hemodynamic

Question 1

volume of blood ejected by the heart in 1 minute into the systemic circuit

Answer 1

cardiac output

Question 2

how to measure cardiac index

Answer 2

CO/body surface area

Question 3

cardiac output vs. cardiac index

Answer 3

output doesn’t account for body size

Question 4

how to measure CO

Answer 4

SV x HR

Question 5

volume of blood ejected from L ventricle during systole

Answer 5

stroke volume

Question 6

normal stroke volume

Answer 6

60-100

Question 7

what 3 things affect stroke volume

Answer 7

preload
afterload
contractility

Question 8

what is right sided preload called

Answer 8

central venous pressure (CVP)

Question 9

amt of stretch on R ventricle before systole

Answer 9

R sided preload (CVP)

Question 10

symptoms of low R sided preload (CVP)

Answer 10

tachycardia
hypotension
dry,cool skin
poor turgor
dry membranes
changed LOC

Question 11

interventions for low right preload (CVP)

Answer 11

fluids (crystalloids, colloids, PRBCs)
modified trendelenburg

Question 12

s/sx of high right preload (CVP)

Answer 12

JVD
edema!!
hepatojugular reflux

Question 13

interventions for high right preload

Answer 13

dec. blood volume (diuretics)
vasodilators (nitrates)
semi/high fowlers

Question 14

amount of stretch on the L ventricle prior to systole

Answer 14

left sided preload (PCWP/wedge)

Question 15

another name for left sided preload

Answer 15

(PCWP/wedge)

Question 16

s/sx of low left preload

Answer 16

tachycardia
hypotension
dry/cool skin
poor turgor
dry membranes
changed LOC

Question 17

are s/sx of low L and R preload the same?

Answer 17

yes

Question 18

s/sx of high left preload

Answer 18

orthopnea
cough
dyspnea
S3
crackles

Question 19

treatment of low left preload

Answer 19

volume admin.
modified trendelenburg

Question 20

treatment of high left preload

Answer 20

diuretics
vasodilators
semi/high fowlers

Question 21

pressure that ventricle has to pump against to eject blood into circulation during systole

Answer 21

afterload

Question 22

what is another name for afterload

Answer 22

systemic vascular resistance (SVR)

Question 23

interventions for low afterlaod (SVR)

Answer 23

-vasopressors (norepi, phenylephrine, high dopamine, vasopressin)
-need to constrict vessels, check fluid status

Question 24

treatment for high afterload (SVR)

Answer 24

vasodilators (nitroprusside, CC blockers, ACE-Is, ARBs)
-they are too constricted, dont give with a low BP

Question 25

the inotropic action of the heart muscle during systole or the force of each ventricular contraction

Answer 25

contractility

Question 26

important hemodynamic parameters for contractility

Answer 26

CO, CI, EF (valve competence)

Question 27

s/sx of low contractility

Answer 27

dec. perfusion tachycardia cool, pale skin dec. urine altered mental status poor circulation & pulses

Question 28

treatment of low contractility

Answer 28

increase preload -> volume expansion + inotropes!! = dobutamine, dopamine, digoxin, milrinone)

Question 29

which line provides continuous BP monitoring and ABGs?

Answer 29

arterial line

Question 30

complications of arterial line?

Answer 30

infection, thrombosis, dislodgement, bleeding!!!!

Question 31

which line is used for CVP monitoring and fluid resusscitation?

Answer 31

central venous catheter (central line)

Question 32

which hemodynamic parameters can be seen from a central venous catheter?

Answer 32

CVP R ventricular preload

Question 33

which parameters does a PA catherter measure

Answer 33

all except BP -CVP (right preload) -PCWP (left preload) -SVR (afterload) -CO -temp

Question 34

what is used to obtain cardiac data to diagnose/evaluate heart disease, shock states, and med/surg conditions that affect cardiac output?

Answer 34

pulmonary artery cath (PA cath)

Question 35

what complication can come from insertion of a PA catheter

Answer 35

ventricular dysrhythmias!

Question 36

describe path of PA cath insertion

Answer 36

vein of insertion -> vena cava -> right atrium -> tricuspid -> right ventricle -> pulmonic valve -> pulmonary artery

Question 37

describe relationionship between CO/CI, RAAS, kidney perfusion

Answer 37

low output and low BPs have bad flow, actovates RAAS and sympathetic system to compensate, epi/norepi release, cause vasoconstriction which increases SVR and HR but kidneys hold on to salt/water

Question 37

what is important to remember about obtaining accurate readings from a PA catheter?

Answer 37

the transducer needs to be at the phlebostatic axis while taking measurements