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Boards (&PP2019) > P&P - Arterial Line > Flashcards

P&P - Arterial Line Flashcards

1
Q

systemic arterial pressure waveform results from

A

ejection of blood from LV into aorta during systole

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2
Q

Systolic waveform components

A

steep pressure upstroke
peak
decline

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3
Q

Systolic waveform occurs when?

A

immediately following ECG R wave

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4
Q

Systolic upstroke occurs when?

A

120-180 milliseconds after beginning R wave

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5
Q

dicrotic notch represents what

A

aortic valve closure

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6
Q

pressure transducer should remain

A

fixed at th elevel of the heart

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7
Q

NBP in dependent arm

A

higher BP

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8
Q

NBP in nondependent (up) arm

A

lower BP

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9
Q

A-line flush rate

A

1-3 mL/hour

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10
Q

Arterial pressure transducers should be placed to best estimate

A

aortic root pressure

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11
Q

Preferred transducer location

A

5cm posterior to sternal border

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12
Q

Underdampened pressure

A

systolic BP overshoot

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13
Q

overdampened pressure

A

Falsely narrowed pulse pressure, MAP reliable, absent dicrotic notch

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14
Q

Damping coefficient is too low

A

underdamped

elevated SBP

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15
Q

Damping coefficient is too high

A

overdamped

decreased SBP

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16
Q

Arterial waveform is produced by

A

summation of sine waves

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17
Q

Which two waves are needed to produce arterial waveform?

A

fundamental wave

harmonic wave

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18
Q

Negative Allens Test

A

palm remains pale >6-10 seconds

19
Q

Peripheral vs central waveforms

A

Higher SBP
Lower DBP
Wider Pulse pressures

20
Q

Waveform in Aortic Stenosis

A 
Small in amplitude (pulsus parvus)
Slowly rising systolic upstroke
Delayed peak in systole (pulsus tardus)
Appears overdamped, anacrotic notch 
No discernible dicrotic notch
21
Q

Waveform in Aortic Regurgitation

A

Sharp increase
wide pulse pressure
bisferiens pulse (two systolic peaks)

22
Q

Waveform in Hypertrophic Cardiomyopathy

A

Bifid shape (“spike-and-dome”)

23
Q

Pulsus Alternans

A

Larger and smaller pulse pressures that alternate with respiratory cycle
Regular rhythm

24
Q

Pulsus Paradoxus

A

exaggeration of a normal variation in bp from spontaneous ventilation

25
Q

causes of Pulsus paradoxus

A 
cardiac tamponade**
pericardial constriction
severe airway obstruction
bronchospasm
dyspnea
26
Q

SPV

A

Systolic Pressure Variation

27
Q

SPV is?

A

normal 7-10mmHg

Dependent on pressures in chest and timing of inspiration/expiration on mechanical ventilation

28
Q

Normal PPV

A

Pulse Pressure Variation

13-17%

29
Q

The accuracy of an ABP waveform is determined by the _______ and ________ of the pressure monitoring system.

A

natural frequency

damping coefficient

30
Q

Because of _____, the ABP recorded from peripheral sites has a ______ pulse pressure than when measured more centrally.

A

wave reflection

wider

31
Q

Complications of NIBP

A

Pain
Petechiae and ecchymoses
Limb edema
Venous stasis and thrombophlebitis Peripheral neuropathy Compartment syndrome

32
Q

Indications for IABP

A

Continuous, real-time blood pressure monitoring Planned pharmacologic or mechanical cardiovascular
manipulation
Repeated blood sampling
Failure of indirect arterial blood pressure measurement

33
Q

established the zero reference point for the transducer system

A

Zeroing

34
Q

matches this reference point to a specific point on the patient’s body

A

Leveling

determines where the value 0 will be and, hence, from where measurements will begin

35
Q

Arterial pressure transducers should be placed to best estimate _________ pressure.

A

aortic root

36
Q

Results in underestimation of aortic pressure

A

Radial artery monitoring during hypothermic cardiopulmonary bypass
Air in transducer tubing

37
Q

How will an arterial pressure transducer that is placed below the level of the heart affect the estimate of the actual blood pressure?

A

It will overestimate the actual blood pressure

38
Q

Which of the following will result in an overestimation of the actual blood pressure?
A. Placing a blood pressure cuff too tightly
B. Using a blood pressure cuff that is too large
C. Placing the cuff on an extremity in which you have placed an intravenous line
D. Placing a blood pressure cuff on an extremity that is below the level of the heart

A

D. Placing a blood pressure cuff on an extremity that is below the level of the heart

39
Q

The most significant expected alteration from a cracked stopcock in an arterial pressure monitoring system would be
A. damping of the arterial waveform
B. overestimation of the blood pressure
C. air entrainment into the transducer tubing
D. acute blood loss

A

D. acute blood loss

40
Q

Determines damping coefficient

A

High Pressure Flush

41
Q

High pressure flush results in 0 oscillations

A

Overdamped system

42
Q

High pressure flush results in 1 oscillation

A

Optimally damped system

43
Q

High pressure flush results in 1+ oscillations

A

Underdamped system

Boards (&PP2019) (12 decks)

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