EXAM 2 Reading (N.Ch17) Flashcards
2 associated with a loss of “a wave” on a CVP waveform?
atrial fibrillation
Ventricular pacing
Which of the following in an overestimation of the actual BP?
Placing a BP cuff on an extremity below the level of the heart.
You are inserting a pulmonary artery catheter via the right internal jugular vein. At what distance would you expect to reach the right atrium?
15-25cm
The distances from the right internal jugular vein to the cardiac and pulmonary structures are as follows: pulmonary artery:
35-45 cm,
distances from the right internal jugular vein to the right ventricle:
25-35cm
Distance to pulmonary artery wedge position:
40-50 cm
When the balloon of a PA catheter is not inflated, what pressures are reflected during diastole?
pulmonary artery diastolic pressure
Transduced during systole
Right ventricular systolic pressure
Transduced during diastole.
PA diastolic pressure
The PA diastolic pressure is also a representation of
left atrial (LA) pressure
What does the y descent on a central venous pressure waveform represent?
Opening of the tricuspid valve
The x descent follows the a wave and represents the
relaxation of the atria.
The x1 descent occurs as a result of the
downward pull of the ventricular septum during systole.
The y descent represents the
opening of the tricuspid valve.
Which of the following are associated with an increased central venous pressure reading? (select two)
Pulmonary hypertension
Heart failure
Mechanical ventilation, PEEP on CVP
Increase
Tension pneumothorax, and pulmonary embolism on CVP
Increase
Chronic LV failure on CVP
Increase
Tricuspid stenosis and TR on CVP
increase
How will an arterial pressure transducer that is placed below the level of the heart affect the estimate of the actual blood pressure?
Overestimates
What factors result in decreased mixed venous oxygen (SVO2) measurements? (select three)
Shivering
Decreased CO
Hemorrhage
Factors that result in an increased SVO2 include:
Cyanide toxicity,
Hypothermia.
A wedged pulmonary artery
catheter
Left-to-right shunts,
SepsisFactors that result in a decreased SVO2 include:
hyperthermia
shivering,
hemorrhage,
decreased cardiac output, and a decrease in the pulmonary transport of oxygen.
Which of the following would you expect to produce a large V wave on a CVP waveform?
Tricuspid regurgitation, mitral regurgitation, or a sudden, dramatic increase in intravascular volume
Which of the following are associated with cannon ‘a’ waves on the central venous pressure waveform? (select two)
Diatolic dysfunction
Compleve AV block
Tricuspid and mitral stenosis will show on CVP
Cannon a waves.
When calculating the mean arterial pressure, the diastolic pressure is doubled
because diastole accounts for two-thirds of the cardiac cycle duration
TEE: Complete absence of wall motion is
Akinesia
TEE; Decreased wall motion is
HYPOKINESIA
TEE: Paradoxical wall motion
Dyskinesia
What is the hallmark of myocardial infarction with ventricular aneurysm?
Dyskinesia (paradoxical motion)
When the balloon of a pulmonary artery catheter is inflated, what pressure can be obtained indirectly during ventricular systole?
left atrial filling pressure
The most significant expected alteration from a cracked stopcock in an arterial pressure monitoring system would be
acute blood loss
Potential complications due to intra-arterial monitoring include:
acute blood loss from a leak or crack in the transducer system, thrombosis, vasospasm, infection, hematoma, nerve damage, and loss of digits.
Which of the following would result in an underestimation of the aortic pressure? (select two)
Radial artery monitoring during hypothermic cardiopulmonary bypass
Air in the transducer tubin g
Hypothermic conditions reduce the vascular resistance in the hand compared to the aorta, and the radial arterial line will
underestimate the aortic pressure.
Placing a blood pressure cuff that is too loose, too small, or positioned below the level of the heart will result in a blood pressure that
overestimates the actual blood pressure.
The presence of air in the transducer tubing and the addition of stopcocks and longer tubing can
decrease the frequency of the monitoring system and lead to overdamping which will tend to underestimate the systolic blood pressure.
The degree of ST elevation or depression on an ECG is measured between the isoelectric line and the
J point
ATrial repolarization occur at
S
Isoelectric line after t wave is
Ventricular repolarization complete.
T wave is the
Ventricular repolarization is beginning
QT interval indicates
Ventricular depolarization is complete.
End of QRS complex at the last downward deflection is
Ventricular depolarization begins
Atria are repolarizing
PR interval is
Atrial depolarization is complete.
P wave is
Atrial depolarization begins
