Module 4 - Hemodynamics Flashcards
The nurse is caring for a patient following an insertion of a left subclavian central venous catheter (CVC). What significant complication would the nurse anticipate as a potential?
Hyperglycemia
Thrombocytopenia
Pneumothorax
Renal Failure
Pneumothorax
The nurse is caring for a mechanically ventilated client being monitored with a left radial arterial line. During the inspiratory phase of ventilation, the nurse assesses a 20 mm Hg decrease in arterial blood pressure. What is the best interpretation of this finding by the nurse?
The left limb may have reduced perfusion.
The patient may require fluid resuscitation.
The arterial line may need to be replaced.
The mechanical ventilator is malfunctioning.
The patient may require fluid resucitation
Zero referencing negates the effect of atmospheric pressure on an invasive hemodynamic monitoring system. When should the nurse perform zero referencing (select all that apply)?
After each pressure recording
At the beginning of every shift
After repositioning the patient
After the catheter is inserted
When there are significant changes in the patient’s hemodynamic status
At the beginning of every shift
After repositioning the patient
After the catheter is inserted
When there are significant changes in the patient’s hemodynamic status
Before a radial arterial line is inserted, an assessment to evaluate circulation to the hand to avoid potential circulatory complications would include:
Capillary refill
Ulnar nerve function
brachial pulse strength
Allen’s test
Allens test
While caring for your patient with a pulmonary artery catheter, you notice that the pulmonary artery occlusion pressure (PAOP) is significantly higher than previously recorded values. Because you are concerned about the accuracy of the reading, you:
zero reference and level the catheter at the phlebostatic axis.
obtain a stat chest x-ray film to verify proper catheter placement.
increase supplemental oxygen and notify respiratory therapy.
notify the provider immediately of the assessment findings.
zero reference and level the catheter at the phlebostatic axis.
The nurse is caring for a mechanically ventilated patient with a pulmonary artery catheter and knows that the patient can be positioned in all of the following positions EXCEPT:
Semi-Fowlers position
HOB elevated 90 degrees
Supine
HOB elevated 30 degrees
HOB elevated 90 degrees
When cells convert from aerobic metabolism to anaerobic metabolism, they release ____________________.
Antigens
Peptides
Sodium
Lactic acid
Lactic Acid
Because you know the increase in thoracic pressure caused by positive pressure ventilation can lead to decreased venous return, you will closely monitor:
Blood glucose levels
Systolic blood pressure
Color changes in respiratory sputum
Bowel sounds
Systolic blood pressure
Following an insertion of a pulmonary artery catheter, the nurse would do the following (select all that apply):
Zero reference and level the catheter at the phlebostatic axis
Measure and record catheter length
Monitor pulmonary artery pressure
Obtain CXR to verify placement
Zero reference and level the catheter at the phlebostatic axis
Measure and record catheter length
Monitor pulmonary artery pressure
Obtain CXR to verify placement
The purpose of monitoring the mixed venous oxygen saturation (SvO2) with a pulmonary artery catheter is to evaluate ________________.
tissue perfusion
the end result of oxygen consumption and oxygen delivery
oxygenation to the venous system
diastolic blood pressure
the end result of oxygen consumption and oxygen delivery
The clinical instructor asked a student nurse about cardiac index. What correct response would indicate that the student nurse has a good understanding of cardiac index?
“The cardiac index is the pressure created by the volume of blood in the left heart.”
“The cardiac index is the amount of blood pumped out by a ventricle per minute.”
“The cardiac index is the amount of blood ejected with each ventricular contraction.”
“The cardiac index is the measurement of cardiac output specific to the patient’s size.”
“The cardiac index is the measurement of cardiac output specific to the patient’s size.”
What is the best action by the nurse to level and zero a hemodynamic monitoring system transducer?
Level the air-fluid interface of the zeroing transducer at the height of the patient’s mattress.
Position the air-fluid interface of the zeroing transducer at the fifth intercostal space, midclavicular line.
Position the air-fluid interface of the zeroing transducer at the patient’s phlebostatic axis (fourth intercostal space, midaxillary line).
Level the air-fluid interface of the zeroing transducer at the second intercostal space, anterior-axillary line.
Position the air-fluid interface of the zeroing transducer at the patient’s phlebostatic axis (fourth intercostal space, midaxillary line).
You are providing education to a patient’s son regarding her esophageal monitoring. Her son has a correct understanding of this type of monitoring when he states:
“This is used to evaluate the condition of my mother’s esophagus.”
“There are no complications with this procedure.”
“My mother will need to be put asleep when this procedure is being done.”
“The doctor will be putting a thin probe into my mother’s esophagus to know how well her heart is working.”
“The doctor will be putting a thin probe into my mother’s esophagus to know how well her heart is working.”
You are caring for a patient who has a central venous catheter. You demonstrate your correct knowledge about recording right atrial pressures when you state:
“The pressure should be recorded at the end of expiration.”
“Right atrial pressures are low with ventricular dysfunction.”
“Zero referencing is not needed before every recording.”
“Right atrial pressures are high with hypovolemia.”
“The pressure should be recorded at the end of expiration.”
Cardiac output is influenced by all of the following EXCEPT:
Contractility
Blood pressure
Preload
Afterload
Blood Pressure
