Hemodynamics

Question 1

What 2 variables directly reflect organ perfusion

Answer 1

Blood pressure and CO

Question 2

What is the formula for CO

Answer 2

HR x SV=CO

Question 3

What is the for formula for SV

Answer 3

Preload + afterload+ contractility

Question 4

What are the arteries responsible for

Answer 4

Afterload

Question 5

What are veins responsible for

Answer 5

Preload as related to ventricular filling

Question 6

What does a narrow pulse pressure indicate

Answer 6

Hypovolemia

Cardiogenic shock

Question 7

What does a widened pulse pressure indicate

Answer 7

Septic
Anaphylactic
Neurogenic

Question 8

What is a change in diastole a result of

Answer 8

Stimulation of the SNS ( blood vessels are constricting to increase BP

Question 9

What VS should you always monitor for

Answer 9

HR above 110 at rest

Wide or narrow pulse pressure

Question 10

What does orthostatic BP indicate

Answer 10

That the patient has no fluid reserve suggest to the DR. fluid resuscitation

Question 11

How do you calculate CI ( cardiac index)

Answer 11

CO/BSA=CI

Question 12

all circulatory measurements are referenced from what part of the body

Answer 12

The 4th intercostal space mid chest, this is known as the phlebostatic axis

Question 13

At what height of the bed would the transducer no longer work

Answer 13

The height of the bed can be up to 60 degree without any ill effects

Question 14

What is the zero technique

Answer 14

It opens air to establish atmospheric air pressure as zero! Turn the stopcock off to the pt. ( open to air and transducer). Press the zero button on the monitor system. Return the stopcock off to the air position.

Question 15

How often should you level a invasive line

Answer 15

Whenever a patient moves

Question 16

When should you zero a invasive line

Answer 16

Q8H

Question 17

What should you always do to a arterial line flush bag

Answer 17

Deair the bag by holding it upside down, and fully filling the drip chamber

Question 18

What are troubleshooting techniques of the damp system

Answer 18

Check all connections
Check for air or blood in the tubing
Check the line for patency
Are flush bags under the correct 300 mmg/Hg
Re zero, relevel, and check the patients position

Question 19

Continuous flush systems for pressure lines deliver how much pressure?

Answer 19

3/cc hr

Question 20

What is another name for central venous pressure (CVP)

Answer 20

Right arterial pressure

Question 21

What does CVP measure

Answer 21

The pressure of the venous system on return to the heart

It measures the filling pressures of the right heart

Question 22

The higher the CVP the what

Answer 22

The higher the CVP the higher the preload

Question 23

What are indications of CVP monitoring

Answer 23

Rapid fluid administration 
Assess intravascular fluid status 
Admin of vasoactive or incompatible drugs, TPN
inadequate peripheral IV access
Frequent blood sampling

Question 24

What are the 2 central venous sites

Answer 24

Interjugular vein
Subclavian vein
The femoral vein isn’t used anymore bc of infections

Question 25

Anything put over a guidewire is called what

Answer 25

The seldinger, after the dr. Who invented it

Question 26

What is important to have the patient do during central venous insertion

Answer 26

Put on a mask and turn there head

Question 27

What are causes of a increased CVP pressure

Answer 27

``` Hypervolemia Fluid overload Renal failure Pulmonary HTN, PE COPD pulmonic valve disease ```

Question 28

What are other cause of increased CVP Pressure

Answer 28

Failing heart, constricting pericarditis Triscuspid defects, ventricular septal defects Cardiac tamponade Severe LV failure

Question 29

What are causes of a decreased CVP PRESSURE

Answer 29

Hypovolemia, hemmorhage, diuretics, vomiting, | Vasodilation, fever, drugs, sepsis, SIRS, THIRD SPACING,

Question 30

Which port should CVP be monitored from

Answer 30

The distal port

Question 31

What are CVP removal techniques

Answer 31

Review PTT, PT, INR place pt. flats, supine in bed Explain the procedure Turn off IV systems, flush system

Question 32

What does CVP lines measure

Answer 32

Preload

Question 33

After insertion of a CVP line what must be done before use

Answer 33

CXR prior to use

Question 34

What is does arterial pressure monitor

Answer 34

Pressure exceeded on the arterial wall | Determined by flow and resistance

Question 35

What is systolic arterial pressure provide

Answer 35

The maximum pressure of blood being excerted from the LV

Question 36

A MAP greater than 65 indicates what

Answer 36

The kidneys are in trouble | It's it's higher than 110, your kidneys are really in trouble

Question 37

What are indications for a arterial line

Answer 37

``` Continuous real time monitoring Shock from any cause, hemmorhage, cardiac arrest Vasoactive drug therapy, Respiratory failure Major surgical procedures ```

Question 38

What side of the body Is the radial artery

Answer 38

Thumb side of hand

Question 39

What side of the body is the ulcer artery

Answer 39

Pinky side of the thumb

Question 40

What test should be done before ABG's and ART line insertion

Answer 40

Modified Allens test

Question 41

Junctional rhythms

Answer 41

Inverted P waves

Question 42

What is pulsus parodoxus

Answer 42

A decrease in systolic pressure during inspiration above 10mm/Hg

Question 43

What type of disease processes is pulsus paradoxes typically get

Answer 43

COPD, barrel chested people Cardiac tamponade Constrictive pericarditis

Question 44

What is pulsus alterans

Answer 44

When every other beat is weak suggesting advanced LV failure

Question 45

What is true of a ART line

Answer 45

NO DRUGS SHOULD EVER GO THROUGH IT