A-line Basics

Question 1

Can an A-line be used for a transfusion?

Answer 1

no

Question 2

What is an A-line used for?

Answer 2

small blood draws to monitor hemodynamics

Question 3

Why does an A-line work?

Answer 3

atmospheric pressure

Question 4

What is used to measure the pressure in an A-line?

Answer 4

transdeucer

Question 5

Where are the most common sites for an A-line?

Answer 5

radial artery then brachial and last resort is femoral

Question 6

Who can place an A-line?

Answer 6

nurse anesthetist, anesthesiologist, and sometimes RT, MD

Question 7

If a patient is on ______ drugs, an A-line may be used to monitor blood pressure

Answer 7

vasoactive

Question 8

What kind of blood sampling is done with A-lines?

Answer 8

ABGs, frequent blood draws, and Q1H BS

Question 9

What area on the arterial wave form shows that the transducer is picking up the right vibration?

Answer 9

dichrotic notch

Question 10

Prior to the notch, the heart is in _______, after the dichrotic notch, the heart is in ________.

Answer 10

systole, diastole

Question 11

Where should the transducer be placed for an A-line?

Answer 11

at the level of the right atrium (phlebostatic axis)

Question 12

Where is the phlebostatic axis located?

Answer 12

4th intercostal space at the level of the right atrium

Question 13

What happens to the reading of the arterial pressure if the transducer is placed too low?

Answer 13

artificial high pressure

Question 14

What happens to the reading of the arterial pressure if the transducer is placed too high?

Answer 14

artificial low pressure

Question 15

How many oscillations should be seen after the fast flush of an A-line?

Answer 15

2

Question 16

What does more than 2 oscillations indicate after pulling a fast flush?

Answer 16

whipping, which will give a false high bp

Question 17

What is happening if there is only 1 oscillation before a normal A-line wave after a fast flush?

Answer 17

dampening that will give a false low BP

Question 18

Do you need to have informed consent for an A-line?

Answer 18

yes

Question 19

What is the purpose of zeroing an A-line?

Answer 19

eliminate gravitational forces affecting pressure readings from the transducer

Question 20

When is zeroing done for an A-line?

Answer 20

upon insertion and prn

Question 21

Why would zeroing of an A-line be performed after the A-line has been placed?

Answer 21

questionable readings or to disconnect

Question 22

What is the test where you pull the flush valve open and the transducer reads the 300mg Hg pressure from the flush bag?

Answer 22

square wave test

Question 23

What may occur if the square wave test ends up being under-dampened?

Answer 23

BP reading may be falsely high