unit 2 study guides Flashcards
(33 cards)
goal of hemodynamic monitoring-2
maintain adequate tissue perfomance, watch trends
cardiac output
amt of bld ejected by heart each min
cardiac output determined by
HR and stroke vol
stroke vol
amt of bld put out by the left vent in 1 contraction
preload
degree of vent stretch before contraction
afterload
amt of resistance the ventricles must overcome to deliver the stroke vol into receiving vasculature
why use art line-3
assess the efficiency of vasoactive meds, frequent ABG analysis, continuous monitoring
why use CVP line-5
est fl status, measure rt heart filling, guide fl resuscitation, administer large vol fl resuscitation, incompatable meds
why use pulmonary artery catheter-3
identify and treat cause of hemodynamic instability, assess pulmonary artery pressure, directly measure cardiac output
why use invasive hemodynamic monitoring-4
cardiogenic shock, hypovolemic shock, cardiac tamponade, low cardiac output
3 RN diagnoses-3
ineffective tissue perfusion, decreased cardiac output, fluid vol excess or deficit
complications of invasive hemodynamic monitoring-5
thrombosis, hematoma, infection, bleeding, pneumothorax
4 components of validating accuracy of hemodynamic monitoring
position pt, zero transducer, level the air-fluid interface, assess dynamic responsiveness
RN implications for art line-4
document assessment q 2 hrs, keep wrist in neutral position, apply pressure when diccontinued, never administer meds in art line
what does O2 bind to in RBC
Hgb
what are some factors that affect oxygen binding-2
temperature and pH
if CVP is low?
give IV fluids
assessment of successful fluid resuscitation
UOP
when ventilation reduced, PaCO2 does what
increase
cause of respiratory failure
hypoventilation
what happens w CO2 in hypoventilation
accumulates and not blown off, respiratory acidosis
age related factors for elderly and ARDS-8
calcification of costal and sternal cartilage, osteoporosis, spinal degeneration, kyphosis, flattening diaphragm, diminished cough, low immune response, decreased pulmonary blood flow
interventions for ARF-5
maintain patent airway, optimize O2 delivery, minimize O2 demand, treat cause, prevent complications
interventions for COPD-7
reduce exposure to irritants, stop smoking, air conditioning, vaccines, bronchodilators, inhaled glucocorticosteroids, O2
