hemodynamic monitoring Flashcards
What are the components of continuous hemodynamic monitoring?
Direct pressure monitoring system, flush system, pressure bag, transducer, and amplifier
How much pressure should the pressure bag be maintained at?
300 mmHg of pressure
How much IV solution is continuously flowing per hour to prevent clotting?
3-5 mL
What does the transducer do?
Converts the pressure coming from the artery or heart chamber into an electrical signal
What does the amplifier do?
Monitor that increases the size of the electrical signal for display on the oscilloscope
What is the nursing interventions for a patient on hemodynamic monitoring?
Keep the tubing patent, keep it in place, establish the reference point for function per shift
At what point should the stopcock be placed?
4th intercostal space, atrium
As hemodynamic monitoring continues, what risks are increased?
Infection, pneumothorax, air embolism
What is the best place for an arterial line
Radial artery
What can be measured from an arterial line
ABG, real time blood pressure
Who is at high risk for low perfusion distal to the arterial line?
Patients with diabetes, PVD, hypotension, on IV vasopressors, previous surgery
What does the Allen Test tell us?
Perfusion of the hand
What does the CVP monitor?
Pressure of the right atrium
What is a normal CVP
2-6 mmHg
How do you treat a high CVP (over 6)
Right sided HF –> diuretics
How do you treat a low CVP (under2)
hypovolemia –> IV fluid
Where is the preferred site for CVP insertion
subclavian vein
What does the Swan Ganz measure
Right atrial
Pulmonary artery systolic
Pulmonary artery diastolic
Mean pulmonary artery
Pulmonary artery wedge
Left ventricular filling pressures
Why do we use wedge pressure to measure preload
its the most accurate
What does increased wedge pressure indicate
LV failure
What does decreased wedge pressure indicate
hypovolemia
How is wedge pressure measured and what must be done when you finish
Blocking the blood flow to the pulmonary artery
Must deflate the balloon
What are some nursing interventions for maintaining a CVP and Swan Ganz catheter?
Catheter care site
Prevent kinking of the tubing
Prevent pulmonary problems
What is a pulse pressure analysis
Uses an arterial pressure waveform to continuously estimate the patients stroke volume, need a good waveform
What would you measure with an esophageal Doppler
estimated cardiac output
What is the Fick Principle
Usage of carbon dioxide measures for sedated, intubated, on MV patients
What are the components of a direct pressure monitoring system?
Arterial line (much stiffer than regular IV line), pressure bag, pressure transducer & automatic flushing system (make sure blood doesn’t shoot out), saline filled non-compressible tubing
What are the components of the flush system?
IV solution (may include heparin or only NS), tubing, stopcocks, flush device (provides continuous and manual flushing)
How often should the arterial line pressure be compared with cuff pressure?
2-3 times per day
What is the balloon capacity of a Swan Ganz?
1.5 mL
