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Adult III > Exam 1- Hemodynamics & Electrical therapies > Flashcards

Exam 1- Hemodynamics & Electrical therapies Flashcards

1
Q

Preload

A

Circulatory effects before blood reaches the heart

VOLUME, VOLUME, VOLUME

Measured by PA pressure

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2
Q

How is the preload measured

A

By Pulmonary artery (PA) pressure

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3
Q

Contractility

A

Cardiac muscle’s capacity to contract

“Stretch”

Contractility looks at Ejection Fraction and Cardiac Output

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4
Q

Afterload

A

Circulatory effects as blood leaves the hear; resistance or pressure that the ventricle must overcome to eject volume

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5
Q

How is afterload measured

A

Measured by BP

-Mean arterial pressure is another measure

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6
Q

To decrease afterload

A
  • Vasodilators
  • ACE Inhibitors
  • CCB
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7
Q

To Increase afterload

A
  • Vasoconstrictors

- Dopamine

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8
Q

To decrease contractility

A

Decrease preload
Electrolyte imbalance
IABP
Beta blockers

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9
Q

To increase contractility

A

Increase preload
Give inotropic drugs
VAD (ventricular assist device)

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10
Q

To increase preload

A

Fluids
Volume expanders
Vasoconstrictors
Blood products

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11
Q

To decrease preload

A

Diuretics

Vasodilators

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12
Q

Normal cardiac output

A

2 to 2.4

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13
Q

Two major uses for an arterial line

A

Blood pressure monitoring

ABG sampling labs

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14
Q

What does SVO2 reflect

A

Tissue oxygen consumption

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15
Q

T/F Vasoactive drugs should be administered through an arterial line?

A

False

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16
Q

Why is an allen’s test performed?

A

Before you place arterial line

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17
Q

What assessments are done by the nurse post arterial line insertion?

A

.

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18
Q

Failure to capture

A

.

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19
Q

Cardiac output

A

Amount of blood pumped into the heart per minute

CO =HR X SV

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20
Q

What is used to evaluate fluid status

A

Central venous pressure (CVP)

21
Q

Which line carries substantial risk of an air embolism?

A

Arterial line

22
Q

Nitroglycerine is a

A

vasodilator

23
Q

Where is the phlebostatic axis? Where is it in reference to the body?

A

4th ICS, midaxillary line

Level of right atrium

24
Q

Where is the transducer leveled to

A

Phlebostatic axis

-re-level each time pt moves

25
Q

Zero referencing

A

Is the act of standardizing the transducer to obtain accurate measurements

Performed:

  • on insertion
  • q4hrs
  • or with position change
26
Q

Arterial pressure monitoring

A

-Accurate, direct, INVASIVE

27
Q

ABP Waveforms

A

should correspond to the ekg waveforms

28
Q

Highest risk of complication for all lines

A

Infection

29
Q

CVP measures

A

volume returning to the heart

30
Q

CVP looks at (indications for cvp)

A

FLUID BALANCE

  • fluid administration
  • blood sampling
31
Q

Causes of Increased CVP

A

Fluids
Hypervolemic
Pulmonary HTN
Increased ITP (intrathoracic pressure)

32
Q

What is the preferred Arterial line site

A

Radial

33
Q

PAP measures

A

Pulmonary artery pressure

-pressure of blood volume in the lung circulation

34
Q

Indication for PAP

A
  • Evaluate cardiac output, fluid volume*

- Aid in dx, monitor effect of interventions

35
Q

Natural Pacemaker

A

SA node

36
Q

Pacing threshold

A

amount of energy the output pulse needs to reliably capture the heart (or cause it to contract)

37
Q

Pace

A

Capturing the hearts electrical impulse

38
Q

Sense

A

“Seeing” the heart’s own intrinsic rhythm (periscope). The pacer decides if it inhibits or triggers an impulse.

39
Q

Failure to capture (non capture)

A

pacer does not stimulate heart

40
Q

Failure to pace

A

lack of pacer stimulus when intrinsic rate < pacer rate

41
Q

Reasons to pace

A
  • Symptomatic bradycardia
  • Uncontrolled tachycardia
  • Failure of the SA node
  • Post op diagnostics
42
Q

Symptomatic Bradycardia “crap”

A 
Weakness
Fatigue
Syncope/Pre-Syncope
Mental confusion
Palpations
Shortness of Breath
Exercise intolerance
43
Q

Fixed pacemaker

A

Set at a rate, no change

44
Q

Demand pacemaker

A

Fires when needed if heart rate falls below threshold

45
Q

Single chamber pacemaker

A

RA or RV

46
Q

Dual chamber pacemaker

A

Both RV & RA

47
Q

Defibrillation

A

UNSYNCHRONIZED

-Done with pulseless VT and VF

48
Q

Cardioversion

A

SYNCHRONIZED

-Used for unstable VT, pulse present unstable PSVT, Afib, Aflutter

Adult III (14 decks)

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