Chapter 9 - Hemodynamic Monitoring Flashcards
Arteries
Away from ♡
Capillaries
Exchange vessels
Veins
To the ♡
Cardiac Output
CO =HR x SV
SV
Preload - before contraction
Afterload - resistance ventricles must over come
Contractibility
HR
ANS , Catecholamine release, electrolytes, temperature, electrolytes,
Hemodynamic Monitoring Modalities
Noninvasive - Noninvasive BP, Jugular Venous Pressure, Lactate
Invasive - Catheter, High pressure noncompliant tubing, transducer w stop clock, pressureized flush, bed side monitoring
Noninvasive BP
Routine, manually, automatic
Jugular Venous Pressure
Jugukar vein distention occurs when CVP is elevated
CVP elevation can be caused by
fluid overload, r ventricular dysfunction, superior vena cava obstruction, and r ♡ failure
Lactate
Normal arterial - .3-.8
venous - .6-2.2
Hemodynamic monitoring keep HOB
flat or 30 degrees
Leveling Air Fluid Interface
Position the zeroing stopclock of the trasducer system at level of atria for accurate reading
Zero referencing
The effects of atmospheric pressure on the fluid filled hemodynamic monitoring system must be negated for accurate measurements
Dynamic Response Testing
Fluid filled monitoring systems rely on the abiloty of transducer to translate vascular system pressure into waveforms/ numerical data
Preventing Infection
Sterile
Chlorahexadine
Optimal site
Complications
Infection Embolism Thrombosis
Arterial Pressure Monitoring
Used for patients at risk for compromised tissue perfusion
R Atrial Pressure/ central Venous Pressure
Critically ill patients, used to estimate central venous blood volume and R ♡ function
Pulmonary Artery Pressure Monitoring
Used oto diagnose and manage a variety of conditions in critically ill patients
Cardiac Output Monitoring
Amount of blood ejected by the ♡
Controversy surrounding the pulmonary artery catheter
Use of PAC suggests increased mortality
Balancing Oxygen Delivery abd Oxygen Demand
The primary goal in caring for critically ill is to determine whether oxygen delivery is meeting the ocygen and metabolic demands of pt
Stroke Volume Optimization
SV assessment is most accurate