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Critical Care FP-C > Invasive Monitoring > Flashcards

Invasive Monitoring Flashcards

1
Q

What is CVP and normal range?

A

Central venous pressure (right side preload)

2-6 mmHg

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2
Q

Increased CVP (2- 6 mmHg norm) can be caused by :

A

Fluid overload
Cardiac tamponade
R heart dysfunction / infarct
PEEP
L Sided HF
COPD
Tricuspid insufficiency
Pulmonary HTN

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3
Q

Decreased CVP can be caused by:

A

Dehydration
Volume loss (fluid or blood)
Venodilation
R atrial pressures

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4
Q

Arterial line

A

Direct and real-time systolic and diastolic pressure and MAP

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5
Q

What is this?

A

Normal art-line waveform

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6
Q

What is this?

A

Overdamped art line waveform

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7
Q

What is this?

A

Underdamped art line

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8
Q

Formula For CO

A

HR x SV

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9
Q

Stroke volume variance (SVV)

A

Another way to measure preload. Norma range under 13

(High and dry, number above 13 has a low preload may need more volume)

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10
Q

Limitations to FloTrac SVV

A

Spontaneous breathing
Open chest
Arrythmias

(Can use passive leg raise 45 degrees to measure if pt needs fluid. “Mini-bolus”)

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11
Q

Swan/PA Catheter

A

In the vena cava, right atrium, right ventricle, resting in the pulmonary artery. Multiple ports along the cath. Gives CVP/RAP, PAP, PCWP, and CO/CI

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12
Q

What is PAP and normal range?

A

Pulmonary artery pressure

Systolic: 15 - 25 mmHg
Diastolic: 8 - 15 mmHg

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13
Q

What can cause an increase in PAP?

A

Atrial septal defect
Pulmonary HTN
LV failure
Mitral stenosis/regurgitation

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14
Q

What is PCWP?

A

Pulmonary Capillary Wedge Pressure.

Measured by inflating a small balloon at the tip of the PA Catheter. Gives and indirect measurement of preload on the left side of the heart.

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15
Q

Normal range for PCWP?

A

8-12 mmHg

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16
Q

Reasons for increased PCWP value?

A

Fluid overload
Aortic stenosis/regurgitation
Mitrial stenosis
LV failure
Tamponade
Constrictive Pericarditis

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17
Q

Reasons for decreased PCWP?

A

Hypovolemia
Vasodilation

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18
Q

Do you leave the balloon inflated for PCWP?

A

No, you inflate, get your measurements, then deflate. Leaving it inflated blocks part of the pulmomary artery.

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19
Q

Cardiac output/ cardiac index (w/ PA Cath)

A

Can be continuous or intermittent

20
Q

Normal range for SVR

A

800-1200 dynes/sec/cm^5

21
Q

What causes low SVR values?

A

Below 800, vessels are very dialated, so there is little resistance. Low BP to be expected

22
Q

What causes elevated SVR?

A

Greater than 1200 dynes/sec/cm^5; vessels are very “clamped down”; expected elevated bp; increases workload of the heart d/t the heart beating against it. Can affect CO

23
Q

Equation to calculate SVR

A

[(MAP - CVP) / CO] * 80

24
Q

Normal PCWP range

A

8 - 12 mmHg

25
Q

Normal range for CVP

A

2 - 6 mmHg

26
Q

Normal RV pressure

A

Systolic: 20 - 30
Diastolic: 0 - 5

27
Q

Normal PVR range

A

100 - 200 dynes/sec/cm^5

28
Q

Equation for PVR

A

PVR = [(Mean PAP)/Q] - PCWP * 80

29
Q

Normal range of Q/CO

A

4 - 8 L/min

30
Q

CI formula

A

Q/BSA

31
Q

Normal range for CI

A

2 - 4 L/min

32
Q

Phlebostatic Axis

A

Mid-point between the anterior-posterior chest and the 4th ICS.

33
Q

What is this?

A

RV waveform in a PA cath. Emergency can cause pt to go into vtach

34
Q

What is this?

A

CVP/RAP waveform

35
Q

What is this?

A

PAP waveform

36
Q

What is this?

A

PCWP waveform

37
Q

What is this?

A

RAP/CVP waveform

38
Q

What causes overdamping of an artline waveform?

A

“Too stiff” blockages or air bubbles

39
Q

What causes underdamping in an artline waveform?

A

“Many bounces” extra tubing or high SVR

40
Q

What causes obstructive shock?

A

Cardiac tamponade
Tension pneumothorax
Pulmonary embolism
Congenital heart defects

41
Q

What causes cardiogenic shock?

A

Left ventricular dysfunction (systolic/diastolic failure)

42
Q

What causes Distributive shock?

A

Sepsis
Anaphylaxis

43
Q

What causes Hypovolemic shock?

A

Hemorrhage
Volume loss
Burn

44
Q

What causes neurogenic shock?

A

Spinal cord transection

45
Q

What causes Dissociative Shock?

A

CO Poisoning
Methemoglobinemia
Toxic metabolites

Critical Care FP-C (17 decks)

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