Central Line and CVP

Question 0

CVP is not a reliable indicator of

Answer 0

Left ventricular performance

It is a reflection of right atrium pressure, which reflects changes in right ventricular end diastolic pressure

Question 1

Central venous pressure is anatomically defined as the blood pressure in the

Answer 1

Vena cava at the junction with the right atrium

Question 2

T or F. If left side preload decreases, CVP will decrease

Answer 2

False. Right side preload

Question 3

Insertion sites for CVP

Answer 3

Internal jugular (left or right)
Subclavian
Femoral
Brachial

Question 4

How does one identify between a vein and artery using ultrasound?

Answer 4

The artery will be the one that does not collapse when pressure is applied (obliteration)

Question 5

What factors can affect the value of CVP?

Answer 5

Cardiac performance
Blood volume
Vascular tone
Increased intraabdominal or intrathoracic pressures
Vasopressor therapy

Question 6

The A wave (atrial contraction) occurs right after

Answer 6

P wave on EKG

Question 7

The A wave is increased by

Answer 7

Tricuspid stenosis
RVH
Pulm stenosis
Pulm HTN
Giant A waves cannon

Question 8

The C wave is caused by the elevation of _________ into the right atrium during early ventricular/systolic contraction

Answer 8

Tricuspid valve

Question 9

The C wave corresponds to what part of the EKG?

Answer 9

The end of QRS

Question 10

Atrial relaxation and downward displacement of the tricuspid valve during ventricular systole is represented by

Answer 10

The X descent

Question 11

What part of the EKG correlates to the X descent?

Answer 11

Before the T wave

Question 12

Caused by pressure produced when the blood filling the right atrium hits against a closed tricuspid valve

Answer 12

The V wave

Question 13

The V wave corresponds to what part of the EKG?

Answer 13

The end of the T wave

Question 14

During tricuspid regurgitation, this wave will be very prominent

Answer 14

V

Question 15

The Y descent is produced by blood flowing into

Answer 15

The right ventricle through an open tricuspid valve

Question 16

The y descent correlates with what part on an EKG?

Answer 16

Occurs before the P wave (prior to atrial contraction)

Question 17

Indications for CVP

Answer 17

Monitor preload, hypovolemia, shock, aspiration of air emboli, TPN, insertion of transcutaneous pacing leads, IV access in patients with poor peripheral veins, infusions of vasoactive meds

Question 18

Contraindications to CVP

Answer 18

Tumors in the right atrium
Severe coagulopathy
Ipsilateral carotid endarterectomy

Question 19

Complications of CVP placement

Answer 19

Pneumothorax, carotid artery puncture, he thorax from vascular puncture, air embolism, wire embolization, thrombosis, cardiac perforation, hematoma, cardiac tamponade, arrhythmias, hydrothorax, chylothorax, infection

Question 20

What are normal CVP values… According to the notes?

Answer 20

10-12 mmHg