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Tracy Hemodynamic
Hymodynamic and shock
| Question | Answer |
|---|---|
| what is hemodynamic definition and goal | Definition: study of forces involved in blood circulation ; Used to assess cardiovascular function in critically ill or unstable client ; Goal: Evaluate cardiac and circulatory function ; Evaluate response to intervention |
| Preload | : pressure or stretch exerted on the walls of the ventricle by the volume of blood filling the ventricle at the end of diastole |
| Afterload: | the resistance to ventricular contraction. The pressure the ventricle has to overcome to open the aortic or pulmonic valve and push blood out of the ventricle |
| Systemic vascular resistance | an estimate of afterload |
| Intra-arterial pressure monitoring use for what? | Very commonly used ; Allows for direct and continuous monitoring of systolic, diastolic and mean arterial pressures ; Used to monitor the effects of vasoactive drugs ; Can be used to obtain frequent blood ;samples i.e ABGs. |
| SVR systemic vascular resistance for what? | SVR is primarily determined by vessel diameter and distensibility (or compliance). |
| Factors affect to SVR? | sympathetic nervous system input , circulating hormones |
| what are some example for sympathetic nervous system input ; circulating hormones | epinephrine, norepinephrine and vasopressin). And renin – angiotensin system affect SVR |
| arterial Diastolic | reflects the arterial elasticity and the ability to maintain blood flow through capillaries. |
| Central Venous Pressure measure what and where? | Aka Right atrial pressure; Measures blood volume and venous return ; Primarily used to measure fluid volume status. |
| where is the CVP catherter inserted? | Catheter is inserted into the subclavian or jugular vein. It is positioned in the superior vena cava or just inside the RA |
| CVP normal value | : 2 – 8 cm of H20, or 2 – 6 mm of Hg |
| what cause CVP increase? | Vasoconstriction ; pulmonary hypertention; right heart failure due to COPD; raise intrathoracic pressure such as PEEP Fluid overload ; Cardiac tamponade ; |
| what cause CVP decrease? | Hypovolemia ; Shock states |
| What do we use CVP for? | The adjust fluid volume replacement mostly Also useful to determine if patient needs vasopressor or fluids ; So if your patient’s HR is 130, BP is 80/40, what is the MAP? CVP is 2 mm Hg. ; Does your patient need vasopressors or fluid? ; |
| 1 what is PA used for? | Used to evaluate left ventricular and overall cardiac function ; |
| 1what PA measure? | We can evaluate a number of pressures : Right atrium ; Right ventricle ; Pulmonary artery ; Left ventricle ; |
| 1 port blue is for what? | Proximal port – [Blue] used to measure central venous pressure/RAP and injectate port for measurement of cardiac output |
| 1port red is for what? | Balloon port – [Red] used to determine pulmonary wedge pressure;1.5 special syringe is connected |
| 1port yellow is for what? | Distal port – [Yellow] used to measure pulmonary artery pressure |
| 11port white is for what? | Infusion port – [White] used for fluid infusion |
| 2 normal value for Pulmonary pressure? | 25/10 |
| 1normal value Pulmonary wedge pressure | 8 – 12 |
| 1 what cause Wedge pressure increased? | LV failure – pulmonary edema ; Pericardial tamponade ; Cardiogenic shock |
| 1what cause Wedge pressure decreased | Hypovolemia ; Hemorrhagic shock |
| 1what valua of pressure on the flush solution at all times? | 300 mmHg |
| what happen if Catheter wedges permanently | considered an emergency, Notify MD, can cause pulmonary infarction |
| 1what cause Ventricular irritation? what are you going to do? | occurs if catheter migrates back into RV. Notify MD immediately can cause VT |
| 1 Normal parameter for Cardiac output | 4 – 8 L/min |
| 1 Normal parameter for Cardiac index | 2.4 – 4.0 L/min/m² |
| 1 Normal parameter for CVP/Right atrial pressure | 2 – 6 mm Hg |
| 1 Normal parameter for Systemic vascular resistance | 800 – 1200 dynes |
| 1 Normal parameter for PA pressure | 25/10 |
| 1 Normal parameter for Pulmonary wedge pressure | 4 – 12 mm Hg |
| 1 | Hypovolemic Fluid volume loss Vasodilation Transport Loss of hemoglobin Carbon Monoxide Obstructive- mechanical barrier Cardiogenic- pump failure |
| 1 four stage reponse for shock? | Initial shock Compensatory shock Progressive shock Refractory shock |
| 1 Initial shock anything change? UO BP HR Temp? | slight change HR, BR, temp cool in exreemities but no change in UO |
| 1 Compensatory shock | increase HR, RR, blood volume |
| 1Progressive Shock | hypotension (late finding);need intubate Patient is cold, altered mentally, oxygen saturations are low, pH is low (acidotic), they are very tachycardic and tachypneic |
| 1 Refractory Shock | Profound hypotension despite potent vasoactive drugs and / or fluids Hypoxemic despite oxygen therapy ; . Patient gets intubated for work of breathing, even if no respiratory issues |
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Created by:
tp667
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