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NUR 415 exam 1

flashcards for cardiology and pulmonary

What is hemodynamic monitoring Measurement of pressure, flow, & oxygenation within the cardiovascular system. Utilizes both invasive & non-invasive techniques and are measured in the ICU.
What are some common values that are measured? Systemic & pulmonic arterial pressuresCVP (Central Venous Pressures)PAWP (Pulmonary artery wedge pressure)CO (cardiac output & indexStroke volume & indexSaO2 (O2 Sats of hemoglobin in arterial bld)SvO2 (o2 Sats of hemoglobin in venous bld)
What is the difference between cardiac output & cardiac index? Basicaly the same measurement. However, indexing is adjusting based on the size of the body and is more accurate.
What is blood pressure? It is the pressure exerted onto the walls of the vessels. It is composed of the opposing blood floow & cardiac output.
What is SVR Systemic vascular resistanceOpposition to the pumping of the left ventricle.
What is PVR Pulmonary Vascular resistanceOpposition to the pumping of the right ventricle
What is preload? The volume within the ventricle at the end of diastole.
What is PAWP? Pulmonary Arterial Wedge Pressure. Pressure taken when a central catherter introduces a wedge that obstructs flow and measures the pressure. It reflects the mean left atrial pressure.
what is afterload? The forces opposing ventricular ejection:Systemic arterial pressure, Aortic valvular resistance, Mass & density of the blood to be moved.Increased afterload = decreased CO
How do you determine stroke volume (Sv), & what s the normal value range? SV = CO/HRThe normal range is 60-150 ml/beat
How do you determine SV index, and what is the normal range? SVI = CI/HRNormal range is 30-65 ml/beat/m2
What is the normal HR? 60-100 BPM
What is the normal CO? What is the calculation? 4-8 L/minCO = SV X HR
What drugs inprove contractility? (Positive inotropes) EpinephrineNorepinephrine (Levophed)dopaminedobutamine (Dobutrex)digitalis like drugsCalciummitrinome (Primacor)
What drugs diminish contractility? (Negative inotropes) barbituatesalcoholcalcium channel blockersb-adrenergic blockers
Arterial line uses and purpose? Central arterial pressure monitoringsystolic BPDiastolic BPMean Arterial Pressure (MAP) BP
Complications of arterial lines hemorrhage - monitor pressureinfection - change tubing every 96 hoursThrombus - Allen test (both ulnar and radial blocked and observe refill.)Neurovascular impariment - emergencyloss of limb - caused by newovascular impairment
Hemodynamic nursing assessment Baseline dataApprearance - TiredLOC - mental changesSkin color - pallortemp - coolvital signsperipheral pulses - decreasedurine output - decreased kidney perfusion
CVP Abnormal values Fluid volume statusDecreased CVP is hypovolemiaincreased CVP - right ventricle failure or volume overload
PAWP abnormal values Indicator of cardiac function and fluid volume.Increased PAWP - heart failure & fluid overloadDecreased PAWP - fluid depletion
What is MAP? Mean arterial pressureMAP = (SBP + 2(DBP))/3
MAP abnormal values less that 60 = hypovolemia (Med. emergency)BleedingdehydrationDecreased HR, decreased CO, decreased SV
Left sided failure Most common, Blood backs up into pulmonary system and left atrium. Increase pumonary pressure causes fluid extravasation into the interstitium & into the alveoli. This presents as pulmonary congestions and edema.
Digitalis toxicity GI - anorexia,nausea, vomitingVisual - blurred vision, colored vision, visual halos around dark objectsCNS - fatigue & drowsinessCardio - Dysrythmias (afib, vfib, heartblock), brady and tachycardia, apical/radial pulse deficit, heart failure.
Signs and Symptoms of decreased Cardiac Output (CO) Increased HR, Pallor, fatigue, dizziness, syncope
Signs and Symptoms of cardiogenic shock decreased cap refill, tachypnea, cyanosis, crackles\rhonchi, Increase Na & H2O, Decreased renal perfusion, decreased urine output, pallor, cool, clammy skin, decreased cerebral perfussion, anxiety/confusion, agitiation, decreased bowel sounds, N/V
Right sided heartfailure murmrs, JVD, edema, weight gain, Increased HR, Ascites, anasarca (Massive edema)
Created by: mpabner