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Flashcards in Hemodynamics Deck (45):
1

What 2 variables directly reflect organ perfusion

Blood pressure and CO

2

What is the formula for CO

HR x SV=CO

3

What is the for formula for SV

Preload + afterload+ contractility

4

What are the arteries responsible for

Afterload

5

What are veins responsible for

Preload as related to ventricular filling

6

What does a narrow pulse pressure indicate

Hypovolemia
Cardiogenic shock

7

What does a widened pulse pressure indicate

Septic
Anaphylactic
Neurogenic

8

What is a change in diastole a result of

Stimulation of the SNS ( blood vessels are constricting to increase BP

9

What VS should you always monitor for

HR above 110 at rest
Wide or narrow pulse pressure

10

What does orthostatic BP indicate

That the patient has no fluid reserve suggest to the DR. fluid resuscitation

11

How do you calculate CI ( cardiac index)

CO/BSA=CI

12

all circulatory measurements are referenced from what part of the body

The 4th intercostal space mid chest, this is known as the phlebostatic axis

13

At what height of the bed would the transducer no longer work

The height of the bed can be up to 60 degree without any ill effects

14

What is the zero technique

It opens air to establish atmospheric air pressure as zero! Turn the stopcock off to the pt. ( open to air and transducer). Press the zero button on the monitor system. Return the stopcock off to the air position.

15

How often should you level a invasive line

Whenever a patient moves

16

When should you zero a invasive line

Q8H

17

What should you always do to a arterial line flush bag

Deair the bag by holding it upside down, and fully filling the drip chamber

18

What are troubleshooting techniques of the damp system

Check all connections
Check for air or blood in the tubing
Check the line for patency
Are flush bags under the correct 300 mmg/Hg
Re zero, relevel, and check the patients position

19

Continuous flush systems for pressure lines deliver how much pressure?

3/cc hr

20

What is another name for central venous pressure (CVP)

Right arterial pressure

21

What does CVP measure

The pressure of the venous system on return to the heart
It measures the filling pressures of the right heart

22

The higher the CVP the what

The higher the CVP the higher the preload

23

What are indications of CVP monitoring

Rapid fluid administration
Assess intravascular fluid status
Admin of vasoactive or incompatible drugs, TPN
inadequate peripheral IV access
Frequent blood sampling

24

What are the 2 central venous sites

Interjugular vein
Subclavian vein
The femoral vein isn't used anymore bc of infections

25

Anything put over a guidewire is called what

The seldinger, after the dr. Who invented it

26

What is important to have the patient do during central venous insertion

Put on a mask and turn there head

27

What are causes of a increased CVP pressure

Hypervolemia
Fluid overload
Renal failure
Pulmonary HTN, PE
COPD
pulmonic valve disease

28

What are other cause of increased CVP Pressure

Failing heart, constricting pericarditis
Triscuspid defects, ventricular septal defects
Cardiac tamponade
Severe LV failure

29

What are causes of a decreased CVP PRESSURE

Hypovolemia, hemmorhage, diuretics, vomiting,
Vasodilation, fever, drugs, sepsis, SIRS, THIRD SPACING,

30

Which port should CVP be monitored from

The distal port

31

What are CVP removal techniques

Review PTT, PT, INR
place pt. flats, supine in bed
Explain the procedure
Turn off IV systems, flush system

32

What does CVP lines measure

Preload

33

After insertion of a CVP line what must be done before use

CXR prior to use

34

What is does arterial pressure monitor

Pressure exceeded on the arterial wall
Determined by flow and resistance

35

What is systolic arterial pressure provide

The maximum pressure of blood being excerted from the LV

36

A MAP greater than 65 indicates what

The kidneys are in trouble
It's it's higher than 110, your kidneys are really in trouble

37

What are indications for a arterial line

Continuous real time monitoring
Shock from any cause, hemmorhage, cardiac arrest
Vasoactive drug therapy,
Respiratory failure
Major surgical procedures

38

What side of the body Is the radial artery

Thumb side of hand

39

What side of the body is the ulcer artery

Pinky side of the thumb

40

What test should be done before ABG's and ART line insertion

Modified Allens test

41

Junctional rhythms

Inverted P waves

42

What is pulsus parodoxus

A decrease in systolic pressure during inspiration above 10mm/Hg

43

What type of disease processes is pulsus paradoxes typically get

COPD, barrel chested people
Cardiac tamponade
Constrictive pericarditis

44

What is pulsus alterans

When every other beat is weak suggesting advanced LV failure

45

What is true of a ART line

NO DRUGS SHOULD EVER GO THROUGH IT