Fundamentals of Hemodynamic Monitoring

Question 1

What are 3 complications of hemodynamic monitoring?

Answer 1

• device complication (e.g. infection)
• misapplication of accurate data
• application of inaccurate data

Question 2

What are 2 common limitations of pulse oximetry?

Answer 2

• artifact (e.g. patient movement)

- poor waveform

Question 3

SBP and DBP is less reliable than ____ for arterial pressure monitoring.

Answer 3

MAP

*MAP is reliable with NIBP measurement

Question 4

Automated NIBP devices are based on _______.

Answer 4

oscillometry

Question 5

In automated NIBP devices, values of SBP/DBP are derived from proprietary formulas that examine what?

Answer 5

the rate of change of the pressure pulsations

Question 6

Relative to a patient’s body, at what level do you want the arterial pressure transducer at?

Answer 6

at the level of RA at phlebostatic axis

Question 7

What stretches the myocytes and allows increased contractile force? (preload)

Answer 7

end diastolic volume

EDV determines stroke volume = Frank-Starling curve

Question 8

What are the 3 waves that are in the central venous pressure waveform?

Answer 8

A, C, V

Question 9

Where does the catheter go to measure ScVO2?

Answer 9

cavoatrial junction

Question 10

Where does the catheter go to measure SVO2?

Answer 10

pulmonary artery

Question 11

What are the typical hemodynamic pressures in the following locations:

a. right atrium
b. right ventricle
c. pulmonary artery
d. left atrium
e. left ventricle
f. aorta

Answer 11

a. right atrium = 5/0
b. right ventricle = 25/5
c. pulmonary artery = 25/10
d. left atrium = 10/5
e. left ventricle = 100/10
f. aorta = 100/70

Question 12

What would be a sign of hypovolemia on echocardiogram?

Answer 12

systemic BP falls by >10 mmHg during spontaneous inspiration

*there is an opposite response when patient is on a ventilator

Question 13

How do you calculate MAP?

Answer 13

MAP = [ SBP + (2 x DBP) ]/3