Hemodynamics (S.G)

Question 1

3 hemodynamic lines

Answer 1

1. Arterial line (a-line)
2. Pulmonary artery catheter (swan ganz)
3. Central venous pressure catheter (CVP/RAP)

Question 2

1. Arterial line (A-line)

- what does it monitor?

Answer 2

-arterial blood pressure

Question 3

Arterial line (A-line) 
-what can it also be used for?

Answer 3

• non-traumatic sampling of ABGs

- measuring MAP (mean arterial pressure)

Question 4

Arterial line (A-line) 
-what CANNOT be infused in this line?

Answer 4

MEDS

Question 5

how to calculate MAP

Answer 5

3

Question 6

2. Pulmonary Artery catheter (swan ganz)

- what does it measure?

Answer 6

• Pulmonary Artery (PA) pressure

- Pulmonary Artery O. Pressure (PAOP)

Question 7

Pulmonary Artery catheter (swan ganz)

-is balloon inflated or deflated for PA pressure ?

Answer 7

Deflated

Question 8

Pulmonary Artery catheter (swan ganz)

-is balloon inflated or deflated for PAOP pressure ?

Answer 8

Inflated (wedge)

*gets LVED reading (left ventricle at end diastole)

Question 9

Pulmonary Artery catheter (swan ganz)

-what port infuses meds?

Answer 9

Proximal port

Question 10

Pulmonary Artery catheter (swan ganz)

-what other measurements can be taken?

Answer 10

• C.O readings
• measures core body temperature
• obtains MIXED venous blood sample

Question 11

Pulmonary Artery catheter (swan ganz)
NORMAL VALUES:
-PA

Answer 11

systolic: 20-30
Diastolic: 5-10

Question 12

Pulmonary Artery catheter (swan ganz)
NORMAL VALUES:
-PAOP

Answer 12

5-12 mmHg

Question 13

Pulmonary Artery catheter (swan ganz)
NORMAL VALUES:
-C.O

Answer 13

4-6 L

Question 14

3. CVP catheter (RAP)

- what does it measure?

Answer 14

Pressure in the RIGHT ATRIUM

*shows preload amount of fluid

Question 15

CVP

-indicates what of the pt?

Answer 15

Fluid balance

Question 16

CVP

-what can be administered?

Answer 16

FLUIDS and MEDS

Question 17

CVP

-Normal value

Answer 17

2-5 mmHg

Question 18

CVP

-cause of a LOW CVP

Answer 18

fluid defecit

- hypovolemia

Question 19

CVP

-cause of a HIGH CVP

Answer 19

fluid overload

-CHF or decreased C.O

Question 20

Zeroing an A-line:

Where do you level the transducer?

Answer 20

4th ICS Mid. axillary line (phlebostatic axis)

Question 21

7 Steps to zeroing an A-line

Answer 21

1. level the transducer
2. turn stopcock OFF to pt
3. OPEN transducer to air
4. Press zero on monitor
5. CLOSE transducer to air
6. turn stopcock ON to pt
7. quick flush line 1-2 times

Question 22

ICP waveforms

-Normal value

Answer 22

4-15 mmHg

Question 23

ICP waveforms

-slightly elevated

Answer 23

15-20 mmHg

Question 24

ICP waveforms

-interventions if >20 mmHg for > 10 min

Answer 24

• NOTIFY MD
• Raise HOB
• O2

Question 25

ICP waveforms

-medications to give if >20 mmHg

Answer 25

• Manitol (diuretic)
• hypertonic saline solution
• consider CO2 and PaO2 levels

Question 26

ICP waveforms

-Interventions if there is an air embolis

Answer 26

-Reverse trendelenberg (HOB elevated)

Question 27

IV Drips:
-orders for titrations must include (5)
(MSG-IT)

Answer 27

M: maximum rate
S:  start rate
G: titration goal
I: incremements between titration
T: time lapse between titration