Week 3 Hemodynamic Monitoring & Cardiovascular Flashcards
1
Q
Hemodynamic monitoring
A
- Measurement of pressure flow & oxygenation within CV system
- Purpose: Assess heart fxn, fluid balance, & effects of fluids & drugs on CO
2
Q
Cardiac output (CO)
A
- Definitions
- ↓CO s/s
- Meds ↑CO
3
Q
Cardiac index (CI)
A
CO adjusted for body surface area (BSA)
4
Q
Stroke volume (SV)
A
Volume of blood coming out of aorta w/ every heartbeat
5
Q
Stroke volume index
A
SV adjusted to BSA
6
Q
Systemic vascular resistance (SVR)
A
Opposition encountered by left ventricle
7
Q
Pulmonary vascular resistance
A
- Opposition encountered by right ventricle
- Resistance to blood flow by vessels
8
Q
Stroke volume variation (SVV)
A
- Variation of arterial pulsation caused by heart-lung interaction
+ Sensitive indicator if preload responsiveness
+ Helps predict if pt benefits from additional IV fluid boluses
9
Q
Preload
A
- Volume that fills up at end-diastole
- Low v High preload
- Measurements of L & R sided preload
10
Q
Afterload
A
- Forces/resistance ventricles has to overcome to push blood forward
- Measurements of L & R sided afterload
11
Q
Diastole
A
When heart is filling; amt of filling in ventricles at end-diastole (preload)
12
Q
Systole
A
Time when heart contracts
13
Q
Contractility
A
- Strength of ventricular contraction
- Positive inotropes (↑contractility)
- Negative inotropes (↓contractility)
14
Q
Formula for CO
A
Cardiac output = HR x Stroke volume
15
Q
Pulmonary artery catheter (Swanz Ganz)
A
- Obtains measurements for fluid status, cardiac status, & heart fxn
- Indications
- Characteristics
+ Insertion - Complications
- Lumens (blue, white, red, yellow)
- Pulmonary artery wedge pressure (PAWP)
- Line placement procedure
- Ensure accuracy
- Infection prevention
16
Q
Arterial line (A-line)
A
- Indications
- Insertion
- Main purpose
- Characteristics
- Invasive arterial BP monitoring
+ Purpose
+ Zero-reference point
+ Square wave test - Complications
- Documentation
17
Q
Acute Coronary Syndrome (ACS)
A
- Blood supply to heart muscle SUDDENLY blocked (by thrombus made of plaque)
- STEMI v NSTEMI
- Stable v Unstable angina
- S/S + Assessment
- Priority intervention
- Diagnostics
+ Cardiac biomarkers - Procedures
+ Angiography/Cardiac catheterization
+ Angioplasty balloon - Post-angio site care
- Priority nursing considerations
+ Pt comes in w/ CP
+ Unstable angina & NSTEMI
+ STEMI - Nutrition
- Complications
18
Q
ACS Medication: Vasodilators
A
- Nitroglycerin
- Actions
- Nursing actions
19
Q
ACS Medication: Analgesics
A
- Morphine
- Actions
- Nursing actions
20
Q
ACS Medication: Beta-blockers
A
- Metoprolol
- Actions
- Nursing actions
21
Q
ACS Medication: Thrombolytics
A
- Alteplase
- Action
- Nursing actions
- STEMI v NSTEMI
22
Q
ACS Medication: Antiplatelets
A
- Aspirin & Clopidogrel (Plavix)
- Actions
- Nursing actions
23
Q
ACS Medication: Anticoagulants
A
- Heparin & Enoxaparin
- Actions
- Nursing actions
24
Q
ACS Medication: Lipid lowering statin
A
- Atorvastatin
- Actions
- Nursing actions
25
Coronary Artery Bypass Graft (CABG)
- Surgical procedure to restore vascularization of myocardium & improve client quality of life; open heart surgery
- Indications
- Machine
+ Pre-procedure
+ Post-procedure
- Common grafts/vessels used
- Complications
26
Pacemakers
- Helps control abnl heart rhythms w/ low-electrical pulses to prompt heart to beat at normal rate
- Types (Transcutaneous, epicardial, transvenous)
- Indications
+ Implantable Cardioverter/Defibrillator (ICD)
+ Pacemaker
- A/V-paced PM
- Nursing care
+ ECG monitoring for malfunction
+ Complications
27
Aneurysm
- Weakness in a section of a dilated ARTERY => Widening or balloon in wall of blood vessel
- Risk factors
- Types (saccular v fusiform)
- Common sites
+ Aortic dissection
+ Thoracic aortic aneurysm
+ Abdominal aortic aneurysm
- Nursing priorities
- Complications
- Tx & nursing interventions
28
Abdominal Aortic Aneurysm (AAA)
- Risk factors
+ Non/modifiable
- Complications
- Diagnostics
- Manifestations
+ Asymptomatic
+ Symptomatic
- Aneurysm rupture s/s
- Treatments
29
Aortic Dissection
- Blood accumulating through inner layer of aorta => TEAR b/w inner & middle layers => Splits apart aorta (dissect)
- Manifestations
+ Acute Type A/B
+ Dissection pain v. MI pain
+ Aortic arch involved
+ Type A
+ Subclavian artery
+ Aortic progression
- Classifications
+ Location of dissection
+ Duration of onset
- Risk factors
- Diagnostics
- Treatments
- Nursing interventions
+ Preoperative
+ Postoperative
+ Discharge teaching
