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Hemo
hemodynamics test review
| Question | Answer |
|---|---|
| Identifying marks for an arterial wave form? | the vertical scale has higher numbers |
| Identifying marks for the CVP waveform? | small thin line, lower to the horizontal scale line. |
| Identifying marks for the RV waveform? | waveform hits the top and the bottom of the scale. |
| Identifying marks for the PAP waveform? | peak is up tall but it never reaches the bottom. |
| Identifying marks for the PWP waveform? | the line is thin and wiggly but higher on the scale than the CVP. |
| Normal value for Arterial? | Sys 90-140 torr, Dia 60-90 torr, Mean 70-105 |
| Normal value for CVP? | 2-6 torr |
| Normal value for RAP? | < 6 torr |
| Normal value for RV? | sys 20-30 torr, dia 2-6 torr, |
| Normal value for PAP? | sys 20-30 torr, dia 8-15 torr, mean 10-20 torr |
| Normal value for PWP? | 4-12 torr |
| Normal value for CI? | 2.5-4.5 L/min/m2 |
| Normal value for QT? | 4-8 L/m |
| Normal value for C(a-v)O2? | 4-6 Vol% |
| Normal value for Stroke volume? | 60-130ml/beat |
| Normal value for ejection fraction? | 65-70% |
| Discuss preload? | stretch of the ventricle before the contraction. Venous return is most important. |
| Discuss afterload? | resistance that opposes ventricular ejection. |
| Procedure for placing an arterial line? | assemble equipment, perform Allen's test, drape pt, inject 1% lidocaine, catheter inserted 30 degree angle, hold needle and advance catheter, remove needle and secure, attach drip and observe waveform. |
| Procedure for placing a pulmonary catheter? | done by physician, check ballon for patency, inserted into selceted sight until reaches R atrium then inflate balloon with 1.5cc's. |
| Common sites for placing pulmonary catheter? | subclavian or internal jugular |
| Common sites for placing arterial catheter? | radial, brachial, or femoral. |
| Equipment needed for a pulmonary catheter? | bedside cardiac monitor, pressurized saline bag, pressure amplifier/monitor, BTFD catheter, pressure transducer system. |
| Equipment needed for an arterial line placement? | arterial catheter, flush device, hepranized saline bag, transducer, 4x4 sterile squares, lidocaine, betadine/alcohol, tape to secure. |
| What pressure is your hepranized bag placed at and what is the rate of your drip? | pressurized to 300 torr and set to drip 2-4ml per hour. |
| Thermodilution method for measuring QT? | dextrose or saline injected at room temp into the proximal port of pulmonary cath. measures heat loss in relation to blood flow. done several times to get and average. |
| Fick method for measuring QT? | requires I and E gases as well as mixed, gold standard, but rarely used. |
| Pulse Contour C.O. monitoring? | simultaneous measurements of art pressure and C.O. by other methods for a baseline. If art prssure goes up them C.O. will go up. |
| Estimated C.O. monitoring? | central venous blood used. If C(a-v)O2 is up then C.I. will be down and vice versa. Keep sats above 95%. |
| Discuss SVR? | Systemic Vascular Resistance- pressure on the vessel's throughout the body (from aorta). |
| Discuss PVR? | Pulmonary Vascular Resistance- pressure on the pulmonary artery |
| Discuss vascular resistance? | component of afterload determined by elasticity (compliance of vessel), size (radius), viscosity (how thick), changes in pressure (from one end of vessel to the other). |
| Discuss Ejection Fraction? | fraction of end diastolic volume ejected with each beat. EF=SV/EDV. <30% exercise tolerance severly limited. |
| Discuss EDV? | End Diastolic Volume- amount of blood before the contraction. Preload, or systole. |
| Discuss ESV? | End Systolic Volume- amount of blood after the contraction. Afterload or diastole. |
| Discuss Cardiac Work? | energy the heart uses to eject blood against the aortic or pulmonary pressures. Correlates with O2 requirments of heart. L ventricle has to work 6X harder then the R. |
| Calculate CaO2, CvO2, C(a-v)O2, C.O., and EF? | CaO2- (Hbx1.34)(SaO2)+(PaO2x0.003), CvO2- (Hbx1.34)(SvO2)+(PvO2x0.003), C(a-v)O2- CaO2-CvO2, C.O.- HRxSV or VO2/C(a-v)O2 x 10, EF- SV/EDV. |
| Discuss factors that affect contractility of the heart? | coronary blood flow, sympathetic nerve stimulation, Inotropic drugs, Physiologic depressants, damage to heart. |
| Discuss performance ability of the heart? | HR and SV |
| Index measurements? | measurements based on body size. |
| Left atrial filling pressures? | preload and PWP |
| Right atrial filling pressures? | amount of blood in R atrium or CVP |
| What do parameters do these reflect: CVP, PAP, PWP, C.O.? | CVP- R heart, fluid management; PAP- lungs, mixed venous blood; PWP- L heart; C.O. blood pumped in one minute. |
| Discuss LCWI? | amount of work on the left side of heart. |
| Discuss RCWI? | amount of work on the right side of the heart. |
| Discuss LVSWI? | directly related to SVR, mycardial mass, viscosity. |
| Discuss RVSWI? | directly related to PVR, myocardial mass, viscosity. |
| Both LVSWI and RVSWI increase with? | tachycardia, hypoxemia, and poor contractility. |
Created by:
ajwooly
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