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ECCC Block 1 > Block 1 Unit 2 Adult And Pediatric Hemodynamic Values > Flashcards

Block 1 Unit 2 Adult And Pediatric Hemodynamic Values Flashcards

1
Q

What’s the definition of Hemodynamics?

A

The physical and physiological principles of governing the movement of blood through the circulatory system

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2
Q

The principles of hemodynamics are divided into 3 categories, what are they?

A
  • Preload
  • Contractility
  • Afterload
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3
Q

What is Preload?

A

The volume of venous blood being returned to the heart.

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4
Q

What happened to the heart during Preload?

A

Preload is essentially the stretch of the right ventricle by the volume of the blood filling the chamber.

Think of it as the tank filling up with blood.

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5
Q

What is Contractility? ( HEMO)

A

The force of the myocardium during systolic ejection

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6
Q

What is Afterload?

A

The resistance to the systolic ejection.

The load or pressure that the heart must eject against.

The obstacle that the ventricle must overcome in order to eject the contents

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7
Q

What is the physiology effects of decreased Preload?

A

Decreased venous return and or decreased blood volume.

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8
Q

What Factors/ conditions may decrease a pts preload?

A
  • Hypovolemia due to hemorrhage
  • Vasodilation from sepsis
  • Trauma
  • Shock
  • Impaired atrial contractions e.g A-Fib
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9
Q

What is the physiology effects of increased Preload?

A
  • increased venous return aka fast filling time

Think of the tank being over filled

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10
Q

What Factors/ conditions may increase a pts preload?

A
  • Volume Overload
  • Vasoconstriction
  • R Heart Disease
  • Increased Intrathoracic Pressures
  • Intrathoracic Mass
  • Pneumothorax
  • Positive Pressure Ventilation
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11
Q

What is the physiology effects of decreased Contractility?

A

Stimulation of the parasympathetic nervous system, releasing the hormone acetylcholine, which decreases HR and BP

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12
Q

What Factors/ conditions may decrease a pts contractility?

A
  • Vagal Maneuvers
  • Drugs
  • Hypothermia
  • Hypoxia
  • Ischemia
  • Hyperkalemia
  • Positive Pressure Ventilation
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13
Q

What is the physiology effects of increased Contractility?

A

Sympathetic nervous system stimulation increases HR/BP

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14
Q

What Factors/ conditions may increase a pts contractility?

A
  • Exercise
  • Emotional Excitement
  • Medications such as Epinephrine and Norepinephrine
  • HF
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15
Q

What is the physiology effects of decreased afterload?

A

Decrease in vascular resistance; the resistance in the circulatory system that is used to create BP and control the flow of blood (decreased BP)

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16
Q

What Factors/ conditions may decrease a pts Afterload?

A
  • Hypotension
  • Hypovolemia
  • Shock
  • Vasodilators
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17
Q

What is the physiology effect of increased afterload?

A

-The heart has to work harder to open the valves and eject blood
- increased BP

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18
Q

What Factors/ conditions may increase a pts Afterload?

A
  • Hypertension
  • Aortic Stenosis
  • Cardiovascular Disease
  • Ventricular Hypertrophy
  • CHF
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19
Q

What is Hemodynamic monitoring?

A

The measurement and interpretation of the performance of the cardiovascular system. It evaluates cardiac performance and oxygenation.

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20
Q

Why do we monitor hemodynamics?

A
  • Early detection
  • Identification of the cause
  • Tx of physiologic change
  • evaluate cardiovascular function
  • Assess response to therapeutic interventions
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21
Q

How does hemodynamic monitoring, determine cardiac performance and tissue perfusion?

A
  • Cardiac output
  • BP
  • Intra-Cardiac volume/ Pressures
  • saturation of venous oxygenation ( Mixed Venous)
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22
Q

What is MAP?

A

Mean Arterial Pressure, Average of BP

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23
Q

What is our MAP important and what is our goal?

A

It’s is a great indicator of perfusion; MAP greater than 60 will keep all organs perfused.

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24
Q

What is Systolic blood pressure?

A

Blood Is ejected into the arteries, during a heartbeat

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25
Q

What is Diastolic blood pressure?

A

Pressure is exerted within the arteries, between heartbeat

26
Q

How are non-invasive O2 saturation calculated?

A

Using a skin probe

27
Q

How are invasive O2 saturation calculated?

A

With arterial blood from an ABG

28
Q

What is Cardiac Index?

A

Amount of cardiac output corrected for body surface area

29
Q

How is the Cardiac Index calculated?

A

Cardiac Output / BSA.

Cardiac output increases or decreases in proportion to the surface area of the body

30
Q

What is Central Venous Pressure?

A

The pressure in the Vena Cava/ R atrial pressure

31
Q

How is CVP measured?

A

Using the distal port of a central line.

32
Q

What is Ejection Fraction?

A

The fraction of the end diastolic ventricular volume that is ejected.

It’s a percentage that expressed how much blood the L ventricle pump south w/ each contraction and how well the heart is pumping blood to the body.

33
Q

You have a pt who has a EF of < 40%, what is this evidence of?

A

Heart Failure.

34
Q

With early detection and proper care/treatment, a pt can improve their EF.
T or F?

A

True

35
Q

What does Systemic Vascular Resistance represents?

A

A quantitative value for the left ventricle afterload.

It reflects changes in the arterioles which can effect the emptying of the left ventricle

36
Q

What does SVR help with?

A

Helps to differentiate among ideologies and guide therapy.

37
Q

What is pulmonary artery pressure?

A

Measure the resistance in the pulmonary vasculature.

38
Q

PAP assists in the dx of what?

A

Pulmonary HTN

39
Q

What is a pulmonary artery wedge/occlusive pressure?

A

A value that is measured by wedging, or occluding a pulmonary catheter with an inflated balloon in the branch of a pulmonary artery

40
Q

PAWP/ PAOP helps in the dx’ing the severity of what?

A

L Ventricular Failure

41
Q

What provides the most accurate and continuous blood pressure value?

A

Arterial Blood Pressure

42
Q

What’s an adult normal HR?

A

60-100 bpm

43
Q

What is considered bradycardia within an adult?

A

< 60 bpm

44
Q

What is considered tachycardia within an adult?

A

> 100 bpm

45
Q

How do you calculate your MAP value?

A

SBP+( DBPx2)/3

46
Q

What is a Stroke volume?

A

Amount of blood ejected from each ventricle with each heartbeat

47
Q

What port is used to measure a CVP?

A

Central line, distal port

48
Q

When are you supposed to zero your A-line?

A

At the beginning of your shift and with each assessment and/or position change

49
Q

Why do we perform a square waveform test?

A

Performed to ensure waveform/ pressure are accurate

50
Q

What is a normal waveform test result?

A

Square waveform shows a square pattern with one or two oscillations before the return of the arterial waveform

51
Q

The dicrotic notch demarcates what?

A

The end of systole and beginning of diastole.

52
Q

When performing a square waveform test with a fast flush, you see there are several oscillations after the square waveform. What does this indicate?

A

An underdamped arterial line

53
Q

What will happen if you have a underdamped arterial line?

A

False high SBP and false low DBP

54
Q

What causes a underdamped A-Line?

A

Extra long tubing, excessive stopcocks, and patients condition.

55
Q

After the flash flush, you receive one/ no oscillations that proceed and your upstroke of the waveform is slurred with loss of height and no visible dicrotic notch. What does this entail?

A

Overdamped arterial line

56
Q

What is the result of a overdamped A-Line?

A

False low SBP and false high DBP

57
Q

What causes a overdamped A-line?

A
  • Obstruction in line
  • Air blood or blood clots
  • Kinked lines
58
Q

You have a CVP < 4, what does this indicate?

A

Hypovolemia or venodilation

59
Q

You have a CVP > 8, what does this indicate?

A

R HF, Cardiac ischemia, or fluid overload

60
Q

What additional information does CVP provide?

A
  • R ventricle preload
  • Cardiovascular status
  • fluid balance

ECCC Block 1 (4 decks)

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