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critical care > hemodynamic > Flashcards

hemodynamic Flashcards

1
Q

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

A

cardiac output

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2
Q

how to measure cardiac index

A

CO/body surface area

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3
Q

cardiac output vs. cardiac index

A

output doesn’t account for body size

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4
Q

how to measure CO

A

SV x HR

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5
Q

volume of blood ejected from L ventricle during systole

A

stroke volume

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6
Q

normal stroke volume

A

60-100

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7
Q

what 3 things affect stroke volume

A

preload
afterload
contractility

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8
Q

what is right sided preload called

A

central venous pressure (CVP)

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9
Q

amt of stretch on R ventricle before systole

A

R sided preload (CVP)

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10
Q

symptoms of low R sided preload (CVP)

A

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

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11
Q

interventions for low right preload (CVP)

A

fluids (crystalloids, colloids, PRBCs)
modified trendelenburg

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12
Q

s/sx of high right preload (CVP)

A

JVD
edema!!
hepatojugular reflux

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13
Q

interventions for high right preload

A

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

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14
Q

amount of stretch on the L ventricle prior to systole

A

left sided preload (PCWP/wedge)

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15
Q

another name for left sided preload

A

(PCWP/wedge)

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16
Q

s/sx of low left preload

A

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

17
Q

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

A

yes

18
Q

s/sx of high left preload

A

orthopnea
cough
dyspnea
S3
crackles

19
Q

treatment of low left preload

A

volume admin.
modified trendelenburg

20
Q

treatment of high left preload

A

diuretics
vasodilators
semi/high fowlers

21
Q

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

A

afterload

22
Q

what is another name for afterload

A

systemic vascular resistance (SVR)

23
Q

interventions for low afterlaod (SVR)

A

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

24
Q

treatment for high afterload (SVR)

A

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

25
Q

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

A

contractility

26
Q

important hemodynamic parameters for contractility

A

CO, CI, EF (valve competence)

27
Q

s/sx of low contractility

A

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

28
Q

treatment of low contractility

A

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

29
Q

which line provides continuous BP monitoring and ABGs?

A

arterial line

30
Q

complications of arterial line?

A

infection, thrombosis, dislodgement, bleeding!!!!

31
Q

which line is used for CVP monitoring and fluid resusscitation?

A

central venous catheter (central line)

32
Q

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

A

CVP
R ventricular preload

33
Q

which parameters does a PA catherter measure

A

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

34
Q

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

A

pulmonary artery cath (PA cath)

35
Q

what complication can come from insertion of a PA catheter

A

ventricular dysrhythmias!

36
Q

describe path of PA cath insertion

A

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

37
Q

describe relationionship between CO/CI, RAAS, kidney perfusion

A

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

37
Q

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

A

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

critical care (23 decks)

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