 1

SVR:
-how constricted (increased) or dilated (decreased) blood flow is

PVR:
-same but for pulmonary

Question 2

CVP is a measurement of what

Answer 2

Right Preload

Question 3

PAOP (pulmonary artery wedge pressure)

What is the ballon
Good measurement of what

Answer 3

Ballon is dilated

Good left heart measurement
-left heart preload

Question 4

PAP catheter (pulmonary artery pressure)

Insertion:
-what we have to set up
-ballon inflation and deflation is based on who -visualize what during advancement
-how to confirm
-can cause what type of dysrhythmias when placing

Answer 4

Prime tube, zero transducer

-per md
-visualize waveform
-ventricular dysrhythmias
-cxr to confirm

Question 5

PAP catheter (pulm artery pressure)

Care after insertion:
-type of dressing
-measure what of swan

Answer 5

Sterile dressing changes

Note measurement of swan at insertion
(To make sure we know if it moves)

Question 6

Cardiac output monitoring

What we inject
What port
Take average of what

Answer 6

5-10 ml of NS
Blue proximal port
Average of 3 readings

Question 7

Low cardiac output

Definition
3 causes ( examples of them)

Answer 7

HR too fast or too slow
-causing inadequate ventricular filling

—Decreased preload
-hemorrhage/hypovolemia
—Increased afterload
-vasoconstriction
—Decreased contractility
-MI, HF, cardiac tamponade

Question 8

High cardiac output

3 causes (example for each)

Answer 8

HR increased
(Fever, anxiety, metabolic demands)

Increased preload
(Too much fluid resuscitation)

Decreased afterload
(Vasodilation in sepsis, meds)

Question 9

Mixed venous oxygen saturation SvO2

-where is a sample frawn from?
Normal range %

Answer 9

Pulmonary artery (yellow port on swan)
60-75%

Question 10

Causes of low SvO2 < 60%

Definition
2 causes

Answer 10

Failure to deliver adequate O2 to tissure or increased O2 consumption

-decreased O2 delivery

-increased O2 consumption

Question 11

Low SvO2 causes

-decreased O2 delivery (examples)

-increased O2 consumption (examples)

Answer 11

Decreased O2 delivery
-anemia, MI CHF, dysrhythmias, cardiogenic shock, hypovolemia, hypoxia, hemorrhage

Increased O2 consumption
-strenuous activity, fever, pain, anxiety, bathing, late phase septic shock, sz, shivering

Question 12

High SvO2 >75%

2 causes and exampls

Answer 12

Increased O2 delivery:
-increased O2 delivery, hyper oxygenation

Decreased O2 consumption:
-hypothermia, anesthesia, hypothyroid, neuromuscular blockage, early sepsis

Question 13

High SvO2 >80%

3 causes (no examples)

Answer 13

PA catheter wedged
Clot at end of catheter
Computer needs recalibrated