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RET 2264 Advanced Modalities > Quiz #3 Hemodynamic Monitoring > Flashcards

Quiz #3 Hemodynamic Monitoring Flashcards

1
Q

What is Hemodynamic monitoring?

A

Is the movement of blood or circulation/perfusion of blood.

Hemodynamic is the movement of Blood pressure

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2
Q

What effect will have Low blood Pressure in cells?

A

The cells will not recieve the oxygen and nutrients they need to survive.

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3
Q

High Blood Pressure causes:

A

Strain on the heart and will eventually cause heart failure and increase the risk for Stroke.

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4
Q

What are the three factors that control Blood pressure?

A
  • Heart
  • Blood
  • vessels
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5
Q

How will the heart react to the administration of Chronotropic Drugs?

A

It will increase heart rate, ↑ BP, for example atropine

↑ HR = ↑ BP = ↑ CO

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6
Q

What effect will have a decreased heart rate, and what drug can cause it?

A

↓ HR, will decrease BP

B-Agonist drugs or Beta blockers will decrease HR, like:

  • Atenolol
  • Propanolol
  • Labetalol
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7
Q

Decrease in heart contractility, will have what effect on BP?, and what drug can decrease contractility?

A

BP will be decreased ↓.

Negative Inotropic drugs will decrease contractility, like:

Calcium Channel Blockers, examples:

  • Amlodipine (Norvasc)
  • Felodipine
  • Isradipine
  • Nicardipine
  • Nisoldipine (Sular)
  • Verapamil (Calan, Verelan)
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8
Q

What drugs can increase heart contractility?

A

Positive inotropic like:

  • dobutamine.
  • dopexamine.
  • adrenaline.
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9
Q

How the amont of fluid in the system will affects Blood Pressure?

A
  • ↑ in fluid will ↑ BP (hypervolemia)
  • ↓ in fluid , will ↓ BP (Hypovolemia)
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10
Q

How we treat excess of fluid in the body system?

A

Diuretics:

  • Lasix (furosemide)
  • bumetanide
  • Demadex (torsemide)
  • Edecrin (ethacrynic acid)
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11
Q

How we treat loss of fluid in the body system?

A

Decreasing the amount of fliud in the system wil decrease blood pressure, this issue can be fixed by adding fluids or blood products.

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12
Q

The contriction of the blood vessels will affect BP?

A

Definately, the contriction of blood vessels will ↑ BP. now, dilation of blood vessels will ↓ BP

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13
Q

To decrease vasocontriction, what type of drug do we use?

A

Vasodilators like:

  • Nitroprosside
  • Hydralazine
  • Milrinone
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14
Q

How we treat vasodilation?

A

With vasocontriction drugs, like:

  • Epinephrine
  • phenylephrine
  • Dopamine
  • Dobotamine
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15
Q

Arterial Pressure can be measured by:

A
  • Sphygmomanometer
  • Indwelling arterial cannula
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16
Q

In what artery is usually inserted the Indwelling arterial cannula?

A

In the Radial Artery

commonly referred as Arterial Line

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17
Q

What is the function of pressure bag?

A

Prevent outflow of blood into arterial line, is usually kept at 300 mm hg

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18
Q

What does Pressure transducer?

A

it detects arterial blood pressure and digitizes that signal into a monitor.

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19
Q

What is important about transducer ubication level?

A

The transducer must remain at the heart level, otherwise bloode pressure may not be accurate.

  • If above heart level, arterial pressure will ↓
  • If bellow heart level, arterial pressure will ↑
20
Q

This is called?

A

3 wat stopcock

21
Q

Indication for Arterial Blood Pressure Line?

A

◼ Indicated for continuous pressure measurement of critically ill patients with extremes of blood pressure requiring aggressive resuscitation efforts or titration of potent vasoactive agents

22
Q

What is the normal Systolic and Diastolic Blood Pressure?

A
  • Systolic: 90 - 140 mm Hg
  • Diastolic: 60 - 90 mm Hg
23
Q

When does start the ejection time on the wave form?

A

At the beginning of the constraction until the end of the constraction (nicrotic notch)

24
Q

CVP can be measured by:

A
  • Single lumen catheter
  • multiple lumen catheter

all on the SVC

25
Q

What condiction may elevate CVP?

A
  • Volume overload
  • Impaired right ventricular contractile function
  • Pulmonary hypertension
  • Right ventricular infarction
  • Pulmonic stenosis
  • Tricuspid valvular disease
  • Left-to-right shunts
26
Q

Pulmonary Artery Catheter are also called?

A

Swan-ganz catheter

27
Q

Pulmonary catheter is usually inserted on:

A

Internal Jugular Vein or Left subclavian vein

28
Q

How many port does PA catheter have?

A

4 ports:

  • Pressure measurements
  • Thermodilution injections
  • Cardiac output measurement
  • Medication infusions
29
Q

What pressure does PA measures?

A
  • Right atrium (2 - 6 mm Hg)
  • Right ventricle (25/0)
  • Pulmonary artery (25/8)
  • Left Atrium by PAOP (4 - 12 mm Hg)
30
Q

Pulmonary Artery Catheter or Pulmonary Artery Oclusion Pressure, meassures what pressure?

A

It is inserted on the right side of the heart, but it acually meassure the left side of the heart (Left Atrium)

31
Q

What pressure will affect the improper functioning of the left ventricle (left ventricular failure)?

A
  • PCWP will ↑
  • PAP will ↑
  • CVP may be affected on severe cases
  • CO will be decreased < 4L/min
  • Systemic Pressure ↓, < 90/60

(This is because left Ventricle is not able to pump blood to the body system normally any more, producing a back flow, increasing in pressure)

32
Q

CVP, PAP, PCWP, CO will move in what direction with

  • Left Heart Failure
  • mitral Valve Stenosis
  • CHF
  • High PEEP effects
A
  • CVP = Normal
  • PAP = ↑
  • PCWP = ↑
  • CO = ↓
  • Systemic Pressure = ↓
33
Q

Hypervolemia will affects CVP(2-6), PAP(25/8), PCWP(4-12), CO(4-8) in what direction?

Hypervolemia is a condition in which there is too much fluid in the blood. It is also known as fluid overload.

A
  • CVP = ↑
  • PAP = ↑
  • PCWP = ↑
  • CO = ↑
34
Q

Hypovolemia will affect CVP, PAP, PCWP, CO in what direction?

A
  • CVP = ↓
  • PAP = ↓
  • PCWP = ↓
  • CO = ↓
35
Q

Lung disordder, Pulmonary embolism, Pulmonary hypertension and Air embolism will affect CVP, PAP, PCWP and CO in what direction?

A
  • CVP = ↑
  • PAP = ↑
  • PCWP = N/↓
  • CO = N
36
Q

Pulse pressure is done by doing what formula?

A

Systolic - Diastolic

120 - 80 = 40 pulse

Normal value is 40 mm Hg

37
Q

Mean arterial pressure (MAP) formula

A

2(Diastolic) + Systolic)/ 3

38
Q

Cardiac Output formula

A

SV x HR = CO

normal value 4 - 8 L/min

39
Q

What is Systemic Vascular Resistant (SVR)

A

Is the pressure gradient across the pulmonary circulation divided by CO

SVR = MAP - CVP / CO

normal value < 20 mm Hg/L/min or 1600 dynes/sec/cm-5

  • SVR = 14 - 4 / 6*
  • SVR = 10 / 6*

SVR = 1.6 mm Hg

40
Q

Pulmonary Vascular resistance (PVR) formula

A

PVR = MPAP - PCWP / CO

normal value < 2.5 mm Hg or 200 dynes/sec/ cm -5

41
Q

What increases PVR

A
  • Hypoxemia
  • Pulmonary Hypertension
  • Lung disease
42
Q

CVP catheter is used for:

A
  • Estimate intravascular volume status
  • Intravenous access for medication Infusion
  • Venous Blood sampling
43
Q

PA have 3 to 4 ports used for:

A
  • Pressure measurements
  • Thermodilution injections ( CO measurements)
  • Medication infusions
44
Q

What pressure does PA catheter measure?

A
  • Right atrium (2-6 mm Hg)
  • Right Ventricle (25/0 Systolic/Diastolic)
  • Pulminary Artery (25/8 Systolic/Diastolic)
45
Q

How Left atrial pressure can be determine?

A

By Pulmonary Artery Occlusion Pressure (PAOP)

RET 2264 Advanced Modalities (5 decks)

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