Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nic’s Exam Prep > Haemodynamic Monitoring > Flashcards

Haemodynamic Monitoring Flashcards

1
Q

Preload

A

Filling pressure in ventricles at end of diastole - the amount of blood volume in the ventricles at end of diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

After load

A

The pressure the ventricles produce to overcome the resistance to ejection. The resistance the ventricles must push against with systolic ejection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Medication to reduce preload

A

Diuretic
Vasodilator- GTN
Morphine - dilated venous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Medication to increase preload

A

Fluid for low flow or shocked states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Medications to reduce after load

A

ACE inhibitors-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Medications to increase after load

A

Need to constrict- vasopressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is contractility

A

Force of myocardial contraction - related to preload and after load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Positive inotrope to improve contractility

A

Dobutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Negative inoptrope to reduce contractility

A

Beta blockers- preserve myocardium oxygen consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indications for an artline

A

Labile BP (easily altered)
Compromised CO, tissue percussion or fluid volume status
Anticipation of haemodynamic instability
Titration of vasoactive drugs- inotrope support.
Frequent arterial blood sampling
Morbid obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common sites for an artline

A

Radial ( most common), femoral. Umbilical (neonates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indications for central venous pressure monitoring

A 
Monitor fluid status (CVP)
Administer lge volumes of fluids
Administer drugs and irritant drugs, TPN
Long  terms access
Difficulty obtaining other access
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Major sites for Central lines

A

Femoral, external jugular, internal jugular, subclavian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a normal CVP

A

0-8 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes for raised CVP

A 
Volume overload
R) ventricular AMI
Cardiac failure 
Cardiac tamponade
Constrictive pericarditis 
Pulmonary HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cause for reduced CVP

A

Dehydration
Hypovolemic shock
Distributive shock states

17
Q

Diagrammatically express the central venous pressure wave form and relate to cardiac cycle

A

3 peaks
A wave - atrial contraction, correlates to PR interval
C wave - closure of the tricuspid valve, correlates to QRS complex
V wave - atrial filling - correlates to t-p interval
2 descents
X descent - atrial relaxation
Y descent - tricuspid valve reopens

18
Q

Metabolic acidosis

A

Decreased HCO3
Normal range 22-26mmol/L
Value indicates how much has been used in buffering acids in the blood

19
Q

Metabolic alkalosis

A

Elevated HCO3

Normal range 22-26 mmol/L

20
Q

Causes of respiratory acidosis

A 
CNS/ respiratory centre depression 
Hypo ventilation 
Lung disease 
Airway obstruction 
Neuromuscular interference
21
Q

Causes of metabolic acidosis

A 
Excessive loss HCO3 (diarrhoea, renal tubular acidosis)
Increased production of H+ (keto acidosis)
Ingestion toxins increase lactate production 
Altered cellular metabolism (lactic acidosis)
Renal failure (decreased excretion H+)
22
Q

Causes of respiratory alkalosis

A 
Hyperthyroidism 
Hypoxia, hypoxaemia
Hyperventilating/ CNS irritation 
Anxiety
Drugs - salicylates
Lung disorders
23
Q

Causes of metabolic alkalosis

A 
Mechanical ventilation 
Fever/sepsis
Cl- wasting diarrhoea 
Vomiting
Citrate in blood transfusions
NG suctioning
Liver failure
Over use antacids
Diuretics
24
Q

Why is an Allen’s test performed

A

Should be done prior to artline insertion.

To determine that there is sufficient collateral circulation to and from the ulnar artery of the limb

25
Q

Fast flush/ square wave test on artline

A

Squeeze the flush device we then get a quick upstroke that squares off at the top and goes back down. Should see 1-2 oscillations after the square is a good wave form

26
Q

Over damped wave form

A

No dicrotic notch, no oscillations after fast flush
“ getting rained on”
To correct: check for blood clots, blood in catheter, air bubbles
Use low compliance (rigid) short monitoring tubing
Check for kinks in line

27
Q

Underdamped wave form

“Falsely high systolic”

A

High peaks , Ringing, repeated oscillations
More than 2 oscillations are not normal.
Remove air bubbles, use lge bore, shorter tubing

28
Q

Complications of an art line

A

Embolus, ishcemia, infection

29
Q

Indication for a cvc

A

Provides an indication of right ventricular filling pressure to guide fluid administration

30
Q

Complications of CVC insertion

A

Pneumothorax, sepsis, arrhythmias

31
Q

What assessment needs to be performed to confirm placement of CVC prior to fluid administration

A

Chest X-ray

Nic’s Exam Prep (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions