Hemodynamics

Question 1

Central venous pressure (CVP) range?

Answer 1

2-6 mmHg

Question 2

Right ventricular pressure (RVP) systolic/diastolic Range?

Answer 2

15-25 systolic
0-5 diastolic

Question 3

Pulmonary artery pressure (PA)
systolic/diastolic

Answer 3

15-25 systolic
8-15 diastolic

Question 4

PAWP range

Answer 4

8-12 mmHg

Question 5

Coronary perfusion pressure (CPP)

Answer 5

50-60 mmHg

Question 6

Cardiac Output Range

Answer 6

4-8 L/Min

Question 7

Cardiac Index range

Answer 7

2.5-5.0 L/M

Question 8

The transducer is placed at the _________ ?

Answer 8

Phlebostatic access 4th intercostal space.midaxillary line.

Question 9

Pic B is an example of an_______ waveform, what causes this?

Answer 9

Underdamped waveform.
extra tubbing or high SVR

Question 10

Pic C is an example of an_________ waveform. What causes this?

Answer 10

Overdamped waveform.
stiff, blockage, or small air bubbles.

Question 11

SVR

Answer 11

800-1200 dynes/ sec

Question 12

In a Swan Ganz the Red port is a _______Port and uses________ of air to inflate or just enough to see a waveform.

Answer 12

Balloon Port
1-1.5ml of air.

Question 13

In a swan Ganz, the red balloon port must remain_________ for transport.

Answer 13

deflated.

Question 14

In a Swan Ganz, The Yellow port is the ________ port and has the_______ at the end and is used to obtain a _________sample and for_________.

Answer 14

distal port
transducer
Mix venous gas
Sv02 sample.
Transducing.

Question 15

In a Swan Ganz cath which 2 ports are not to be used?

Answer 15

Red and yellow with the thermister connector

Question 16

In a Swan Ganz Cath the Proximal injectate port is________cm from the tip of the cath.

Answer 16

30cm and infusion injectate port is 31 cm from the tip of the cath.

Question 17

In a Swan Ganz cath which port is used to administer blood, fluids, and meds. and what is the color of the port?

Answer 17

The proximal port
Yellow.

Question 18

In a Swan Ganz cath there are two black markings

Answer 18

Thin black lines 10cm
Thick black lines 50cm

Question 19

discribe a pulmonary artery waveform.

Answer 19

has a dicrotic notch on the descending side indicating the closure of the aortic and pulmonic valves.
The waveform sits higher on the screen 15-25 systolic and 8-15 diastolic

Question 20

Name three types of obstructive shock.

Answer 20

cardiac tamponade. PE. tension pneumothorax. congenital heart

Question 21

Name two types of cardiac shock.

Answer 21

Left ventricular failure and dysfunction

Question 22

Name two types of distributive shock

Answer 22

Sepsis, anaphylaxis

Question 23

Three types of hypovolemic shock?

Answer 23

Loss of volume, burns, hemorrhage

Question 24

One type of neurogenic shock?

Answer 24

Spinal cord transection

Question 25

Name three types of dissociative shock.

Answer 25

Co-poisoning, toxic metabolites, methemoglobinemia. G.O.L.D.M.A.R.K

Question 26

What is the formula for systemic vascular resistance (SVR)?

Answer 26

MAP-CVP/ Cardiac Output X 80=

Question 27

CO (Q) formula

Answer 27

(SV) X (HR)/ 1000= Cardiac output

Question 28

CI formula

Answer 28

Q/BSI=

Question 29

A decrease in CVP ( right atrial ) may indicate?

Answer 29

Hypovolemia Vasodilation.

Question 30

Increased CVP ( right atria) may indicate?

Answer 30

RV infarct tricuspid insufficiency COPD or any chest issues... pressure in the PA backs up in the RV then Atria.

Question 31

A low RV may indicate a?

Answer 31

No preload Vasodilation

Question 32

An increase in RV may indicate?

Answer 32

RV failure, CHF, pulmonary HTN, and pressures on the PA.

Question 33

Anacrotic notch represents _______ on the RV waveform.

Answer 33

Atrial kick

Question 34

Can the (PAP) be used to estimate the wedge pressure?

Answer 34

Yes

Question 35

The (PAP) indirectly reflects______________?

Answer 35

Left ventricular end diastolic pressure.

Question 36

Decreased PAP may indicate?

Answer 36

Hypovolemia or vasodilation

Question 37

A high PAP may indicate?

Answer 37

left atrial or ventricular issues. mitral valve regurgitation or stenosis. pulmonary issues, COPD ext

Question 38

PCWP measures pressures in the?

Answer 38

Left ventricular end-diastolic pressure and Atrial pressure. Also known as a rolling waveform there is no correlation with the QRS.

Question 39

What causes a low PCWP?

Answer 39

Hypovolemia and Vasodilation.

Question 40

What causes an increase in PCWP?

Answer 40

LV failure, mitral valve stenosis cardiac tamponade.

Question 41

What two types of shock are identical in hemodynamic parameters? WHY?

Answer 41

Cardiogenic and Obstructive. The left ventricle is not ejecting blood out and obstructive shock is obstructed not pushing out as well.

Question 42

What are the hemodynamic parameters in Septic shock?

Answer 42

All parameters are low. There is no SVR due to pro-inflammatory mediators ( infection) causing vasodilation.

Question 43

What are the hemodynamic parameters in hypovolemic shock?

Answer 43

All are low except for SVR. No circulating volume so all is low and SVR has constricted.

Question 44

What are the hemodynamics in neurogenic ( distributive ) shock?

Answer 44

All are low and cardiac output ( CI) is normal. The spinal cord is severed and the system is dilated. But there is no fluid loss so CI is normal.

Question 45

What are the hemodynamic parameters in right heart failure? RHF

Answer 45

Wedge and CVP are opposite. CVP is high wedge is low.