Critical Care Flashcards
What information does an arterial line give?
provides systolic, diastolic, and mean arterial pressure information (also allows for blood draw access)
t/f, an arterial line in the neck or radial artery limits a patient’s mobility
false, can have full mobility unless it is in the groin- which can limit it
What does MAP tell us and what range is not good?
reflects the tissue perfusion pressure (avg pressure tending to push blood through the circulatory system), less than 60 may indicate inadequate tissue perfusion
Which veins can a central line be inserted into and what information does it give us?
subclavian or jugular vein (femoral sometimes as well), allows for continuous monitoring of central venous pressure or right arterial pressure-> assesses cardiac function and intravascular fluid status
t/f, a PICC line is used instead of a central line when a pt requires prolonged stay
true, a PICC line is used instead and inserted into a peripheral vein and its tip ends up in the distal SUPERIOR VENA CAVA
a low central venous pressure (CVP) may indicate ____
hypovolemia/dehydration
Which catheter is being shown in the picture?
pulmonary artery catheter/ swan ganz catheter
Which catheter would give you the best information about the pressures of the heart atria and heart O2, resistance and pacing of atria and ventricles?
pulmonary artery catheter/swan ganz catheter
t/f, the pressure of the pulmonary veins, capillaries, and artery are equal to the pressure at the end of diastole
true, since the pulmonary venous system has no valves, LAP reflects value of LVEDP
What term describes the outflow or venous pressure for the pulmonary circulation?
pulmonary capillary wedge pressure (LAP)
pulmonary artery end diastolic pressure is essentially equal to the LVEDP which is normally LESS THAN ____ mmHg
12mmHg
What are some reasons we would measure pulmonary capillary wedge pressure?
assess severity of L ventricular fxn
assess mitral and aortic valve dysfxn
assess and treat pulmonary edema
assess pulmonary HTN
assess and treat hypovolemic state
in patients with brain injury, a high ICP correlates with low ___ ___ ____
cerebral perfusion pressure
What is the normal ICP for adults, children (based on this lecture slide)
adults: 0-10 mmHg
children under 5: 0-5 mmHg
t/f, you can mobilize a patient with an intraaortic balloon pump
false, mobility is contraindicated until it is removed (no hip flexion in leg with catheter as well)
What does an intraaortic balloon pump help improve?
helps improve blood flow to the myocardium
Which types of patients would be on ecmo (4)?
those with lungs that can’t provide enough oxygen to the body even when given extra oxygen
whose lungs can’t get rid of CO2 even with help from mechanical ventilator
heart can’t pump enough blood to the body
those waiting for organ transplant
What is the name of the heart pump used to maintain blood flow in babies and small children with serious heart failure?
Berlin Heart
What is one of the main side effects that affects up to 80% of mechanically ventilated ICU patients?
delirium
What are some of the warning signs for post-intensive care syndrome?
mm weakness or problems with balance
problems with thinking and memory
severe anxiety
depression
nightmares
What are three rehab interventions you can do in the ICU?
cognitive stimulation, in-bed cycling, early mobility
When should you stop early mobility in the ICU?
What are some PT keys to treatment in the acute care setting?
check the placement of all femoral catheters before and after treatment- includes all femoral arterial lines, venous lines, ECMO cannulas