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CTITICAL CARE > Hemodynamics > Flashcards

Hemodynamics Flashcards

1
Q

What 2 variables directly reflect organ perfusion

A

Blood pressure and CO

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2
Q

What is the formula for CO

A

HR x SV=CO

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3
Q

What is the for formula for SV

A

Preload + afterload+ contractility

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4
Q

What are the arteries responsible for

A

Afterload

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5
Q

What are veins responsible for

A

Preload as related to ventricular filling

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6
Q

What does a narrow pulse pressure indicate

A

Hypovolemia

Cardiogenic shock

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7
Q

What does a widened pulse pressure indicate

A

Septic
Anaphylactic
Neurogenic

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8
Q

What is a change in diastole a result of

A

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

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9
Q

What VS should you always monitor for

A

HR above 110 at rest

Wide or narrow pulse pressure

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10
Q

What does orthostatic BP indicate

A

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

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11
Q

How do you calculate CI ( cardiac index)

A

CO/BSA=CI

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12
Q

all circulatory measurements are referenced from what part of the body

A

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

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13
Q

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

A

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

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14
Q

What is the zero technique

A

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.

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15
Q

How often should you level a invasive line

A

Whenever a patient moves

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16
Q

When should you zero a invasive line

A

Q8H

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17
Q

What should you always do to a arterial line flush bag

A

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

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18
Q

What are troubleshooting techniques of the damp system

A

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

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19
Q

Continuous flush systems for pressure lines deliver how much pressure?

A

3/cc hr

20
Q

What is another name for central venous pressure (CVP)

A

Right arterial pressure

21
Q

What does CVP measure

A

The pressure of the venous system on return to the heart

It measures the filling pressures of the right heart

22
Q

The higher the CVP the what

A

The higher the CVP the higher the preload

23
Q

What are indications of CVP monitoring

A 
Rapid fluid administration 
Assess intravascular fluid status 
Admin of vasoactive or incompatible drugs, TPN
inadequate peripheral IV access
Frequent blood sampling
24
Q

What are the 2 central venous sites

A

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

25
Q

Anything put over a guidewire is called what

A

The seldinger, after the dr. Who invented it

26
Q

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

A

Put on a mask and turn there head

27
Q

What are causes of a increased CVP pressure

A 
Hypervolemia 
Fluid overload 
Renal failure 
Pulmonary HTN, PE
COPD
pulmonic valve disease
28
Q

What are other cause of increased CVP Pressure

A

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

29
Q

What are causes of a decreased CVP PRESSURE

A

Hypovolemia, hemmorhage, diuretics, vomiting,

Vasodilation, fever, drugs, sepsis, SIRS, THIRD SPACING,

30
Q

Which port should CVP be monitored from

A

The distal port

31
Q

What are CVP removal techniques

A

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

32
Q

What does CVP lines measure

A

Preload

33
Q

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

A

CXR prior to use

34
Q

What is does arterial pressure monitor

A

Pressure exceeded on the arterial wall

Determined by flow and resistance

35
Q

What is systolic arterial pressure provide

A

The maximum pressure of blood being excerted from the LV

36
Q

A MAP greater than 65 indicates what

A

The kidneys are in trouble

It’s it’s higher than 110, your kidneys are really in trouble

37
Q

What are indications for a arterial line

A 
Continuous real time monitoring 
Shock from any cause, hemmorhage, cardiac arrest 
Vasoactive drug therapy, 
Respiratory failure
Major surgical procedures
38
Q

What side of the body Is the radial artery

A

Thumb side of hand

39
Q

What side of the body is the ulcer artery

A

Pinky side of the thumb

40
Q

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

A

Modified Allens test

41
Q

Junctional rhythms

A

Inverted P waves

42
Q

What is pulsus parodoxus

A

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

43
Q

What type of disease processes is pulsus paradoxes typically get

A

COPD, barrel chested people
Cardiac tamponade
Constrictive pericarditis

44
Q

What is pulsus alterans

A

When every other beat is weak suggesting advanced LV failure

45
Q

What is true of a ART line

A

NO DRUGS SHOULD EVER GO THROUGH IT

CTITICAL CARE (6 decks)

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