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nursing vet tech > blood pressure monitoring > Flashcards

blood pressure monitoring Flashcards

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1
Q

what is blood pressure

A

the force that the flow of blood puts on the wall of the vessels

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2
Q

what is blood pressure measured in?

A

mmHg

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3
Q

when was blood pressure first performed

A

1733 - horse jugular

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4
Q

what are the 3 numbers of arterial BP

A

top - SAP - Systolic Arterial Pressure
bottom - DAP - Diastolic A. P
overall number - MAP - Mean A. P.

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5
Q

what is systolic arterial pressure

A

pressure against the arteries - generated when the left ventricle is fully contracted

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6
Q

what is diastolic arterial pressure

A

minimum pressure maintained between contractions - pressure measured when the left ventricle relaxes or at rest

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7
Q

what is mean arterial pressure

A

equates to overall pressure throughout the cardiac cycle

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8
Q

what is the formula to calculate MAP

A

= (SAP-DAP)/3 + DAP

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9
Q

when considering perfusion pressure on an organ was is more important of the 3 measurements

A

MAP

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10
Q

what is the formula for BP

A

Cardiac Output (CO) x Systemic Vascular Resistance (how much resistance/elasticity the blood vessels are)(SVR)

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11
Q

what is the formula for cardiac output

A

Heart rate x Stroke Volume (volume in the circulation)

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12
Q

what are the 2 mechanisms that control the response to changes in BP

A

short-duration and long-duration systems

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13
Q

what is the short- duration system for blood pressure regulation

A

Mediated through changes in HR and SVR (regulated blood pressure minute by minute)

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14
Q

what is the long duration system for blood pressure regulation

A

Acts primary via changes in blood volume and ↑ SV

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15
Q

where are the main areas to find baroreceptors

A

o Left Atrium
o Aortic arch
o Carotid sinus

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16
Q

what happens in the rapid-responding short duration system

A
  • increase parasympathetic stimulation of the heart
    o Decrease HR
  • decrease sympathetic stimulation of the heart
    o Decrease HR and SV
  • decrease sympathetic stimulation of the vasomotor center
    o vasodilation of the blood vessels
17
Q

what is the renin-angiotensin-aldosterone system

A

hormone system that regulates BP and fluid balance

Triggered by baroreceptors and by direct effects of hypotension on the kidneys

18
Q

what can activate the RAAS (renin-angiotensin-aldosterone system)

A

o Profound vasoconstriction
o Water and sodium retention
o ↑ thirst
o Net result = expansion of blood volume to maintain BP

19
Q

what patients might we do for BP measurement

A 
	All hospitalized patients – baseline data
	Geriatric patients
	Patients receiving cardiac meds
	ICU patients
	Peri and post-op monitoring
	Trauma
	Renal failure
	Hypertension/hypotension
20
Q

what is direct BP measurement

A

 Arterial catheterization (dorsopedal or femoral artery)
 Connected to a pressure transducer →convert mechanical fluctuations in the fluid into an electrical signal
 Continuous measurement of BP

21
Q

what is indirect BP measurement

A

 Less expensive, less time consuming and less technically demanding
 Detect blood flow under or past a pressurized cuff
 2 most popular systems:
o Doppler Sphygmomanometric method
o Oscillometric System

22
Q

what is the doppler system

A

 “Korotkoff” sounds are inaudible in veterinary patients
 Piezoelectric crystal on a peripheral artery to determine flow throughout that artery
 A BP cuff is placed proximal to the probe and connected to a syphgmomanometer
 Inflate cuff until artery is fully occluded → loss of sound
 Reduce cuff pressure slowly until the sound returns → SAP in dogs and ~ MAP in cats

23
Q

why might you not hear anything for the doppler system

A 
	Weakly/absent audible signals:
o	Insufficient coupling gel
o	Hair interference
o	Crystal placement
o	Hypothermia
o	Vasoconstriction
	Inability to determine DAP and MAP(dogs)
24
Q

what is the Oscillometric System

A

 Detects oscillation produced by changes in artery wall diameter during blood flow
 Inflating the cuff collapses the artery
 As the cuff is deflated, Amplitude of oscillation:
o Increases at SAP
o Reaches a maximum at MAP
o Decreases at DAP

25
Q

where is the site for cuff placements

A

o Forelimbs and Hindlimbs, proximal to carpus/tarsus

o Tail

26
Q

what happens if the cuff is too big

A

o False low BP

o Wide cuff spreads pressure over a larger area, delaying return of the distal pulse

27
Q

what happens if the cuff is too small

A

o Falsely high BP

o Insufficient pressure and allow early return of the pulse

28
Q

what is the correct cuff width for dogs and cats

A

o 40% of limb circumference for dogs

o 30% of limb circumference for cats

29
Q

what is the BP range for dogs (SAP?DAP?MAP?)

A

o SAP: 90-140
o DAP: 50-80
o MAP: 60-100

30
Q

what is the BP range for cats (SAP?DAP?MAP?)

A

o SAP: 80-140
o DAP: 55-75
o MAP: 60-100

31
Q

what is the in general BP range

A

o SAP of 120
o DAP of 80
o MAP of 90

32
Q

what is the central venous pressure

A

 Hydrostatic pressure in the intrathoraxic vena cava – approx = right ventricular pressure
 Changes in blood volume → pressure changes in vena cava
 Estimate right ventricular end-diastolic volume capacity
 Estimate the cardiac function

33
Q

what are the indications of central venous pressure

A

◦ Monitoring fluid therapy for hypovolemic patients

◦ At risk of volume overload

34
Q

if you have a low CVP what does it mean

A

less than 0 cmH2O

◦ Hypovolemia (↓ SV), vasodilation

35
Q

when do you not want to place a central line in an animal

A

 Coagulopathies
 Thromboembolic disease - Hyperadrenocorticism (cushing disease – prone to developing micro clots), Immune-mediated disease
 Intracranial disease - Head trauma, Seizures

36
Q

if you have a high CVP what does it mean

A

(Greater than 10cmH2O)
◦ Volume over load
◦ Right-sided heart failure
◦ Significant pleural effusion,
◦ Pericardial effusion (acculmation of fluid in the pericardial sac)
◦ Cardiac tamponade (a result of pericardial effusion)

37
Q

what is the normal range for central venous pressure

A

◦ 0-10cmH2O TRENDS

nursing vet tech (13 decks)

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