Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CardioPulm Final Exam > CP Final: Ventricular Assist Device > Flashcards

CP Final: Ventricular Assist Device Flashcards

1
Q

What is a VAD?

A

a blood pump, that is a mechanical device that supports one or both ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the indications of a VAD?

A

advanced heart failure, NYHA functional class 4 or AHA D symptoms despite optimal medical therapy

peak VO2 less than 12 ml/kg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are heart failure treatments?

A
  1. lifestyle changes
  2. invasive interventions
  3. medical management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the goals of mechanical support?

A
  1. bridge to therapy
  2. destination therapy
  3. bridge to recovery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Bridge to transplant?

A

VAD is implanted to improve survival and quality of life while awaiting transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is destination therapy?

A

indefinite mechanical support b/c pt doesn’t want transplant or patient not a candidate for surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are reasons pt may not be eligible for transplant?

A

age, co-morbidity, size, immune sensitivity , neoplasm, social/financial support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is bridge to recovery?

A

temporary support, recovery is expected without need for transplant, can be weaned or removed

any type of acute incident: MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are physiological benefits of VAD?

A

increases CO, VO2 peak, reverse remodeling, improved survival, improved QOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Do patients with VAD still have heart failure?

A

Yes, max benefits won’t be achieved till 12 weeks post surgery

pts will improve AC and other aspects of training but then improvement will level off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How long will it take pt to realize where they are functionally?

A

4-6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the three different locations of a VAD?

A
  1. left ventricle- inflow: left ventricle apex, outflow: aorta
  2. right ventricle- inflow: RA or RV, outflow: pulm artery
  3. biventricular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are short term devices used for?

A

days to weeks, bridge to recovery, not designed for mobility, usually in ICU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are long term devices used for?

A

months to years, bridge to transplant + destination therapy, designed for mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do PT need to know?

A

someone on site needs to know:

  1. how to operate the device
  2. how to interpret data
  3. how to respond to alarms
  4. what to do in case of emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are differences in inpatient vs outpatient role of PT?

A

IN: you teach them about device

OUT: pt should know information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are considerations for CPR in pts with VAD?

A

no chest compressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Who are important team members involved with VAD?

A

VAD coordinator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is important to consider about the Driveline?

A

its percutaneous so watch for infection and delivers power and date to pump

20
Q

What are the two types of pump classifications?

A
  1. pulsatile

2. continuous flow

21
Q

What is pulsatile pump?

A

flow is produced by vacuum induced pressure changes creating periods of systole and diastole

pumping chambers consists of a mobile sac and diaphragm, valves prevent backflow

22
Q

What do pulsatile VAD’s have their own?

A
  1. rate (bpm)- when you palpate pulse its bc of the device
  2. stroke volume (ml)
  3. volume output (L/min)
23
Q

If you have a LVAD what is true about hemodynamic measures?

A

HR via palplation (VAD) does NOT equal HR via ECG (native heart)

BP: as usual

24
Q

What are the two types of VAD rates with pulsatile pump?

A
  1. fixed- set by medical team

2. variable- pump chamber fills to capacity before emptying

25
Q

What is fixed?

A

stroke volume variable, chamber empties regardless of SV

26
Q

What is variable?

A

SV is fixed, CO dept on preload, allows for variability with rest and exercise however its not that common

27
Q

What is a continuous flow pump?

A

axial flow or centrifugal flow, pump flow follows native cardiac pulse

no valves

28
Q

How are HD measured in continuous pumps?

A

HR- telemetry, auscultation- don’t need it if stable

BP: MAP is most relevant, doppler + sphyg

29
Q

What is MAP?

A

mean arterial pressure- average blood pressure in the system at any given time

MAP over 60 mmHG needed

MAP under 60 mmHG is RED flag, unless a known baseline and is well tolerated by pt

30
Q

What is MAP equation?

A

MAP= SBP + 2 (DBP)/ 3

31
Q

What is flow with continuous VAD?

A

amount of blood moving through the device, usually an estimate so may not account for entire CO

32
Q

What is a yellow flag for VAD flow?

A

if the flow is lower than normal but watch for symptoms and suction event as that would be a red flag

33
Q

What is speed with continuous VAD?

A

set by surgical team, if changed between PT sessions watch for exercise tolerance changes

34
Q

What is pump power with continuous VAD?

A

amount of power then pump requires to maintain speed

major red flag if: sudden increase in power as it could be a blood clot

35
Q

What is pulse index/pulsatility with continuous VAD?

A

difference between max flow and min flow divided average flow

36
Q

What does a higher vs lower pulsatility mean?

A

higher: native heart doing more work- usually with exercise

lower- VAD doing most of work, very low is OTN

37
Q

What is a sucction event?

A

occurs only in continuous devices, LV drops below filling threshold, may cause VTach usually caused by hypovolemia, OTN usually during PT which is a red flag

38
Q

What are precautions with VAD?

A

same sternal precautions, avoid trauma to driveline, avoid moisture to all components

39
Q

How do you manage VAD post op?

A

wean inotrope meds, all pts go on anti coags, optimize fluid balance, physical rehab and pt education

40
Q

What are common post -op complications?

A

clots, bleeding, infection

41
Q

What are potential impairments specific to patient with LVAD?

A

arousal, pain, circulation, integument, muscle performance, gait, AC, ventilation

42
Q

Why are VAD at a fall risk?

A

lines and wires, cognition, alteration of COM

43
Q

How is ventilation affected with VAD pts?

A

dyspnea may be a primary impairment due to limited diaphragm excursion, as well as post-op atelectasis, pulm edema

44
Q

What types of rhythms could affect pts on VAD?

A

a fib, v tach

pts not be symtomatic of VT, VF or asystole if on a bivad this is still a red flag but may not threaten life—lay pt flat and assess HD and call EMS/VAD coordinator

45
Q

What can a Heart Mate 2 tell you?

A

flow, pump speed, pulse index, pump power

suction can be detected only if connected to monitor

CardioPulm Final Exam (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions