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Adult Health I > T1: Cardiovascular Assessment (2) > Flashcards

T1: Cardiovascular Assessment (2) Flashcards

1
Q

What information does HEMODYNAMIC MONITORING provide?

A

(Continuously shows the BP)

  • vascular capacity
  • blood volume
  • pump effectiveness
  • tissue perfusion
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2
Q

Hemodynamic monitoring is usually done in the _____ artery.

A

Radial

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3
Q

Responsibilities of the nurse during hemodynamic monitoring:

A
  • What is being MEASURED?
  • Is the device ACCURATE & working properly?
  • Survey for COMPLICATIONS
  • Monitor for TRENDS in values
  • What other PARAMETERS need to be assessed?
  • When, what, who to NOTIFY?
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4
Q

Components of hemodynamic monitoring equipment:

A
  • high pressure tubing
  • flush system
  • transducer
  • monitor
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5
Q

What is the pressure bag set at?

A

300 mmHg

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6
Q

Where is the transducer positioned?

A

phlebostatic axis

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7
Q

Where is the phlebostatic axis?

A

4th intercostal space, mid-way of the AP diameter of chest

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8
Q

What should the bed position be during hemodynamic monitoring?

A

Keep consistent at 0-60 degrees

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9
Q

To calibrate, “zero” with transducer open to _____ _____ every shift and every position change.

A

atmospheric pressure

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10
Q

What does a FAST FLUSH WAVEFORM TEST evaluate?

A

checks the monitoring system’s ability to transmit accurate waveforms

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11
Q

What is an Allen’s test?

A

checks patency in both radial & ulnar arteries

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12
Q

If the systolic BP declines > 10 mmHg during INSPIRATION during normal spontaneous respiration, this is called ____ ____. What condition does this often accompany?

A

pulsus paradoxus

cardiac tamponade

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13
Q

When the pulse alternates in strength it is called ____ ____. What condition is this seen in?

A

pulsus alterans

heart failure

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14
Q

4 common locations of a central line:

A

1) internal jugular
2) subclavian
3) femoral
4) peripheral

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15
Q

4 values of a central line:

A

1) provides access for RAPID INFUSION of large volumes of fluid or blood
2) safer for infusion of CAUSTIC meds
3) allows measurement of filling PRESSURES of the right side of heart
4) can be used to measure MIXED VENOUS blood

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16
Q

Complications of central lines:

A
  • INFECTION!!!
  • pneumothorax
  • bleeding
  • thrombus
  • air embolus
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17
Q

Interventions for air embolus:

A

(treat the pt first, THEN call for help…or have someone else call while you intervene)

  • Trendelenburg
  • left side
  • 100% O2
  • notify MD
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18
Q

What is a CLABSI?

A

central line associated blood stream infection

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19
Q

Name 2 ways central venous pressure (CVP) is measured:

A
  • H2O manometer (intermittent)

- Mercury (continuous)

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20
Q

H2O manometer normal value:

A

3-8 cm H2O

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21
Q

Mercury normal value:

A

2-5 mmHg

22
Q

A pulmonary artery catheter monitors the pressure of the ___ ___.

A

left ventricle

23
Q

What needs to function normally for the pulmonary artery pressure to be accurate?

A

heart valves

24
Q

Normal PAS pressure:

A

20-30 mmHg

systolic pressure of pulmonary artery

25
Q

Normal PAD pressure:

A

5-10 mmHg

diastolic pressure of the pulmonary artery

26
Q

Normal PAPm:

A

10-15 mmHg

mean pressure of the pulmonary artery

27
Q

Normal PAWP:

A

(Remember, animals have 4 paws)
4-12 mmHg

AKA PAOP…reflects the filling pressures in the pulmonary vasculature LEFT sided pressures

28
Q

Central venous pressure (CVP) measures ____ side of the heart.
Wedge pressure measures ____ side of the heart.

A

CVP –> RIGHT (remember the venous system feeds into the right side of the heart)

Wedge –> LEFT (remember the wedge pressure is in the pulmonary artery which feeds into the left side of the heart)

29
Q

Right side of heart:

Normal preload pressure

A

2-5 mmHg

30
Q

Right side of heart:

____ reflects filling pressures

A

CVP (central venous pressure)

AKA: RVEDP, right ventricular end diastolic pressure

31
Q

Right side of heart:

Abnormal values are caused by what 4 things?

A

1) volume overload
2) right heart failure
3) dehydration
4) hypovolemia

32
Q

Right side of heart:

Treatment for abnormal values:

A
  • diuretics
  • fluid restriction
  • fluid bolus
  • blood or blood products
33
Q

Left side of heart:

Normal preload pressure

A

5-12 mmHg

34
Q

Left side of heart:

____ reflects filling pressures

A

PAWP (pulmonary artery wedge pressure)

AKA: LVEDV, left ventricular end diastolic pressure

35
Q

Left side of heart:

Abnormal values are caused by what 4 things?

A

1) volume overload
2) left heart failure
3) dehydration
4) hypovolemia

36
Q

Left side of heart:

Treatment for abnormal values:

A
  • fluid restriction
  • venodilation
  • diuresis
  • fluid
  • blood & blood products
37
Q

What is SVR (peripheral vascular resistance)?

A

Resistance of ejection of blood from the LEFT side of the heart

38
Q

Normal SVR:

A

800-1400 dynes/sec/cm-5

39
Q

Formula for SVR:

A

(MAP-CVP/CO) x 80

40
Q

Drugs to INCREASE SVR:

A

dopamine, norepinephrine

vasoconstriction & increased CO

41
Q

Drugs to DECREASE SVR:

A

nitroprusside, NTG, hydralazine

vasodilation

42
Q

What is PVR (pulmonary vascular resistance)?

A

Resistance of ejection of blood from RIGHT side of heart

43
Q

Normal PVR:

A

100-250 dynes/sec/cm-5

44
Q

PVR is ___ of SVR.

A

1/6th

45
Q

What 4 factors effect CONTRACTILITY?

A

1) preload volume
2) afterload
3) drugs with positive inotropic effects
4) drugs with negative inotropic effects

46
Q

How is LEFT SIDED preload volume measured?

A

PAOP

47
Q

How is LEFT SIDED afterload measured?

A

SVR

48
Q

What drugs have POSITIVE inotropic effects?

A

dopamine

dobutamine

49
Q

What drugs have NEGATIVE inotropic effects?

A

beta blockers

calcium channel blockers

50
Q

What 2 ways can contractility be measured?

A
  • cardiac output (from swangans catheter)

- left ventricular stroke work index (LVSWI)

51
Q

What 3 things effect stroke volume?

A

preload
afterload
contractility

52
Q

What 2 things effect cardiac output?

A

HR x SV = CO

Adult Health I (10 decks)

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