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health assessment > hemodynamic monitoring > Flashcards

hemodynamic monitoring Flashcards

0
Q

what are the standards headings for basic anesthetic monitoring

A

oxygen, ventilation, circulation, temperature

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1
Q

why do we do hemodynamic monitoring

A 
assess homeostasis, trends
observe for adverse reactions
assess therapeutic interventions
manage anestheic depth 
eval equipment fx
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2
Q

look at to assess o2

A

pulse ox, oxygen analyzer on machine, LOOK AT YOUR PT

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3
Q

ass ventilation

A

LOOK AT PT- chest rise/bs/bag mvt, etco2

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4
Q

what are the minimal standard monitors

A 
EKG
bp
precordial stethoscope
pulse ox
ox analyzer
etco2
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5
Q

minimal standard for graph display

A 
ekg
bp
hr
vent status - etco2
o2sat
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6
Q

how often must we document

A

at least every 5 min

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7
Q

basic monitoring techniques

A

inspection
auscultation
palpation

ALERT AND VIGILANT PROVIDERS

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8
Q

CONSIDERATIONS

A 
INDICATIONS/CONTRA
risk/benifit
technques/alternatives
complications
cost
my skill level
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9
Q

hemodynamic monitoring

A 
stethoscope
ekg
bp
cvp
pap/pcwp
tee
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10
Q

precordial steth

A

continual assess of breath sounds and heart tones
INTUBATED PTS ONLY
28030 cm into esophagus
very sensitive for bronchospasm and changes in peds

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11
Q

ekg purpose

A 
detect arrhythmias
monitor hr
detect ischemia
detect electrolyte changes
monitor pacemaker fxn
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12
Q

ekg tells me ___________________

A

ZERO ABOUT THE PULSE

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13
Q

3 lead EKG— what leads and where don’t you see?

A

i, ii, iii

no anterior view

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14
Q

5 lead ekg ___ views and leads

A

7

i, ii, iii, aVR, aVL, aVF, V

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15
Q

see changes in 2, 3, and aVF- where and artery

A

posterior wall ischemia

right coronary artery

16
Q

changes in lead 1, AVL, V5-V6- where and artery

A

lateral wall ischemia

circumflex branch of left coronary artery

17
Q

changes in lead 1 AVL, V1-V4—- where and artery

A

anterior wall ischemia

LCA

18
Q

changes in lead V1-V4

A

anterioseptal ischemia

Left descending coronary artery

19
Q

what don’t you see with a 3 lead ekg

A

anterior LAD!!!

20
Q

5 lead shows you

A

septum and lad

21
Q

what should my gain and frequency be set at

A

1mV= 10mm calibration pulse; 1mm st segment is accurately assessed

diagnostic mode—— if you select filter could distort st segment

22
Q

5 principle indicators for acute ischemia

A 
st segment elevation, >=1mm
T wave inversion
Development of Qwaves
St segment depression, flat or downslope of >= 1mm
Peaked Twaves
23
Q

what do changes in SBP correlate to?

A

changes in myocardial o2 requirements

24
Q

changes in DBP reflect

A

changes in coronary perfusion pressures

25
Q

pulse pressure=

A

SBP-DBP

26
Q

when do you get a wider pulse pressure

A

as a pulse moves peripherally– the reflection distorts

health assessment (4 decks)

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