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hemodynamics

AD245 nursing

QuestionAnswer
Preload volume of blood in ventricle at end of diastole (REST) - the amount of blood in the ventricle before the next beat.
Afterload Resistance to the flow of blood from ventricles thru the aortic and pulmonic valves.
Contractility Strenght of contraction.
Starlings law As preload increased, CO increases until it reaches a PEAK and then it fails (CO will drop, blood continues to fill till it over flows and it will fail)
Increased Preload Increased CO
What increases preload? Fluids and vasopressors
What decreases preload? hemorrhage and fluid loss
Increased afterload = decreased CO
What causes increased afterload? HTN
What decreases afterload? vasodilators.
Decreased contractility = Decreased CO
What increases contractility? Adernergic vasopressor
What decreased contractility? MI and CHF
Which labs are considered before giving a swan? K, Na, mg and Ical
K (potassium) 3.5 to 5
Na 135 -145
mg 1.6 to 2.6
ical 4.5 to 5.6
CVP Central venous pressure
CVP Norm 4 to 10
Where is CVP measured? Right atrium
What does CVP measure? Right atrium pressure
What does increase CVP indicate? High blood volume & increase venous tone = decrease R ventricular contractitliy
What instrument do you need for CVP? Artline....no need for swan, but swan can measure it if in place.
CO 4L to 8L/min of bloodflow
How many beats per min is a normal HR? 60 to 80
How much blood flow per min is normal for stroke volume? 60 to 70ml
Calculation that determines CO HR x SV = Number of heart beats/min x the amount of ml of blood per min
What measures the CO? The swan
Where is CO measured? Right atrium
Example of HR x SV = ??? 80 bpm x 70ml/min = CO 5600 ml/min or 5.6 L/min
Cardiac index normal? 2.8 to 4.2 L/min
What measures CI swan ganz
Where is it measured? R atrium
Why is CI better than CO? Heart is based on clients weight and height.
SCV02 Central venous oxygen saturation
what does swan measure SCVO2? oxygen saturation rate, the oygen reserve (oxygen not used by the body)
normal value for SCVO2? ~ 70%
what devices measures SCVO2? artline, not swan
SvO2 is measured with what? Swan
Normal SvO2? 60 to 80%
What does <60% of SvO2 indicate? Decreased oxygen is being delivered to the body.
What causes <60% of Sv02 Body is consuming more oxygen because of decreased CO, decreased Hgb, decreased vent support,
What does >80% Sv02 indicate? Body is not taking in the blood d/t shunting. Body is not getting enough oxygen
PA or (PAP)normal 25/10 mmHg
what instrument measures the PAP? Need swan
What does PAP measure? Left preload and R Afterload
What causes an increase in PAP? Respiratory disorders (pneumonia, ARDS, emphysema) fluid, atelectasis, chest, trauma and pulmonary htn
PCWP 6 to 10 mmHG
This is measured when balloon is inflated and is needs swan ganz? PCWP
When balloon is inflated, what does PCWP measure? Right afterload and Left preload
When PCWP is >10 mmHg, this indicates? Left sided heart failure r/t pressure or high fluid.
MAP normal 70 to 90 mmHg
In some cases, what value is okay for MAP? < 65 mmHg
What value of MAP indicuated underperfusion? <60 mmHg
MAP is measured? Art line
SVR measures ? Systemic vascular resistance, via an artline or B/P
SVR norm 900 to 1600
What does SVR measure Left side afterload.
Created by: Wends1984