Exam 1- Hemodynamics & Electrical therapies

Question 1

Preload

Answer 1

Circulatory effects before blood reaches the heart

VOLUME, VOLUME, VOLUME

Measured by PA pressure

Question 2

How is the preload measured

Answer 2

By Pulmonary artery (PA) pressure

Question 3

Contractility

Answer 3

Cardiac muscle’s capacity to contract

“Stretch”

Contractility looks at Ejection Fraction and Cardiac Output

Question 4

Afterload

Answer 4

Circulatory effects as blood leaves the hear; resistance or pressure that the ventricle must overcome to eject volume

Question 5

How is afterload measured

Answer 5

Measured by BP

-Mean arterial pressure is another measure

Question 6

To decrease afterload

Answer 6

• Vasodilators
• ACE Inhibitors
• CCB

Question 7

To Increase afterload

Answer 7

• Vasoconstrictors

- Dopamine

Question 8

To decrease contractility

Answer 8

Decrease preload
Electrolyte imbalance
IABP
Beta blockers

Question 9

To increase contractility

Answer 9

Increase preload
Give inotropic drugs
VAD (ventricular assist device)

Question 10

To increase preload

Answer 10

Fluids
Volume expanders
Vasoconstrictors
Blood products

Question 11

To decrease preload

Answer 11

Diuretics

Vasodilators

Question 12

Normal cardiac output

Answer 12

2 to 2.4

Question 13

Two major uses for an arterial line

Answer 13

Blood pressure monitoring

ABG sampling labs

Question 14

What does SVO2 reflect

Answer 14

Tissue oxygen consumption

Question 15

T/F Vasoactive drugs should be administered through an arterial line?

Answer 15

False

Question 16

Why is an allen’s test performed?

Answer 16

Before you place arterial line

Question 17

What assessments are done by the nurse post arterial line insertion?

Answer 17

.

Question 18

Failure to capture

Answer 18

.

Question 19

Cardiac output

Answer 19

Amount of blood pumped into the heart per minute

CO =HR X SV

Question 20

What is used to evaluate fluid status

Answer 20

Central venous pressure (CVP)

Question 21

Which line carries substantial risk of an air embolism?

Answer 21

Arterial line

Question 22

Nitroglycerine is a

Answer 22

vasodilator

Question 23

Where is the phlebostatic axis? Where is it in reference to the body?

Answer 23

4th ICS, midaxillary line

Level of right atrium

Question 24

Where is the transducer leveled to

Answer 24

Phlebostatic axis

-re-level each time pt moves

Question 25

Zero referencing

Answer 25

Is the act of standardizing the transducer to obtain accurate measurements Performed: - on insertion - q4hrs - or with position change

Question 26

Arterial pressure monitoring

Answer 26

-Accurate, direct, INVASIVE

Question 27

ABP Waveforms

Answer 27

should correspond to the ekg waveforms

Question 28

Highest risk of complication for all lines

Answer 28

Infection

Question 29

CVP measures

Answer 29

volume returning to the heart

Question 30

CVP looks at (indications for cvp)

Answer 30

FLUID BALANCE - fluid administration - blood sampling

Question 31

Causes of Increased CVP

Answer 31

Fluids Hypervolemic Pulmonary HTN Increased ITP (intrathoracic pressure)

Question 32

What is the preferred Arterial line site

Answer 32

Radial

Question 33

PAP measures

Answer 33

Pulmonary artery pressure | -pressure of blood volume in the lung circulation

Question 34

Indication for PAP

Answer 34

* Evaluate cardiac output, fluid volume* | - Aid in dx, monitor effect of interventions

Question 35

Natural Pacemaker

Answer 35

SA node

Question 36

Pacing threshold

Answer 36

amount of energy the output pulse needs to reliably capture the heart (or cause it to contract)

Question 37

Pace

Answer 37

Capturing the hearts electrical impulse

Question 38

Sense

Answer 38

"Seeing" the heart's own intrinsic rhythm (periscope). The pacer decides if it inhibits or triggers an impulse.

Question 39

Failure to capture (non capture)

Answer 39

pacer does not stimulate heart

Question 40

Failure to pace

Answer 40

lack of pacer stimulus when intrinsic rate < pacer rate

Question 41

Reasons to pace

Answer 41

- Symptomatic bradycardia - Uncontrolled tachycardia - Failure of the SA node - Post op diagnostics

Question 42

Symptomatic Bradycardia "crap"

Answer 42

``` Weakness Fatigue Syncope/Pre-Syncope Mental confusion Palpations Shortness of Breath Exercise intolerance ```

Question 43

Fixed pacemaker

Answer 43

Set at a rate, no change

Question 44

Demand pacemaker

Answer 44

Fires when needed if heart rate falls below threshold

Question 45

Single chamber pacemaker

Answer 45

RA or RV

Question 46

Dual chamber pacemaker

Answer 46

Both RV & RA

Question 47

Defibrillation

Answer 47

UNSYNCHRONIZED | -Done with pulseless VT and VF

Question 48

Cardioversion

Answer 48

SYNCHRONIZED | -Used for unstable VT, pulse present unstable PSVT, Afib, Aflutter