Critical Care Monitoring Flashcards
(20 cards)
a-line aortic regurgitation
a-line aortic stenosis
a-line HTN / atherosclerosis
CVP cannon a-waves (common w/ AV block, strong a-waves also observed in pulm HTN)
CVP tricuspid regurgitation
CVP tricuspid stenosis
CVP AFib
identify what each letter represents
a. ) atrial contracture
c. ) tricuspid valve elevation into RA
x. ) downward movement of contracting RV
v. ) back pressure wave from blood filling the RA
y. ) tricuspid valve opens in early ventricular diastole
identify each what is occurring at each “x”
- systolic uptake
- peak systolic P
- systolic decline
- dicrotic notch
- diastolic runoff
- end-diastolic P
a-line overdamped
a-line underdamped
a-line IABP
normal RA pressure __-__mmHg
0-8mmHg
what are the contraindications to PA catheterization?
- LBBB (because PAC can cause RBBB; combined, these two would create total heart block)
- cardiac pacemaker (may be for LBBB and pacer may be turned off for surgery)
- prosthetic tricuspid or pulmonic valve (more susceptible to infection)
- bleeding diathesis or coagulopathy
- MRI requirements
What complications can arise from PA catheterization (4)?
- transient RBBB (up to 5%) indication for external pacer if existing LBBB
- pulmonary infarction
- endocarditis (esp. w/ prosthetic valves)
- structural damage - PA rupture etc.
Where should the CVP be zeroed/positioned?
supine - mid-axillary line
Why do cannon A-Waves appear?
atria & ventricles contract at the same time –> blood pushes against the AV valve –> large pressure observed
Define:
- pulse pressure
- pulse pressure variation
- systolic pressure variation
- pulse P = systolic - diastolic (mmHg)
- pulse P variation = beat-to-beat diff b/t pulse P’s (%change)
- systolic P variation = beat-to-beat diff b/t systolic P’s only (because typically the systolic P varies a lot more than the diastolic P)
normal RV pressure __-__/__-__mmHg
15-25/0-8mmHg
normal PA pressure __-__/__-__mmHg
PA 15-25/8-15mmHg
