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RCIS > Senior Monitor > Flashcards

Senior Monitor Flashcards

1
Q

State how a pressure wave is created

A

A pressure wave is created by cardiac muscular contraction and is transmitted from the vessel or chamber along a closed fluid filled column to a pressure transducer

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2
Q

RA Pressure

A

A wave2-10
V Wave2-10
mean0-8

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3
Q

RV Pressure

A

Sys 15-30

EDP 0-8

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4
Q

PA Pressure

A

Sys 15-30
Dia 5-14
Mean10-22

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5
Q

PCW/LA Pressure

A

a wave5-15
v wave5-15
Mean4-12

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6
Q

LV Pressure

A

Sys 90-150

EDP 4-12

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7
Q

AO Pressure

A

Sys 90-150
Dia 60-90
Mean70-105

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8
Q

Define mean pressure

A

Mean pressure represents the average pressure driving blood to the bodytissue throughout one cardiac cycle.

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9
Q

Given a method of determining cardiac output, choose when that method is most appropriate

A

The Fick method is prefered in cases with aortic and mitral regurgitation, and patients with low CO

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10
Q

“a” wave

A

small pressure wave produced by atrial systole

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11
Q

“x” descent

A

immediately follows the “a” wave and represents the atrial relaxation.

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12
Q

“c” wave

A

result partially from upward bulging of the AV valvesearly in ventricular systole.

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13
Q

“x^” descent

A

is produced by a downward pulling of the septum during ventricular systole.

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14
Q

“v” wave

A

increasein atrial pressure produced by right atrial filling during concomitant ventricular systole

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15
Q

“y” descent

A

produced by the opening of the AV valves and emptying of the atria into the ventricles

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16
Q

List the indications for a right heart catheterization

A

A right heart catheterization is indicated in a patient with a history of dyspnea, valvular heart disease, or intracardiac shunts

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17
Q

List the causes of an elevated PCWP

A
  1. LV failure
  2. Decreased LV compliance
  3. Mitral stenosis or regurgitation
  4. Cardiac tamponade/effusion
  5. Constrictive pericarditis.
  6. Volume overload.
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18
Q

State the formula for determining mean pressure

A 
           3
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19
Q

Select or list the complications of a right heart catheterization

A

Complications of a right heart cath are arrhythmias originating from stimulation of the RVOT, AV block, or RBBB

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20
Q

Define pressure gradient

A

A pressure gradient is the pressure difference across an area of valvular or vascular obstruction, such as stenosis or an occlusion or a narrowed valve

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21
Q

Given a ventricular pressure wave, select the components of the systolic phase

A

Isovoluminic contraction, rapid ejection and reduced ejection are the main components of the systolic phase.

22
Q

List the leads examined to determine if a patient has a left bundle branch block

A

V5, and V6 are used to determine if a patient has a left bundle branch block.

23
Q

List the leads examined to determine if a patient has a right bundle branch block

A

V1 and V2 for a right bundle branch block

24
Q

Given a ventricular pressure wave, select the components of the diastolic phase

A

Isovolumetric relaxation, early diastole, Atrial Systole, and end-diastole are the components of the diastolic phase

25
Q

List the artifactual variables that affect accurate measurements of pressure gradients

A
  1. Miscalibrated pressure transducers
  2. Pressure leaks on catheter manifold or connecting tubing.
  3. Pressure tubing type, length , and connectors.
  4. Air in system.
  5. Catheter sizes (especially in small diameters.
  6. Fluid viscosity (viscous contrast material tends to damp pressure wave).
  7. Position of catheter side holes (aortic stenosis with pigtail catheter.
26
Q

Given a component of the systolic phase of the ventricular pressure wave, choose the correct statement regarding that component

A

Isovolumic contraction Commences with closure of AV valve and ends with opening of semilunar valve
Ejection covers the period from the opening of the semilunar valve to the beginning of protodiastole when the slow downslope of the ventricular pressure pulse gives way to a rapid downslope.
Protodiastole ends when the rapidly declining ventricular pressure falls below that of the corresponding great artery and the semilunar valve closes.

27
Q

leads used to confirm the area of the heart that has suffered a myocardial infarction, Posterior

A

Posterior- large R waves with ST depression in V1 and V2

28
Q

leads used to confirm the area of the heart that has suffered a myocardial infarction, Inferior-

A

Inferior- ST elevation, significant. Q waves in II, III, and AVF

29
Q

leads used to confirm the area of the heart that has suffered a myocardial infarction, Lateral

A

Lateral- ST elevation, significant Q waves in I and AVL, V5, V6

30
Q

leads used to confirm the area of the heart that has suffered a myocardial infarction, Anterior

A

Anterior- ST elevation, significant Q’s in leads V1-V4

31
Q

Given a condition regarding catheter selection for aortic stenosis

A

Initial catheter selection is a matter of operator choice. Other choices for crossing the aortic valve are the left and right amplatz catheter, right judkins catheter, multipurpose catheter, and specially designed catheters that have been reported in the technical literature

32
Q

Select the correct points to remember when using guide wires to cross the aortic valve

A

Adequate heparinization, a maximal rate of 3 minutes per crossing attempt, a 0.035-inch or a 0.038 can be used, and gentle manipulation of the wire should be used to avoid damaging the valve

33
Q

Given a condition needed to accurately use the Fick oxygen consumption method

A

The Fick method is prefered in cases with aortic and mitral regurgitation, and patients with low CO

34
Q

List the different division of the autonomic nervous system

A

The different divisions of the autonomic nervous system are the sympathetic and the parasympathetic systems

35
Q

Given a principle, in which Fick and or indicator dilution cardiac output method is based on

A

Indicator dilution cardiac output method is prefered on shunt studies. Fick principle is based on cardiac outputs

36
Q

List three proposed explanations for the c-wave on the left atrial waveform

A

Each time the atria contracts, it not only forces blood into the LV but also into the pulmonary veins. C wave is the return of that blood.

37
Q

Given a list of statements, select the correct one regarding the timing of electrical events on an EKG compared to actual cardiac mechanical events

A

The “a” wave is immediately after the P wave on the EKG. The “c” wave coresponds to the RST junction of the EKG. The “v” wave can be found in the TP

38
Q

Given a list of statements, select the correct one regarding the hemodynamic setup used for recording of optimal pressure measurements

A

Zero the transducer properly at the midchest level, use the proper scale, and anticipate changes in the recording technique as the catheter is moved to new positions. Change pressure scales and paper recording speeds as necessary

39
Q

Pressure recording from a patient with tricuspid regurgitation

A

In tricuspid regurgitation the RA pressure rises during RV systole.

40
Q

Pressure recording from a patient with Atrioventricular Dissociation

A

In Atrioventricular Dissociation if the P wave comes after the tricuspid valve is closeda giant a or cannon wave is seen. Giant a waves occur during pacing.

41
Q

Pressure recording from a patient with aortic regurgitation

A

In aortic regurgitation the characteristic hemodynamic feature is a wide pulse pressure.

42
Q

Pressure recording from a patient with Mitral regurgitation

A

In Mitral regurgitation large v waves in the PCW tracing represent LV pressure transmitted backward through an incompetent mitral valve

43
Q

Select the correct use of the peak to peak and mean pressure gradients when determining the degree of aortic stenosis

A

Peak to peak pressure gradients are easily seen and are often used to estimate severity of stenosis

44
Q

Name the types of leads found on a standard twelve lead EKG

A

The types of leads found on a typical 12 lead EKG are chest leads and limb leads that are either unipolar or bipolar

45
Q

Given a patient with right or left atrial hypertrophy, state or select the correct configuration of the P-wave

A

With atrial enlargement the P wave in lead V1 is usually diphasic (both positive and negative). If the initial portion of the P wave is larger it is right atrial enlargement, if the terminal portion is larger than it is left atrial enlargement

46
Q

Which leads are unipolar

A

AVR, AVL, and AVF are unipolar leads

47
Q

Which leads are bipolar

A

I, II, III are bipolar leads

48
Q

Which leads are Limb leads

A

I, II, III, AVR, AVL, and AVF are Limb leads

49
Q

Which leads are chest leads.

A

V1, V2, V3, V4, V5, and V6 are chest leads.

50
Q

Select or state the effects of stimulating one of the divisions of the autonomic nervous system

A

By stimulating the sympathetic beta receptors are cardiac excitatory effects are an increase in rate of SA node pacing, and increased rate of conduction, an increased force of conduction, and an increased irritability of foci. Stimulation of the parasympathetic system are cardiac inhibitory effects such as a decreased rate of SA node pacing, decreased rate of conduction, decreased force of contraction, and decreased irritability of atrial and junctional foci

RCIS (4 decks)

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