Hemodynamic monitors & equipment 3 Flashcards
When does pulmonary artery occlusion pressure overestimate left ventricular end-diastolic volume? (Select 2)
a. PA catheter tip in West zone 3
b. PEEP
c. Diastolic dysfunction
d. aortic insufficiency
b. PEEP
c. diastolic dysfunction
Conditions where PAOP overestimates LVEDP include
mitral valve disease
COPD
pulmonary hypertension
PEEP
non West zone 3 placement of PAC
impaired LV compliance (ischemia)
left-to-right cardiac shut
tachycardia
PPV
_________ causes PAOP to underestimate LVEDV
Aortic insufficiency
Which situation underestimates cardiac output obtained by the thermodilution method?
a. over warmed injectate
b. right-to-left intracardiac shunt
c. high injectate volume
d. partially wedged pulmonary artery catheter
c. high injectate volume
_________ is the most common method of measuring cardiac output.
The thermodilution method
Cardiac output is underestimated when
the injectate volume is too high or the injectate solution is too cold
Cardiac output is overestimated when
the injection volume is too low, the injectate is too hot, the PAC is partially wedged, or there’s a thrombus on the tip of the PAC
Advantages of continuous cardiac output monitoring includes
providing continuous data & avoiding inaccuracies from the human element
The major drawback of continuous cardiac output monitoring includes
slower response time & the data is typically averaged over time
An injection of _______________________ is bolused through _____________- for the thermodilution method
5% dextrose or 0.9% NaCl of known quantity & temperature is bolused through the proximal port on the PAC
Each injection should occur during
the same phase of the respiratory cycle and be completed in <4 seconds
If CO is high, the injectate
rapidly travels towards the distal tip of the PAC
The area under the curve will be _______________, if CO is higher.
smaller
These conditions can make it difficult to predict the accuracy of CO:
intracardiac shunt
tricuspid regurgitation
When would it be preferential to measure CO using the standard thermodilution technique over continuous cardiac output?
in a hemodynamically unstable patient (due to a delay time between measurement and the data appearing on the monitor)
Factors that increase mixed venous oxygen saturation include: (select 2)
a. thyroid storm
b. sodium nitroprusside toxicity
c. anemia
d. sepsis
b. sodium nitroprusside toxicity
d. sepsis