6 Hemodynamic Monitors

Question 1

NIBP cuff: ideal length and width

Answer 1

Length- 80% of circumference, width- 40% of circumference

Question 2

How bp changes from aortic root to periphery

Answer 2

SBP increases, DBP decreases, pp widens, map is the same

Question 3

How bp changes above or below heart per inch

Answer 3

BP 2mmhg per inch

Question 4

When a line is under dampened or over dampened

Answer 4

Under: baseline after several oscillations, SBP over estim and DBP under. Over damp: baseline w no oscillations, SBP under DBP over

Question 5

Risk of Pa rupture w CVL insertion inc by

Answer 5

Elderly, hypothermia, anticoag, irrit of vessel wall, filling balloon w liquid

Question 6

CVP waveform

Answer 6

A- RA contraction, c- tricuspid elev, x- downward RV, v- RA passive filling, y- RA empties into open valve

Question 7

Electrical event with cvp waveform

Answer 7

A- after p wave, c-just after QRS, x-st seg, v- just after t wave starts, y- after t wave

Question 8

What happens when lose a wave on cvp

Answer 8

A fib or v pacing w no underlying rhythm

Question 9

What large a wave on cvp means

Answer 9

Tricuspid stenosis, Dias dysfunc, Myo ischemia, chronic lung dis w RV hypertrophy, av dissociation, junctional rhythm, v pacing a synchronous, pvcs

Question 10

What large v wave on cvp means

Answer 10

Tricuspid regurg, inc in iv vol, RV papillary muscle ischemia

Question 11

What waveform of PAOP is: a c v

Answer 11

A- LA systole, c- mitral valve elev during lv systole, v- la filling

Question 12

How to tell if pa tip isn’t in zone 3

Answer 12

Paop > pa end DBP, nonphaseic paop tracing, cant aspirate blood when wedged

Question 13

When paop overestimates LVEDP

Answer 13

Ischemia, mitral valve dis, l to right shunt, tachycardia, PPV, peep, COPD, pulm htn, not in west zone 3

Question 14

When paop underestimates LVEDV

Answer 14

Aortic insufficiency

Question 15

Co tracing when co high vs low

Answer 15

When high, less area under curve, when low more area under curve

Question 16

Thermodilution co: when underestimates vs over estimates co

Answer 16

Under: injectate vol too high or sol too cold. Over: injec vol too low or sol too hot. Partially wedged pac or thrombus on tip of pac

Question 17

How to calc svo2

Answer 17

Sao2 - vo2/(q x 1.34 x hgb x 10)

Question 18

Nml svo2

Answer 18

65-75%

Question 19

When PPV may not be accurate

Answer 19

Spont vent, small tv, peep, open chest, RV dysfunc, dysrhythmias

Question 20

When esophageal Doppler means;urement may not be accurate

Answer 20

As, AI, thoracic aorta disease, aortic cross clamp, after CPB, pregnancy