Physiologic Monitoring Flashcards
ECG normal
60-90 bpm
A-line normals
BP and MAP
120/80
60-110
What is CVP
Central Venous pressure
Normal for CVP
2-8 cmH2O
2-6 mmHg
ICP normals
Intercranial pressure
15 mmHg
SpO2 normal
Arterial oxygen saturation
97-98
Purpose of tracheal tubes
Access upper airway when obstructed
Suctioning
Enable mechanical vent
Protect airway
2 types of trach tubes
Endotracheal
Tracheostomy
Complications of Trach tubes
Ulcer Scarring Fistula Larynx damage Infection A/W obstruction
ET-Tubes used for
Short term 7-10 days
Trachs have a ___
Low-pressure (25 cmH2O) cuff which inflates during mechanical ventilation
Have an opening in posterior wall of tube above cuff
Fenestrated trach
Purpose of chest tubes
To remove excess fluid or air from pleural/mediasinal cavity
Chest tube for fluid
Chest tube for pneumothorax
Fluid: 3/4 intercostal space
pneumothorax: 2nd intercostal space
3 compartments for draining container of Chest tube
Under-water-seal drainage
Collection chamber
Suction chamber
Air bubbles in chest tube indicative of
Air leak
Can you be mobilized and ambulated with under-water-seal drainage?
How about wall suction?
CHEAA bruh
Naww
Used to detect hypoxemia
Pulse oX
SpO2 of 90% corresponds to PaO2 of
60mmHg
Direct measurement of Artieial BP, CVP, intracardiac pressure
Hemodynamic monitoring (HDM)
A-line
Peripheral arterial catheter
Aline used to monitor
Arterial pressure by drawing blood samples
Complications of Continuous arterial pressure monitoring
Eccymosis, Hematoma, and soreness
Sites of Aline
Radial (most common)
Dorsalis pedis
Femoral
Brachial
Transducer of Aline placed at
Level of R artium
CVP catheter
Central venous pressure catheter
Where are CVP placed and for what
RA to monitor RA pressure
If right ventricle failing, CVP will
RISE
CVP waveform fluctuates with _____, decrease with _____ and increases with ______
Respiration
spontaneous inspirtation
Positive pressure respiration
Swan-Ganz is a
Pulmonary Artery Catheter
Where is swan-ganz inserted and for what
RA->RV->pulmonary artery
Detect heart failure, sepsis, and pulmonary edema
What can be calculated from Swan Ganz
preload
Contractile state of heart
And Afterload
Indications for swan-gaz
-Measure patient’s hemo status
Used in medical management of pt with brain injury
Neurologic monitoring device
Where are ICPs placed and for what
Injured side of brain
-monitor pressure against skull, help guide interventions to decrease pressure and increase cerebral perfusion
Two types of ICPs
External ventricular drain
Bolt
High intercranial pressure results in decreased
Cerebral perfusion
Normal ICP waveform has how many peaks
3
Driving pressure of blood to the brain
Cerebral perfusion pressure
Normal CPP
60 mm HG
What is PICC and what is it for
Peripherally inserted catheter
Provide venous access for meds, nutrition, fluids
Where is PICC placed
Antecubital fossa
Tip into superior vena cava
Risks of PICC
Mechanical phlebitis
Infection
Venous thrombis
Catheter Embolus
Purpose of Triple lumen catheter
3 catheters in 1 to provide:
Meds
Nutrition
Blood products
TLC goes through
Subclavian -> SVC
Risks of TLC
Pneumothorax Embolization Tissue damage Hemorrage Infection
PT with TLC
Defer if pneumothorax
Avoid HTN of neck
Clarify otransfer orders
Avoid displacement
Provide vascular access to pts needing infusion of drugs,TPN,other fluids
Implantable port
Where is implantable port placed
Percutaneous place from subclavia->SVC
Pacemaker purpose
Electrical stimulation to myocardium
Implantable port risk
Pneumothorax
Infection
Venous Thrombosis
Catheter migration/embolus
Temp pacemaker risk
Infection
Arrhythmia
Myocardial perforation
Pulmonary emboli
Implications for Pacemaker PT
Clarify ordered therapy
Traction-> flexion can pull out lead
Coughing can displace lead
Purpose of hemocath
Permit access for urgen dialysis
Where is hemocatheter placed?
Subclavian
Internal jug
Femoral vein
Risk of hemo cath
Pneumothorax
Hemothorax
Bleeding
Implications for PT and hemo cath at femoral site and neck site
Femoral: clarify LE ROM, transfer ambulation
Nek: Clarify UE ROM
Used as life saving IV for those in respiratory failure
Mechanical Ventilation
Factors leading to intubation
RR>30/min
>90% O2 saturation
PaO2 <50 PaCO2 >50
3 important parameters of Mech Ventilation
Volume
Frequency
Oxygen
Breaths delivered by vent
Assist control or continuous mandatory Ventilation
Partial support mechanical ventilation
Synchronized intermittent mandatory ventilation
Alarms in mechanical Vent
High pressure
Low Pressure
A/w blocked or tension in pneumothorax
Disconnected vent, air leak
