Hemodynamics Monitoring Flashcards Preview

Psurg > Hemodynamics Monitoring > Flashcards

Flashcards in Hemodynamics Monitoring Deck (24):
1

Hemodynamic Physical Assessment

JVD, BLE edema, crackles d/t fluid overload

2

Hemodynamic Non invasive monitoring

MAP, SaO2, EKG, VS

3

Hemodynamic Invasive monitoring

Arterial line; central venous pressure; swan-ganz catheter

4

Allen test is done when

q1hr and BEFORE insertion of invasive monitor; hold both ulnar and radial pulse then release ulnar pulse to see if there is enough perfusion with only that artery

5

Where is Arterial line inserted?

through radial artery

6

What does Arterial line measure?

MORE ACCURATE MAP than one acquired noninvasively; it constantly measures systolic and diastolic; so we know all organs are getting enough perfusion (kidney needs 60 mmHg)

7

What intervention with an Arterial line

use heparin to prevent clot in line

8

Arterial Line PC

loss of tissue s/p infarction

9

Central Venous Pressure?

measure R ventricular preload (the stretch); the mean pressure at the end of expiration.

10

Where is Central Venous catheter inserted?

through internal jugular or subclavian vein.

11

What does Central Venous Pressure dx?

fluid volume problem; the greater the CVP = R ventricular failure or fluid overload; the lower the CVP = hypovolemia

12

What can Swan Ganz dx?

dx L ventricular failure and mitral valve stenosis for, via L atrial pressure being equal to the pressure at pulmonary artery; can dx pulmonary HTN and pulmonary edema.

13

How is Swan Ganz Catheter inserted?

via subclavian, 4th intercostal space between sternum and axilla, through R atrium, tricuspid, to R ventricle; inflate the balloon and let float to pulmonary artery to wedge, then deflate balloon

14

Swan Ganz Catheter PC

DYSRHYTHMIA; then puncture ventricle; can rupture pulmonary artery with balloon; can cause infarction with balloon

15

Swan Ganz Catheter measures pressures in the

R atria, R ventricle, pulmonary artery pressure = to pressure as L atria

16

Intervention regarding the transducer r/t Swan Ganz

Keep level to atria of heart; zero to atmospheric pressure; HOB < 45 degrees; don't move it up and down;

17

why do we do zeroing?

so the monitor reads zero at atmospheric pressure

18

transducer should be at what level

at phlebostatic axis; level to atria of heart

19

If the transducer is placed too high

the reading will be low; erroneous reading

20

if the transducer is placed too low

the reading will be high; erroneous reading

21

PC of invasive monitoring

erroneous readings; hemorrhage slowly over 3 days, infection, thrombus, neuro impairment, loss of limb; death of tissue; maintenance complications;

22

Nursing Assessment with invasive monitoring

LOC, color, temp, VS, peripheral pulses, cap refill, UO, hypoactive BS; if pt change position reposition transducer to phlebostatic axis.

23

Patient teaching for invasive monitoring

don't pull it out

24

Nursing Dx

alteration in tissue perfusion; decreased cardiac output; fluid volume excess/deficit; activity intolerance (don't walk to bathroom with this);