hemodynamic monitoring

Question 1

What are the components of continuous hemodynamic monitoring?

Answer 1

Direct pressure monitoring system, flush system, pressure bag, transducer, and amplifier

Question 2

How much pressure should the pressure bag be maintained at?

Answer 2

300 mmHg of pressure

Question 3

How much IV solution is continuously flowing per hour to prevent clotting?

Answer 3

3-5 mL

Question 4

What does the transducer do?

Answer 4

Converts the pressure coming from the artery or heart chamber into an electrical signal

Question 5

What does the amplifier do?

Answer 5

Monitor that increases the size of the electrical signal for display on the oscilloscope

Question 6

What is the nursing interventions for a patient on hemodynamic monitoring?

Answer 6

Keep the tubing patent, keep it in place, establish the reference point for function per shift

Question 7

At what point should the stopcock be placed?

Answer 7

4th intercostal space, atrium

Question 8

As hemodynamic monitoring continues, what risks are increased?

Answer 8

Infection, pneumothorax, air embolism

Question 9

What is the best place for an arterial line

Answer 9

Radial artery

Question 10

What can be measured from an arterial line

Answer 10

ABG, real time blood pressure

Question 11

Who is at high risk for low perfusion distal to the arterial line?

Answer 11

Patients with diabetes, PVD, hypotension, on IV vasopressors, previous surgery

Question 12

What does the Allen Test tell us?

Answer 12

Perfusion of the hand

Question 13

What does the CVP monitor?

Answer 13

Pressure of the right atrium

Question 14

What is a normal CVP

Answer 14

2-6 mmHg

Question 15

How do you treat a high CVP (over 6)

Answer 15

Right sided HF –> diuretics

Question 16

How do you treat a low CVP (under2)

Answer 16

hypovolemia –> IV fluid

Question 17

Where is the preferred site for CVP insertion

Answer 17

subclavian vein

Question 18

What does the Swan Ganz measure

Answer 18

Right atrial
Pulmonary artery systolic
Pulmonary artery diastolic
Mean pulmonary artery
Pulmonary artery wedge
Left ventricular filling pressures

Question 19

Why do we use wedge pressure to measure preload

Answer 19

its the most accurate

Question 20

What does increased wedge pressure indicate

Answer 20

LV failure

Question 21

What does decreased wedge pressure indicate

Answer 21

hypovolemia

Question 22

How is wedge pressure measured and what must be done when you finish

Answer 22

Blocking the blood flow to the pulmonary artery
Must deflate the balloon

Question 23

What are some nursing interventions for maintaining a CVP and Swan Ganz catheter?

Answer 23

Catheter care site
Prevent kinking of the tubing
Prevent pulmonary problems

Question 24

What is a pulse pressure analysis

Answer 24

Uses an arterial pressure waveform to continuously estimate the patients stroke volume, need a good waveform

Question 25

What would you measure with an esophageal Doppler

Answer 25

estimated cardiac output

Question 26

What is the Fick Principle

Answer 26

Usage of carbon dioxide measures for sedated, intubated, on MV patients

Question 27

What are the components of a direct pressure monitoring system?

Answer 27

Arterial line (much stiffer than regular IV line), pressure bag, pressure transducer & automatic flushing system (make sure blood doesn’t shoot out), saline filled non-compressible tubing

Question 28

What are the components of the flush system?

Answer 28

IV solution (may include heparin or only NS), tubing, stopcocks, flush device (provides continuous and manual flushing)

Question 29

How often should the arterial line pressure be compared with cuff pressure?

Answer 29

2-3 times per day

Question 30

What is the balloon capacity of a Swan Ganz?

Answer 30

1.5 mL