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RTH 236 > Pulmonary Artery Catheters 2 > Flashcards

Pulmonary Artery Catheters 2 Flashcards

0
Q

What are lung problems?

A
  • non cardiogenic pulmonary edema (aspiration, gram - sepsis, ARDS)
  • excessive PEEP level
  • pulmonary emboli
  • alveolar hypoxia leading to pulmonary artery constriction (COPD)
  • general shunt hypertension
  • shunt
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1
Q

What are right heart problems?

A
  • tricuspid stenosis or regurgitation
  • right sided myocardial infarction
  • cardiac tamponade
  • ruptured septum
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2
Q

What are left heart problems?

A
  • cardiogenic pulmonary edema
  • mitral regurgitation/stenosis
  • aortic stenosis
  • MI to left ventricle
  • constrictive pericarditis
  • patient ductus arteriosus
  • arteriosclerotic heart disease
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3
Q

What should PADP be compared to PCWP so it increases PVR?

A

> 3-5

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4
Q

What causes an increase in PVR?

A
  • acidosis
  • hypercarbia
  • hypoxia
  • less common: pulmonary emboli, alveolar septal defect, surgical removal
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5
Q

What are complications of vein cann?

A
  • local infection
  • bleeding and hematoma
  • pneumo/hemothorax
  • injury to trachea/thoracic duct
  • damage to vein
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6
Q

What are complications during placement?

A
  • cardiac arrhythymias
  • local infections, PA rupture
  • pulmonary emboli
  • balloon rupture and air emboli
  • intercardiac knotting
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7
Q

What are problems that disrupt accuracy in a waveform?

A
  • dampened (decrease in amp due to air or kink)
  • catheter whip (movement of catheter)
  • pressure values (transducer not in correct place)
  • respiratory effect (low press during inhalation)
  • PEEP
  • zones
  • migration
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8
Q

How does peep affect the waveform?

A
  • causes zones to shift
  • compliant lungs transmit more peep
  • 5cmh2o peep = 1cmh2o added to measurement
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9
Q

What determines cardiac output?

A
  • stroke volume

- heart rate

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10
Q

What factors affect stroke volume?

A
  • preload
  • contractility
  • afterload
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11
Q

What is the normal cardiac output?

A

75 x 75 = 5400

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12
Q

What is preload?

A

The stretching of muscle fibers in the ventricle

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13
Q

What is contractility?

A

The inherent ability of the myocardium to contract normally. The greater the stretch the more forceful the contraction

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14
Q

What is afterload?

A

The pressure that the ventricular muscles must generate to overcome the higher pressure in the aorta to get the blood out of the heart

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15
Q

How does heart failure affect preload?

A

Increases

16
Q

How do adrenergic drugs affect left ventricular afterload?

A

Increase

17
Q

How do calcium channel blockers affect contractility?

A

Decrease

18
Q

What are vascular factors?

A
  • exercise and venous blood flow
  • peripheral vascular resistance (high pressure and increase in left heart work)
  • blood volume (decreased then low co, increased them high co)
19
Q

How does an increase in contractility affect the heart?

A
  • increase in CO

- decrease pressure

20
Q

How does a decrease in contractility affect the heart?

A
  • decreased CO

- higher pressure

21
Q

How does increase blood volume affect the heart?

A
  • increased CO

- increased pressure

22
Q

How does low blood volume affect the heart?

A
  • decrease CO

- decreased pressure

23
Q

How does uncompensated failure affect the heart?

A
  • decreased pressure

- decreased CO

24
Q

How does compensated failure affect the heart?

A
  • still below normal
  • increased pressure
  • increased CO
25
Q

What does hypovolemia cause?

A

Low pressure, low CO

26
Q

What does sepsis cause?

A

Low pressure, high CO

27
Q

What does hypervolemia cause?

A

High pressure, high CO

28
Q

What does CHF cause?

A

High pressure, low CO

29
Q

How do you know if therapy is effective?

A

Does intervention change the relationship between intravascular space and blood volume?

30
Q

What are left physical findings?

A
  • dyspnea
  • crackles
  • orthopnea
  • JVD
  • hepatomegaly
  • pedal edema
31
Q

What are physical findings of the right heart?

A
  • pedal edema
  • PCWP will not be as high
  • no crackles
  • no pulmonary veins/capillary issues
32
Q

What does an increase in preload cause?

A
  • increased fluid volume

- vasoconstriction

33
Q

What does decreased preload cause?

A
  • hypovolemia

- vasodilation

34
Q

What does increased afterload cause?

A
  • hypovolemia

- vasoconstriction

35
Q

What does decreased afterload cause?

A

-vasodilation

36
Q

What is the primary goal of all hemodynamic therapeutic intervention?

A

To optimize cardiovascular function in order to ensure adequate tissue oxygenation

RTH 236 (21 decks)

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