Quiz 2 - Monitoring the Cardiovascular Patient Flashcards
What advantages does a right internal jugular have when doing a central line?
- Predictable Anatomy
- Landmarks easily identified
- Straight shot to the Superior Vena Cava
- Easy access
- High success rate (90-99%)
What are the benefits of placing a central line SUBCLAVIAN versus the internal jugular?
- Easier to insert
- Comfort (patient)
What are the benefits of placing a central line EXTERNAL JUGULAR versus the internal jugular?
-Easier cannulation if land marks are visible
T/F: Double cannulation of central lines can cause vein avulsion, catheter entanglement, catheter fracture.
TRUE
A SINGLE central venous pressure can give you valuable patient information.
FALSE (Trending multiple values give you important patient information.)
What values can a pulmonary artery catheter give?
- Cardiac output (CO)
- Pulmonary Artery Pressure (PAP)
- Pulmonary Capillary Wedge Pressure (PCWP)
- Central venous pressure (CVP)
- Left ventricular filling pressure
- guide fluid therapy
- Vasoactive drug therapy
What are some indications for using an
arterial line?
- Rapid moment to moment BP changes
- Freq blood sampling
- circulatory therapies: Bypass, IABP, vasoactive drugs, deliberate hypotension
- Failure of indirect BP: burns, morbid obesity
- Pulse contour analysis: SPV, SV
In what types of pts are complications with arterial lines more common?
- vasospastic disease
- prolonged shock
- high dose vasopressors
- prolonged cannulation
Which arterial line sites are more likely to thrombose, Proximal or Distal?
Proximal sites
What are some common sites for arterial lines?
Radial artery
Brachial artery
Femoral artery
What are some problems with a brachial artery line?
collateral circulation is not as good as a radial artery line. pt must keep arm extended with this type of line
What is Systolic Pressure Variation (SPV)? what is it predictive of?
SVP is the difference between maximal and minimal values of systolic BP during positive pressure ventilation.
A pressure difference > 15mmHg is HIGHLY predictive of hypovolemia
What are some indications for a Central Venous Line?
- CVP monitoring
- Advanced CV disease and needing major surgery
- secure vascular access for drugs
- secure access for fluids: introducer sheath
- Aspiration of entrained air (sitting craniotomy)
- Inadequate PIV access
- Pacer, or PAC
A patient is going to have a pulmonary arterial catheter placed in the right internal jugular. The patient’s EKG shows a sinus brady with PACs and LBBB. What should the health provider be prepared for?
-Complete Hearth Block (External Pacer should be applied to patient)
What is the normal of SvO2?
65 (60-75)
