Hemodynamics-Vironee

Question 1

what is hemodynaimcs

Answer 1

the study of blood flow through the cardiovascular and circulatory system

PRESSURE-FLOW-RESISTANCE

Question 2

COMPONETS OF HEMODYNAMICS

Answer 2

central venous pressure(CVP)
Pulmonary Artery Pressure(PAP)
Arterial Blood Pressure(BP)-direct measure of pressure

Question 3

purpose of monitoring Cardiac Outpu Co and Cardiac Index

Answer 3

heart function and 02 delivery to body

Question 4

Cardiac Output is affected by =

Answer 4

CO=SV X HR

stroke volume the amount of blood ejected with each heart beat

Question 5

Normal Stroke Volume

Answer 5

60-70

Question 6

CI=

what is this?

Answer 6

CI=CO/ BSA
normal 2-4
cardiac output is corrected by body size-more accurate

Question 7

preload is

Answer 7

volume in the ventricles at the end of diastole

Question 8

factors that affect preload

Answer 8

increased fluid volume

vasocontriction and the % of total volume

Question 9

afterload is

Answer 9

the amount of resistance the heart pumps against

Question 10

vasoconstriction is inversly related to

Answer 10

Stroke volume and CO

Question 11

Types of afterload

Answer 11

PVR-pulmonary vascular resistance

SVR-systemic vascular resistance

Question 12

PVR
what is this
norm

Answer 12

the pressure the right ventrice must overcome to pump blood through the pulmonary circulation
norm is 120-200
–this takes less force than left

Question 13

SVR

Answer 13

the amount of resistance the left ventricle must overcome to pump blood through the systemic circulation

norm 800-1200

Question 14

what is CVP

Answer 14

central venous pressure

Question 15

what is the normal cvp

Answer 15

5-10 mmHg

Question 16

where does the CVP measure

Answer 16

measures filling pressure the SVC or in the right atrium when the when the tricuspid is open

Question 17

where is ths CVP measured

Answer 17

in the SVC

Question 18

what can the CVP assess

Answer 18

it can assess the right ventricular function and the venous return to the right side of the heart (intravascular blood volume)
RV function
RA pressure

Question 19

overall guide to fluid balance is

Answer 19

what the central venous pressure measures

Question 20

what is used to measue the CVP

Answer 20

central line or pulmonary artery catheter

Question 21

insertion site of cvp monitor

Answer 21

IJ or Subclavian SC most common

Question 22

decreased CVP indicates

Answer 22

hypovolemia

vasodilation

Question 23

increased CVP pressure indicate

Answer 23

hypervolemia
RV failure
mechanical ventilation

Question 24

what port will we use when measuring the CVP

Answer 24

distal port

Question 25

how will we remove CVP *********

Answer 25

this is a sterile procedure-mask make sure patient is flat or in trendelenburg if patients condition allows --ask pt to take a deep breath(increase intrathorasic pressure decreases chance of embolism) --then apply firm pressure

Question 26

True False | when inserting and removing we will see changes in the ECG these are abnormal and we should stop.

Answer 26

FALSE-these are nomal and we should not stop

Question 27

what does PAP measure?

Answer 27

measure systolic, diastolic, and mean pressure --assess Left ventricular pressure (Pulmonary wedge pressure)

Question 28

Normal systolic pressure PAP Diastolic PAP MEan PAP

Answer 28

15-25 8-15 10-15

Question 29

PAOP what is this cautions highs and lows

Answer 29

PAOP what is this :pulmonary artery occlusion pressure--ballon inflation occludes forward flow in branch of PA 1.2-2 cc of air cautions highs and lows

Question 30

mixed venous o2 saturation?

Answer 30

refelcts the balance of 02 supply and demand - measure the oxyhemoglobic in desaturated blood returning to RV and PA - -can see what percentage is left typically 75 %

Question 31

increase in V02=

Answer 31

an increase in oxygen consumption will lead to a decrease in the amount of mixed venous oxygen saturation that will go to RV

Question 32

Nursing consideration when inserting a PA cath

Answer 32

insert at the end of expiration chest x-ray daily make sure ballon remain deflated

Question 33

What is an art line?

Answer 33

continous pressure of systole, diastole, and MAP are needed-blood gases and glucose

Question 34

sites we can use for art line

Answer 34

radial, femoral brachial, axillary

Question 35

what can we do to see if an art line is suitable in our location

Answer 35

allen test

Question 36

in a normovolemic patient how does art line measurements compare with actual blood pressure

Answer 36

Bp is within 10-15 of BP

Question 37

what is plebostatic axis | why

Answer 37

want to keep the transducer at phelbostatic axis:which is intersection between the midclavicular and 4 ics ------approxiate level of right atrium

Question 38

what happens if transducer is below the phlebostatic axis | above?

Answer 38

below=false high | above=false low

Question 39

what is zeroing and leveling

Answer 39

-make sure transducer does not have ecess air -remove cap TURN STOPCLOCK OFF TO PATIENT(UP) OPEN TO AIR & PRESS ZEROON MONITOR DONE AT LEAST ONCE PER SHIFT