ANP1 Exam 3
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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LA pressure | correlates with LVP during diastolic filling (w/ normal MV)
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how does LA connect w/ R side of heart | pulmonary vasculature
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correctly wedged PAC | ~isolated from R pressures by balloon inflation
~distal opening exposed only to capillary pressure which is = to LA pressure
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PCWP is indirect monitor | 1. LV fiber length
2. according to Starling's Law, LV function
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PA indications | 1. ↓ LV fx (EF <40% / CI <2)
2. assess fluid status
3. eval response to fluids, pressors, inotropes
4. valve disease, CM, tamponade, HF
5. recent MI
6. ARDS
7. trauma/shock/hemorrhage
8. major vascular surg (cross-clamp)
9. high risk OB
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PA contraindications | 1. complete L BBB (risk of CHB)
2. WPW
3. Ebstein's malformation (risk tachyarrhythmia)
4. nidus of infection in bacteremic pt
5. thrombus formation w/ hypercoagulation pts
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PA insertion | ~thru RIJ
~continuous display of pressures
~recognition of waveforms
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PA complications | 1. Central line complications
2. bacteremia
3. endocarditis
4. thrombogenesis
5. pulmonary infarction
6. PA rupture
7. PA hemorrhage
8. catheter knotting
9. dysrhythmias
10. conduction abnormalities
11. PV damage
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PA duration of catheterization | < 72 (risk of complications increases)
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PA rupture | ~50-70% fatal
~nominal hemoptysis should not be ignored
~prompt placement double-lumen ETT
~maintain adequate oxygenation by unaffected lung
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SV formula | CO x 1000 / HR
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normal SV | 60-90 ml/beat
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SVR formula | (MAP - CVP / CO) x 80
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normal SVR | 1200-1500
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