Hemodynamics values

Question 1

Cardiac Output normal value

Answer 1

4-8 L/min

Question 2

What is cardiac output?

Answer 2

Volume of blood ejected from the left ventricle each minute

Question 3

What is ejection fraction?
What is the normal %?

If it is below ___ then pt is at risk for cardiac arrest

Answer 3

percentage of blood volume in LV ejected with each contraction

60-70%

Below 25%= BAD!

Question 4

What does lactic acid tell you?

What is a critically high lactic acid value?

Answer 4

Lactate is produced when the body is in anaerobic respiration, a.k.a., when there is hypoperfusion and not enough O2. Happens in sepsis

Critical lactate value= 4mEq/L

Question 5

What is stroke volume?

What is the normal value for SV?

Answer 5

Amount of blood that leaves the LV with each contraction

Normal value: 60-150ml/BEAT. Be able to convert to L to calculate CO!

Question 6

What is MAP?

What is the normal range of MAP?

What is the BARE minimum MAP?

Answer 6

MAP= mean arterial pressure

Normal values: 70-105 mmHg

BARE minimum for brain perfusion: 60 mmHg

Question 7

What are 3 factors that affect afterload?

Answer 7

1. Lumen size
2. Blood viscosity
3. Valve competency

Question 8

Where should the transducer be placed?

Answer 8

Phlebostatic axis

Fourth intercostal space, mid-chest line`

Question 9

Main complications of Art-lines

Answer 9

1. Thrombus (clot)
2. Embolus (clot that has traveled)
3. Hemorrhage (bleed out at site)
4. Infection (lack of sterility)

Question 10

CVC Complications:

Answer 10

Infection
Pneumothorax or hemothorax
Carotid puncture
Heart perforation
Dysrhythmias

Question 11

PAC Complications

Answer 11

Infection
Dysrhythmias- PVC’s
Tamponade
Air embolism
Thromboembolism
PA Rupture
Pulmonary infarction
Vessel damage
Unintended wedging

Question 12

Steps to ensure accurate CVC readings:

Answer 12

1. Phlebostatic axis
2. Zero/balance, open to air
3. Square wave test

Question 13

What do you recheck in the CVC every time the patient moves positions?

Answer 13

1. Position of transducer. Should be 4th intercostal space and midline
2. Zero
3. Square wave

Question 14

PAOP/PAWP Value

Answer 14

6-12mm HG

Question 15

CVP/RAP value

Answer 15

2 to 8 mm Hg

Question 16

ScvO2:

Answer 16

70%

Question 17

SaO2:

Answer 17

93-95-100% (ABG)

Question 18

Sv02:

Answer 18

60-80%

Question 19

CO:

Answer 19

4-8 L/min

Question 20

EF:

Answer 20

50-70%/ Anything < 25%= high risk of cardiac death

Question 21

Preload

Answer 21

Directly related to fluid volume & venous return
Give fluids or diuretics

Question 22

Afterload

Answer 22

Resistance of the vascular system
Medications to vasoconstrict (dopamine/levophed) or vasodilate (nitrates/milrinone)

Question 23

Contractility

Answer 23

How well the heart is pumping (get ECHO for EF)
Positive and Negative Inotropic medications