2) HD Flashcards
1
Q
What do we monitor and how frequent
A
Temp, BP, HR, rhythm, O2 sat, ETCO2 Q5M
2
Q
What is the SBP, DBP, MAP, and pulse pressure
A
SBP - peak pressure generated during systolic ventricular contraction; reflects myocardial O2 requirements
DBP - trough pressure during diastolic ventricular relaxation; reflects myocardial O2 supply and coronary perfusion pressure
PP - SBP minus DBP
MAP - time weighted pressure during a cardiac cycle; DBP + 1/3 SBP
3
Q
Indication of A-line insertion
A
- continuous blood pressure monitoring
- hypotension that is undetectable from NIBP
- anticipated swings in HD during induction
- large volume fluid shifts
- titration of vasoactive drugs
- shock
- repeating blood samples
- failure of indirect BP measurements
4
Q
CVC indications
A
- vasoactive medications
- vessicant medications
- long term ABX
- TVP
- PAP
- CVP monitoring
- intermittent HD
- air aspiration
5
Q
CVC placement
A
- SVC/RA junction, parallel to vessel wall, below level of clavicle, above level of the rib, at the T4T5 interspace and the carina
6
Q
CVC complications
A
- vascular injury, cardiac tamponade, hematoma, pneumothorax, nerve injury, arrhythmia, thrombosis, P.E, infection
7
Q
CVP events
A
A wave C wave X descent V wave Y descent
8
Q
A wave
A
Atrial contraction
Corresponds with P wave
End diastole
Corresponds with atrial kick
9
Q
C wave
A
- occurs during isovolumetric contraction
- tricuspid valve bulges into atrium
- early systole
- occurs right after QRS
10
Q
X descent
A
- Atrial relaxation
- mid systole
11
Q
V wave
A
- ventricular ejection
- passive filling of RA with TV closed
- late systole
- occurs just after T-wave
12
Q
Y descent
A
- TV opens
- passive filling of ventricle
13
Q
What does a PAC measure
A
- intracardiac pressure
- LV filling pressures
- CO/CI
- mixed venous
- SVR/PVR
- can pace
14
Q
Describe swan
A
- 4 ports
- 7 French
- distal port PAP
- second port CVP
- 3rd port balloon
- 4th port temp/pacer
15
Q
PCWP waveform
A
A wave
C wave
V wave
