Unit 3 Week 9 Monitoring and Life Support Flashcards
(47 cards)
what are considered noninvasive monitoring devices?
EKG, Vital monitors
when monitoring vitals what does the display usually include?
lead II EKG, HR, temp, BP, O2, RR
what are the indications of a declining status to look for in a patient? (common signs of emergency)
ST segment changes, multiple PVCs of change in foci, onset of ventricular tachycardia or ventricular fibrillation
what does pulse oximetry measure?
arterial oxygen saturation SpO2
expressed as a percentage of oxygen bound to hemoglobin
what is the threshold level of SpO2?
90%
what are the limitations of the pulse oximeter?
low perfusion or circulation, anemia, nail polish, fluorescent lighting, dark skin, jaundice, arrythmias
T/F: you should always rely on the pulse oximeter for an accurate pulse.
False
you should always take the pulse manually in the first couple of visits with a cardiac patient
what are the normal adult values of HR?
50-100 beats per min
what are the normal adult values of BP?
systolic 85 to 140 mmHg
diastolic 40 to 90 mmHg
what are the normal adult values of RR?
12 to 20 breaths per min
what are the normal adult values of oxygen saturation?
> 95% on fraction of inspired oxygen
what are the functions of an arterial line?
continuous BP management or hemodynamic monitoring, frequent ABGs taken, and drug administration
what are the common locations of arterial line placements?
- radial artery
- femoral artery
- brachial artery
- axillary artery
- ulnar artery
- dorsalis pedis artery
- posterior tibial artery
what precautions should you take when working with someone with an arterial line?
avoid dislodging - large blood loss
radial - limit or avoid WB on wrist
femoral - monitor closely and avoid dislodging
what are the functions of a central (venous) line?
measures central venous pressure (CVP) or right atrial pressure
allows IV access for medication administration
what is the difference between tunneled and non-tunneled central lines?
tunneled: long term - there is a short distance that the line is burrowed under the skin prior to entering the vein
non-tunneled: short term
where are central lines usually located?
inserted in the central vein like the subclavian or internal jugular; usually on the right side to give quick access close to the heart
femoral veins can also be used
where are PICC lines usually located?
cephalic, basilic, or brachial vein
for long term meds
what precautions should be taken when working with a patient with a CVP or PICC?
they need to remain sterile
usually well covered near skin insertion
secure ends before mobilizing
be aware of the location and avoid dislodging
what is a swan ganz- pulmonary artery catheter?
surgically inserted catheter through a central vein threaded through the right atrium and ventricle into the pulmonary artery
what are the functions of a swan ganz catheter?
measurement of blood pressure to locate/monitor heart failure through central venous pressure, right atrial pressure, pulmonary artery pressure, or pulmonary capillary wedge pressure
can also help with calculation of vascular resistance, SvO2 and temporary pacing
what is pulmonary capillary wedge pressure? what is the significance of a swan ganz catheter is relation?
(indirect) left sided heart filling pressure
elevated PCWP indicates pulmonary HTN and resistance to flow into the left ventricle
swan ganz measures left atrial pressure, filling pressure of the left ventricle and an indirect assessment of left ventricular function
what is a swan ganz catheter used for?
monitoring heart function (post sx)
diagnosing chronic heart failure
differentiating causes of pulmonary edema
and guiding dosing to manage fluid overload
what complications can arise with the dislodgement of the swan ganz catheter?
serious arrythmias
pulmonary artery rupture
pulmonary valve damage
infection of the heart
