CVP & Art Flashcards
What are the indications for CVP catheters?
Give Fluids, drugs, blood, TPN
Monitor fluid status
Blood Sampling
T or F: CVP lines can read how much pressure and where the pressure is located
False: CVP lines only can read pressures, not where the pressures are located
T or F: CVP lines cannot differentiate between rt & left heart or lung problems
True
Right Arterial pressure reflects: 1. Right Vent end diastolic pressure 2. Left arterial pressure 3. When tricuspid valve open 4. When pulmonary sl valve open A. 1, 2, 3 B. 1, 2 C. 1, 3 D. 1, 2, 4
C: Rt arterial pressure reflects rt ventricular end diastolic pressure when tricuspid valve open
Name 5 locations where CVP lines can be inserted
Right internal Jugular Vein Subclavian Brachial Medial Basilic Lateral Cephalic
What waves are created and what do they correspond to on ECG?
A-wave = P-R C-wave = QRS V-wave = T wave
Central Venous pressure catheters can provide an indication for A. Left ventricle afterload B. Right heart preload C. Left heart preload D. Right ventricle afterload
B. Right heart preload
What are complications of CVP: 7
Infection Thromboembolism Thromboplebitis Vasal damage at insertion Bleeding Hemo/pneumothorax Air embolism
What 4 pieces of equipment are needed:
3 way stopcock
IV solution
3 port cvp catheter
Transducer of water manometer
What is a normal CVP pressure?
2-6 mmHg
Name 5 causes when a CVP may be less than 2 mmHg
Hypovolemia Vasodilation by drugs or increase in temp Spontaneous inspiration Transducer below right atrium Air bubbles or leaks
Causes of high CVP include (10 total)
Volume overload Infusion of blood/fluids Cardiac tamponade Rt heart failure Left heart failure Tricuspid stenosis/regurg Pulm valve stenosis Pulmonary embolism Pulm hypertension increased intra-thoracic pressure
What does CVP monitor?
right heart pressure
During systole a CVP is reading actual/inferred right atrial pressure, then it reads actual/inferred right ventricular pressure
Actual
Inferred
CVP reads right atrial pressure & reflects right ventricular pressure
What is the formula for SV?
SV = EDV - ESV
What is the formula for EF (ejection factor)
EF = SV/EDV x 100%
What is a main limitation of CVP?
Can’t tell you where problem in heart is
What is another name for CVP?
RA
T or F: If an increased pressure is measured it can be inferred that an increased volume is present
False: catheters are measuring pressures but this does not mean more volume
Name 4 indications for Arterial catheters
Arterial pressure in unstable patients: receiving vasoactive drugs, extremes in BP, or increased sV
Obtaining ABG
Determining CMO
May include gas analyzers
What are sites of insertion for Art Catheters?
Radial Axillary Brachial Dorsalis pedis Femoral (if BP low or clotting in radial)
What is most common site of insertion of Art Catheters?
Radial
What are 6 complications of arterial catheters
Arteritis Bleeding Clot Emboli Infection Air emboli Ischemia & necrosis
What equipment is needed for arterial catheters?
Arterial Line Kit Heparinized IV solution Leur Lock Transducer Recorder/monitor
What is the formula for MAP?
map = systolic + (diastolic x 2)/3
How can you find pulse pressure?
Systolic press - diastolic pressure
What causes the dicrotic notch to form on arterial pressure waveform?
produced by aortic valve closing
What happens to your waveform when diastole progresses?
Pressure falls to lowest level
What is the normal diastolic pressure?
60-90 mmhg
What is your normal systolic pressure?
120 mmHg
What causes decrease in pressure in art catheter?
hypovolemia: fluid blood loss, cardiac failure, cardiac failure, vasodilation
aortic stenosis
arrhythmias
What causes increase in art pressure?
Increased volumes vasoconstriction drugs that cause vasoconstriction arteriosclerosis aortic insufficiency
Pulse pressure is a measurement of A. Blood pressure B. Gross estimate of CMO C. SV D. Compliance E. Arterial Resistance
B, C, D, E
What might cause an increase in systolic pressure? 1. Increase in SV 2. Decreased in compliance 3. Increase in compliance 4. Decrease in SV A. 1, 2, 4 B. 1, 2 C. 3, 4 D. 1 only
B. increase in SV, decrease in compliance can cause increase in systolic pressure
What is a normal MAP range
80mmHg
70-110 mmHG
What does MAP indicate if normal?
Good indicator of tissue perfusion
If your MAP is less than ______ it means vital organs not being perfused
60
What causes a reading in cuff pressure?
Vibrations of arterial wall
When you have an increased arterial contraction it causes an increase/decrease in diastolic runoff;
decrease in diastolic runoff and decrease in pressure gradient
Cuff pressure is
A. higher than arterial pressure by 5-20 mmHg
B. lower than arterial pressure by 5-20 mmHg
C. Falsely low by 25 mmHG
D. Falsely high by approx. 25 mmHg
B. Cuff pressure is 5-20 mmhg lower than arterial pressure
Which is higher: arterial pressure or cuff pressure?
Arterial pressure is higher
Hemodynamic monitoring is defined as?
A. Physical characteristic of blood flow
B. Physical characteristic of blood perfusion
C. Both airway and blood flows
D. Invasive monitoring of blood vessels
A. physical characteristic of blood flow
The majority of blood flow at 2/3 of total takes place where? A. Arteries B. Aorta C. Veins D. Pulmonary vasculature
C. 2/3 of blood volume is in venous system
Which system allows for assessment of right heart, lungs & left heart
A. CVP
B. PAC
C. Arterial Catheter
B. PAC
T or F: An arterial catheter is directed into pulmonary artery by a balloon tip
False; Swanz Ganz or PAC goes into pulmonary artery
T or F: The SV of left heart should match SV of right heart
True; if not & varies by 0.1 ml will cause pulmonary edema
Indications for PAC include:
Right heart function
Pulmonary function
Left heart function
If I needed to determine the CMO of a patient which catheter would you use?
A. CVP
B. Art Catheter
C. All of the above
Arterial Catheter will allow you to measure CMO
If I need to give TPN which type of catheter would you use
A. CVP
B. Art Catheter
C. All of the above
A. CVP
This type of catheter often includes gas analyzers?
A. CVP
B. Art Catheter
C. All of the above
B. Arterial Catheter
This type of catheter will allow you to obtain blood samples?
A. CVP
B. Art Catheter
C. All of the above
C. All of the above
Complications can include Arteritis, clot emboli, air emboli, ischemia, or necrosis
A. CVP
B. Art Catheter
C. All of the Above
B. Art Catheter
An indication for this includes to monitor fluid status?
A. CVP
B. Art Catheter
C. All of the above
A. CVP
Locations for insertion include RIJ, subclavian, medial basilica, lateral cephalic
A. CVP
B. Art Catheter
C. All of the above
A. CVP
This type of catheter can be inserted in the dorsalis pedis, axillary, radial, brachial, and femoral?
A. CVP
B. Art Catheter
C. All of the above
B. Art Catheter
Complications can include hemo/pneumothorax, air embolism, thromboembolism, thrombophlebitis?
A. CVP
B. Art Catheter
C. All of the above
A. CVP
This can measure pulse pressure?
A. CVP
B. Art Catheter
C. All of the above
B. Art Catheters
This measures right heart pressure?
A. CVP
B. Art Catheter
C. All of the above
A. CVP
Hypovolemia can cause a decrease in pressure in?
A. CVP
B. Art Catheter
C. All of the above
C. All of the above
Arrhythmias, & aortic stenosis can cause a decrease in evaluation of pressure in?
A. CVP
B. Art Catheter
C. All of the above
B. Arterial Catheter
Arteriosclerosis may cause an increase in pressure in
A. CVP
B. Art Catheter
C. All of the above
B. Art catheters
Cardiac tamponade may cause high pressure in
A. CVP
B. Art Catheters
C. All of the above
A. CVP
Pulmonary hypertension & pulmonary hypertension may cause an increase in
A. CVP
B. Art Catheters
C. All of the above
A. CVP
Increased intra thoracic pressure would cause an increased pressure in
A. CVP
B. Art Catheters
C. All of the above
A. CVP
Infusion of blood/fluids may cause an increase in pressure in
A. CVP
B. Art Catheters
C. All of the above
A. CVP
A gross estimate of CO is a result of? A. Stroke volume B. Arterial Compliance C. Arterial Resistance D. All of the above
D. all of the above
What value is a good indicator of tissue perfusion?
MAP
Vasodilation will cause a low pressure reading in?
A. CVP
B. Art Catheters
C. All of the above
A. CVP
When the tricuspid valve opens at end of diastole then pressure measured in right atrium is? A. Left atrial pressure B. Left Ventricular pressure C. Pulmonary artery pressure D. Right Ventricular pressure
D. RVP
Pressure measurements are often done during A. Inhale B. Exhale C. Both D. does not matter
B. exhale
In a CVP pressure readings of right atrium are direct reading, is right ventricle pressure actual?
A. Yes
B. No, it is not available
C. No, it is reflective
C. right vent pressure is reflected
Why can a CVP cannot tell you what is happening ahead in the lungs?
because the valves are never all open at same time
T or F: CVP can often cause heart valve complications
False, CVP is not placed in the heart so would not cause valve complications
If you have spontaneous inspiration it can cause a low pressure reading in?
A. CVP
B. Arterial lines
C. All of the above
A. CVP
What is a normal pressure reading for the right atrium?
2-6 mmHg
What is a normal reading for the right ventricle?
20-30 mmHg in systole
0-5 in diastole
What is a normal reading for pulmonary artery?
20-30 mmHg
6-15 mmHg in diastole
What is a normal pulmonary capillary wedge pressure?
4-12 mmHg
What is a normal diameter of the PAC? A. 110 cm B. 4-8 F C. 2-6 cm D. 60 cm
B. 4-8 french
What is normal length of PAC? A. 110 cm B. 4-8 F C. 2-6 cm D. 60 cm
A. 110
When looking at a PAC the following colors represent certain parts, name them
Yellow = ?
Red = ?
Blue = ?
Yellow is Distal port
Red is Port to balloon
Blue is Proximal
What part measures venous saturation?
O2 Saturation
This measures blood temperature for CMO?
Thermistor
Where can a PAC be inserted? name 5
Internal jugular subclavian basilica cephalic femoral
The following catheters can be inserted into the internal jugular? A. CVP B. Art Catheter C. PAC D. All of the above E. A & B F. B & C G. A & C
G. A & C; both cvp & PAC can be inserted into IJ
T or F: A common site to insert the CVP is the femoral site?
False, RIJ, Subclavian, Brachial, Medial basilica, lateral cephalic are common locations of insertion for CVP
What is a site the PAC can be inserted that CVP cannot?
Femoral
What is a site of insertion for CVP but not PAC?
Brachial
When inserting a catheter, which can be inserted in the dorsalis pedis? A. CVP B. PAC C. Art line D. All of the above
C. arterial line
If someone develops a clot emboli they probably have which type of catheter A. CVP B. PAC C. Art line D. All of the above
C. Arterial lines
The anacrotic limb is seen on a waveform of? A. CVP B. PAC C. Art line D. All fo the above
C. Art line
What causes the highest pressure in the pulmonary artery during systolic pressure?
A. Rt Ventricular SV
B. Rate of blood ejection from rt ventricle
C. Blood ejection in the left ventricle to systemic circulation
D. Elasticity
E. Resistance
F. A, B, C
G. A, B, D
H. All of the above
G. A, B D
highest pressure in ventricular caused by rt vent stroke volume, rate of blood ejection from rt ventricle, elasticity of pulm arterial tree
Where should a transducer be placed? A. Elevated above head B. Below the chest C. at midchest D. any would beok
C. midchest
For every inch the transducer is placed above midchest will cause vascular or intra cardiac pressure to be ______ less than actual.
2 mmHg less if transducer above chest
If transducer is set below patient chest its readings will be
A. falsely high
B. Falsely low
C. accurate within acceptable range
D. dependant upon resistance in vascular system
A. falsely high reading
By setting the transducer at midchest it prevents effects of \_\_\_\_\_\_\_ pressure. A. MAP B. actual C. plateau D. hydrostatic
D. hydrostatic pressure
If transducer is set too high what happens to your pressure reading? A. Falsely high B. Falsely low C. no change in pressure D. MAP decreases
B. Falsely low
This catheter only reads whether pressure high but unable to identify the source A. CVP B. Art C. PAC D. All of the above
A. CVP
If I need to measure the left heart pressures which should I use? A. CVP B. ART C. PAC D. Any of the above
C. PAC
A pneumothorax is complication of which procedure A. CVP B. ART C. PAC D. All of the above
A. CVP
This type of catheter uses transducer of water manometer A. CVP B. ART C. PAC D. all of the above
A. CVP
With this type of catheter you will probably not have heart related effects? A. CVP B. Art line C. PAC D. A & C
B. Arterial lines are inserted in radial, axillary, brachial dorsalis pedis, femoral, not in heart veins
If you are hypovolemic you probably have a A. increase in fluid B. increase in blood loss C. decreased fluid D. Aortic stenosis
C. decrease in food
What do drugs that cause vasoconstriction due to your pressure?
A. increase
B. decrease
C. no change
A. increased pressure
If you have aortic insufficiency what does this do to pressure and which catheter would you see? A. Pressure increases B. Pressure decreases C. CVP D. PAC E. Art F. A & C G. B & E
G. Increased pressure found with Art line
Arteritis is a complication of A. CVP B. PAC C. Art D. A, B
C. Art
If a patient receives vasopressors which catheter may be used?
A. Art Catheters
B. CVP
C. PAC
A Art catheters
What would rt or left heart failure due to your pressure readings on your CVP?
A. Increase
B. Decrease
C. No change
A. increase
When the tricuspid valve opens at end of ventricular diastole and atrial systole the pressure measured in rt atrium is A. Rt atrial pressure B. Left atrial pressure C. Rt ventricular pressure D. Left ventricular pressure
C. rt vent pressure or RVP
If you have a faulty tricuspid vale that causes regurg what catheter would you be using to see this? A. CVP B. Art line C. PAC D. Any would catch this
A. CVP
