Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Apex Flashcards > hemodynamic monitors and equipment > Flashcards

hemodynamic monitors and equipment Flashcards

1
Q

during oscillometric method of BP measurement, MAP is measured when

A

amplitude of oscillations are greatest (most accurate data obtained form oscillometric method)

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

ideal bladder length and width of BP cuff

A

length: 80% of extremity circumference
ideal width: 40% of extremity circumference

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

is the pressure utilized to occlude artery different when cuff is too small or large?

A

yes, pressure utilized to occlude artery is less when cuff is too large and
more when cuff is too small

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

as the pulse moves from the aortic root to the periphery, what happens to SBP DBP and PP

A

SBP increases
DBP decreases
PP widens

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

describe SBP DBP and PP at aortic root

A

SBP is lowest
DBP is highest
PP is narrowest

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

describe SBP DBP and PP at radial artery

A

SBP is higher
DBP is lower
PP is wider

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

describe SBP DBP and PP at dorsalis pedis

A

SBP is highest
DBP is lowest
PP is widest

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

what happens to the dichrotic notch as you move further away from the heart

A

it moves further from the systolic peak

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

for every 10cm change, the BP changes

A

7.4mmHg

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

for every inch change, the BP changes

A

2mmHg

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

arterial wave form analysis:
SBP
DBP
PP
contractility
SV
dichrotic north

A

SBP: peak of wave form
DBP: trough of wave form
PP: peak value minus trough value
contractility: up stroke
SV: area under curve
dichrotic notch: closure of aortic valve

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

a line transducer should be at the level of the

A

right atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if you want to monitor CPP, where do you put aline transducer

A

external auditory meatus (corresponds to circle of willis)

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

what happens when a line is under damped

A

baseline re established after several oscillations
SBP over estimated, DBP under estimated, MAP is accurate
causes include stiff tubing (catheter) and whip (artifact)

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

what happens when a line is over damped and causes (5)

A

baseline is established with no oscillations
SBP under estimated, DBP over estimated, MAP accurate
causes: air bubble in pressure tubing, clot in catheter, low flush bag pressure, kinks, loose connection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

tip of CVP catheter should rest (and normal value)

A

just above junction of vena cava and RA
1-10mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how far is pulmonic artery (where PA cath is placed) in relation to vena cava junction?

A

25-35cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how far to insert CVC to vena cava/right atrial junction?
subclavian (either side)
RIJ, LIJ
R/L median basillic
femoral

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how much further to insert catheter from vena cava/right atrial junction to get to
right atrium
right ventricle
PAOP position
pulmonary artery

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if you encounter resistance when pulling PA cath back, what is probably happening

A

knotted in chordae tendinae (get CXR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

complication of CVC’s while obtaining venous access include

A

arterial puncture
pneumothorax
air embolism
neuropathy
catheter knot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

catheter resistance while inserting CVC complications include

A

bacterial colonization on catheter
bacterial colonization of heart or pulmonary artery
myocardial or valvular injury
sepsis
thrombus formation
thrombophlebitis
misinterpretation of data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

complications that can occur when floating PA catheter include (4)

A

pulmonary artery rupture
R bundle branch block
complete heart block (if pre existing LBBB)
dysthrythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

obtaining access via left IJ has added risk of

A

puncturing thoracic duct. can cause chylothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
do you float a PAC in a patient with LBBB
LOL, no. you can cause a RBBB when you get in the right atrium then ded
26
classic presentation of pulmonary artery rupture
hemoptysis
27
ID the parts of this right atrial wave form and the correlating mechanical events of the heart
28
ID how the CVP wave form correlates with electrical events of the heart
29
A wave mechanical event and electrical event
right atrial contraction just after P wave (atrial depol)
30
C wave mechanical event and electrical event
right ventricular contraction (bulging of tricuspid into RA) just after QRS complex (ventricular depol)
31
V wave mechanical event and electrical event
passive filling of RA just after T wave begins (ventricular repol)
32
X descent mechanical event and electrical event
RA relaxation ST segment
33
Y descent mechanical event and electrical event
RA empties through open tricuspid valve after T wave ends
34
how does PEEP affect CVP
PEEP increases CVP because it increases PVR
35
where (and when) CVP should be measured
at phlebostatic axis. (4th ICS at mid anteroposterior level) measured at end expiration (not affected by intrathoracic pressure, reading in relation to solely atmospheric pressure)
36
normal CVP value
1-10mmHg
37
CVP is a function of (3)
intravascular volume venous tone RV compliance
38
factors that increase CVP
transducer below phlebostatic axis hypervolemia RV failure tricuspid stenosis or regurg pulmonic stenosis PEEP VSD constrictive pericarditis pericardial tamponade
39
factors that decrease CVP
transducer above phlebostatic axis hypovolemia
40
explain why this would occur
loss of a wave: afib, v pacing if underlying rhythm is asystole
41
explain why this would occur
atrium contracting and emptying against high resistance --> large a wave tricuspid stenosis diastolic dysfunction MI chronic lung disease leading to RV hypertrophy AV dissociation junctional rhythm asynchronous v pacing PVC's
42
explain why this would occur
increased volume and pressure in RA manifests as increased V waves ( c and v waves may blend into each other) tricuspid regurg acute increase in intravascular volume RV papillary muscle ischemia
43
which findings are observed when tip of PAC enters this area?
dichrotic notch, increased DBP
44
PA waveform: RAP
same as CVP (so nothing new to add)
45
PA waveform: RVP
systolic pressure increases DBP = CVP
46
PA waveform: PAP
SBP remains same DBP rises dichrotic notch formed during pulmonic valve closure during diastole
47
PA waveform: PAOP
waveform is akin to CVP of left heart a wave caused by left atrial systole c wave is caused by mitral valve elevation into LA during LV systole (is-volumetric contraction) v wave is caused by passive left atrial filling
48
which lung zone should the tip of the PAC be placed?
west zone 3 (provides most accurate estimation of LVEDP)
49
west zone review (1-3)
50
how can you tell the tip of the PAC is in west zone 3
PAOP > pulmonary artery end diastolic pressure nonphaseic PAOP tracing inability to aspirate blood from distal port when balloon is in wedged position
51
when does PAOP over estimate LVEDV/P? under estimate?
over estimate: PEEP and diastolic dysfunction, impaired LV compliance (ishchemia), MV disease (stenosis or regurg), left to right cardiac shunt, tachycardia, PPV, COPD, pHTN, non west zone placement of PAC under estimate: aortic insufficiency
52
which situation under estimates CO obtained by thermodilution method
high injectate volume
53
explain thermodilution method
injection of 5% dextrose or .9% NaCl of known quantity and temp is bolused through proximal port on PAC each injection should occur during the same phase of the respiratory cycle and be completed in <4 seconds usually average 3 separate injections area under curve (AUC) is inversely proportional to CO if CO is high, injectate rapidly goes towards AUC and waveform is smaller. takes more time for low CO to travel past tip so AUC is larger
54
ways thermodilution method under estimates CO
injectate volume too high injectate solution too cold
55
ways thermodilution method over estimates CO
injectate volume too low injectate solution too hot partially wedged PAC thrombus on tip of PAC
56
ways thermodilution method is unable to estimate CO (2)
intracardiac shunt tricuspid regurg
57
drawback to continuous CO (CCO)
its an average of the CO for 3-6m so is not helpful in unstable patient
58
mixed venous O2 sat is a function of 4 variables (and equation/normal value)
1. Q= CO (L/min) 2. VO2 = O2 consumption (mL O2/min) 3. Hgb = (g/dL) 4. SaO2 = loading of HGB in arterial blood (%) normal = 65-75%
59
when can mixed venous O2 become an indirect monitor of CO
when Hgb, SaO2, VO2 are all held constant
60
factors that decrease SvO2
increased O2 consumption (stress, pain, thyroid storm, shivering, fever) decreased O2 delivery (decreased PaO2, decreased HGB, decreased CO)
61
factors that increase SvO2
decreased O2 consumption (hypothermia, cyanide toxicity), increased O2 delivery (increased PaO2, HGB, CO)
62
sepsis and SvO2
causes high output CO state. even though it causes end organ hypoxia, O2 essentially bypasses organs and causes increase in SvO2
63
SvO2 and cyanide poisoning/Na NTP
impairs O2 uptake by tissues, increases SvO2
64
SvO2 and left to right shunt
oxygenated blood travels from left to right heart and is added to p.venous blood
65
explain pulse contour analysis
provides measure of preload responsiveness as a function of how stroke volume changes during the respiratory cycle (assuming PPV) (aka changes in intrathoracic pressure during PPV can affect SV)
66
preload responsiveness can be assumed when 200-250mL bolus increases SV by
10%
67
limitations to pulse contour analysis include (6)
spontaneous ventilation small Vt PEEP open chest RV dysfunction dysrhythmias
68
tip of TEE probe should be positioned at
~35cm from incisors (T5/T6) or at third intercostal junction
69
define peak velocity r/t TEE
index of contractility
70
define flow time r/t TEE
timing of flow from LV during systole
71
define flow time corrected (FTC) r/t TEE
flow time indexed to a HR of 60BPM
72
define mean acceleration r/t TEE
average speed of up stroke of wave form (cm/sec)
73
define cycle time r/t TEE
time of one cardiac cycle
74
define stroke distance r/t TEE
how far SV is pumped along aorta per beat
75
TEE waveform decreased versus increased preload
76
TEE waveform decreased versus increrased afterload
77
TEE waveform deceased versus increased inotropy
78
limitations r/t esophageal doppler
aortic stenosis aortic insufficiency disease of thoracic aorta aortic cross clamping after CPB pregnancy
79
normal PAOP value
5-15mmhg
80
SvO2= (equation)
normal 65-75%
81
change via a vasodilator (ex clevidipine)

Apex Flashcards (71 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions