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A1 > Monitor cardiac patient Lecture > Flashcards

Monitor cardiac patient Lecture Flashcards

1
Q

What is the dicrotic notch

A

closure of aortic valve

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2
Q

when is the cvp in regards to ekg

A

a is after p wave
c is after qrs
v is after t wave

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3
Q

acv xy meaning

A

a- ra contraction
c- rv contraction/ tricuspid closure
x- ra relax
v- ra refill
y- ra empty

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4
Q

what is st depression

A

subendocardial ischemia

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5
Q

what is st elevation

A

transmural myocardial ischemia

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6
Q

pulsus paradoxus suggests

A

suggest hypovolemia
decrease in aortic systolic pressure with positive pressure ventilation

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7
Q

what causes overdampened waveform

A

clot
air bubbles
long tubing
low pressure in bag
vasospasm

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8
Q

what causes underdamp wave form

A

artifact
stiff tubing
hypothermia, tachycardia, dysrhthmias

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9
Q

what causes elevated systolic pressure on a line

A

systemic htn
arteriosclerosis
aortic insufficiency

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10
Q

what causes decreased systolic pressure

A

aortic stenosis
heart failure
hypovolemia

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11
Q

what causes widened pulse pressure

A

systemic htn
aortic regurg

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12
Q

what causes narrow pulse pressure

A

cardiac tamponade
chf
cardiogenic shock
aortic stenosis

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13
Q

what causes pulsus bisferiens

A

aortic regurg
Obstructive hypertrophic cardiomyopathy

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14
Q

what causes pulses paradoxus

A

hypovolemia
tamponade
copd
pulmonary embolism

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15
Q

what causes pulsus alternans

A

chf
cmp

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16
Q

contraindications of ij insertion

A

carotid disease
recent cannulation
contralateral diaphragmatic dysfunction
thryomegaly, prior neck surgery

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17
Q

red and blue on ultrasound

A

red- towards transducer
blue- away from transducer

18
Q

1st and 2nd best place for cvc

A

rij
lsc

19
Q

distance from insertion to junction of vena cava

A

rij 15
lij 20
rsc 10
lsc 10
femoral 40
r median basilic 40
l median basilic 50

20
Q

distance from junction of vena cava to:

A

ra- 0-10cm
rv- 10-15cm
pa- 15-30
PAWP- 25-35

21
Q

What causes a loss of a wave

A

a fib
v pacing

22
Q

what causes giant a wave

A

tricuspid stenosis
rv failure
myocardial ischemia
diastolic dysfunction

23
Q

what causes giant v waves

A

tricuspid regurg
increase in cvp
rv papillary muscle ischemia

24
Q

what can cause a high cvp

A

rv failure
tricuspid stenosis or regurg
cardiac tamponade
pericarditis
volume overload
pulmonary htn
peep
transducer below phlebostatic axis

25
Q

what can cause a low cvp

A

hypovolemia
ards
high level of transducer

26
Q

Normal PA pressures

A

20-30
/
80-12

27
Q

pa pressures while placing it

A

RA- 0-4
RV 25/0-5
PA- 25/10
PAWP- 8-12

28
Q

What can cause high pa pressures

A

LV failure
mitral disease
l-r shunt
ASD VSD
FVO
pulmonary htn
catheter whip- advanced too far

29
Q

what can cause low pa pressures

A

hypovolemia
rv failure
tricuspid disease

30
Q

PCWP estimates:

A

LVEDP

31
Q

what can cause high pcwp

A

lv failure
mitral disease
cardiac tamponade
pericarditis
fvo
ischemia

32
Q

what can cause low pcwp

A

hypovolemia
rv fialure
tricsupid disease
pulmonary embolism

33
Q

thermodilution injection should be:

A

during same phase of respiratory cycle and <4 seconds to complete
3 injections for accuracy

34
Q

what may overestimate thermodilution method

A

“hot and low”
too hot
too low volume
thormbus
wedged cath

35
Q

what underestimates thermodilution

A

high and cold

36
Q

normal svo2

A

70

37
Q

what makes up svo2

A

svc
ivc
coronary sinus

38
Q

what can increase svo2

A

sepsis
methemoglobinemia
cyanide toxicity from snp
hypothermia
increased pao2, hgb, co

39
Q

what can decrease svo2

A

stress
pain
anxiety
shivering
low co, hgb, pao2
seizure
fiver

40
Q

gold standard for assessing myocardial dysfunction

A

tee

41
Q

best axis for routine monitoring systolic wall motion abnormalities

A

short axis midpapillary

A1 (122 decks)

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