invasive and non-invasive monitoring equipment Flashcards
what does Electrocardiogram monitor
heart rate and heart rhythm
what in basicc terms is a ECG
Graphic representation of electrical activity of the heart
Some indications of declining cardiac status
- ST change (elevation or depression)
- Onset, increase, or change of foci of premature ventricular contractions
(PVCs) - Onset of ventricular tachycardia or fibrillation
- Onset of atrial flutter or fibrillation
- Progression of heart block
- Loss of pacer spike
what is a pulse ox measuring
Measurement of arterial oxygen saturation
what is pulse ox expressed as
oxygen bound to hemo
threshold for pulse ox
above 90%
- Normal adult respiratory rate
12–18 bpm
tachypnea RR
above normal
bradypnea RR
below normal
Causes of tachypnea
Exercise
Atelectasis
Fever
Hypoxemia
Anxiety
Pain
Bradypnea
Head injuries
Sedation
Drug overdose
Indications of respiratory distress
- Increased respiratory rate
- Nasal flaring
- Intercostal and sternal retractions
- Visible expression of distress
- Increased use of neck accessories
- Paradoxical breathing
Paradoxical breathing
The deflation of a lung or of a portion of a lung during the phase of inspiration and the inflation of the lung during the phase of expiration
The chest and abdomen should expand when they inhale and contract when they exhale
Bispectral (BIS) index monitor assists with what
assists with monitoring sedation
levels in ICU
Bispectral (BIS) index monitor - what does it mesure
Measures the muscular and cortical activity
using a single, small, flexible sensor applied to forehead and temporal region
NI
what does 0 mean for Bispectral (BIS) index monitor
no cortical electrical activity/full suppression
what does 100 mean for Bispectral (BIS) index monitor
awake, aware, no suppression
Arterial Line invasive or non
invasive
Arterial Line function
Measurements of arterial blood pressure continuously
- Systolic and diastolic
- Mean arterial pressure
(MAP) interpretation
Arterial Line common location
Radial artery or femoral artery
what is another advantage of the arterial line
Allows access for drawing blood for arterial blood gas
Arterial Line parts
- Pressure transducer
- Pressure transmission
(connective) tubing - Pressure monitor or recorder
Transducer for an arterial line should be positioned where
at the level of the right atrium to assure accurate pressure values
If transducer is too low - arterial line
blood pressure will read higher
If transducer is too high - arterial line
blood pressure will read lower
arterial line is dislodged
pressure
nursing
Central Line function
Measures central venous pressure (CVP) or right atrial pressure
Central Line other functions
Allows IV access for medication administration
High CVP may result from
fluid overload, right ventricle failure, tricuspid insufficient, chronic left ventricular failure
Low CVP may result from
hyperlipemia and dehydration
Central Line prolonged placement name
PICC line
PICC line placment
cephalic, basilic, or brachial vein
Risks Associated During Insertion of Central Venous Access
- Pneumothorax(achestradiograph should be done to rule this out before mobilization)
- Bleeding
- Arrhythmias
- Arterialentry
Pneumothorax
collasped lung
Delayed Risks Associated with Central Venous Access
- Infection
- Catheterfracture
- Catheterdislodgement
- Catheterocculsion
- Airinthecatheter
Pulmonary Artery Catheter other name
Swan–Ganz catheter
Pulmonary Artery Catheter (Swan–Ganz catheter) passes through what
passes through the right atrium and ventricle to rest in the pulmonary artery
Pulmonary Artery Catheter Distal port measures what
Distal port pulmonary art pressure
Pulmonary Artery Catheter proximal port measures what
atrial pressure
Complications of insertion and dislodgement of the PA catheter include:
- Malignant arrhythmias
- Pulmonary artery rupture
- Pulmonary valve tear
- Infection
PA catheter mobilzation
recommended that mobilization, if essential, only be undertaken by an experienced clinican after it has been determined that the patient is hemodynamically stable.
Pulmonary Capillary Wedge Pressure (PCWP) provide what kind of infromation
Primary indicator for ventricular performance
- provides information regarding left atrial and ventricular end-diastolic pressures
As measured by the Swan–Ganz catheter
left atrial and ventricular end-diastolic pressures normally
8 to 12 mm Hg
Swan–Ganz and CO
Measured using thermodilution technique
normal cardiac output
CO=4to8L/min
Cardiac index
cardiac output per square meter of body surface area à ~ 3.0 L/min/m2
Mixed venous oxygen saturation (SvO2)
Balance between oxygen delivery and oxygen demand
- Amount of oxygen returning to the heart
- Direct measure of venous oxygen reserve
swan
what is the most accurate why to get temp
rectal temp
Intracranial Pressure Monitoring normal
Range 0 to 10 mmHg (adults)
what is the ideal position for venous drainage
HOB >30 deg ideal position for venous drainage
Activities That Cause an Increase ICP
- Isometric exercise
- Valsalva maneuver
- Extreme hip flexion
- Lateral neck flexion
- Coughing
- Prone position
- Head below 15 degrees horizontal * Occlusion of the tube
- Pain