AD245 nursing
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| Preload | volume of blood in ventricle at end of diastole (REST) - the amount of blood in the ventricle before the next beat.
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| Afterload | Resistance to the flow of blood from ventricles thru the aortic and pulmonic valves.
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| Contractility | Strenght of contraction.
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| 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)
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| Increased Preload | Increased CO
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| What increases preload? | Fluids and vasopressors
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| What decreases preload? | hemorrhage and fluid loss
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| Increased afterload = | decreased CO
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| What causes increased afterload? | HTN
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| What decreases afterload? | vasodilators.
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| Decreased contractility = | Decreased CO
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| What increases contractility? | Adernergic vasopressor
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| What decreased contractility? | MI and CHF
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| Which labs are considered before giving a swan? | K, Na, mg and Ical
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| K (potassium) | 3.5 to 5
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| Na | 135 -145
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| mg | 1.6 to 2.6
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| ical | 4.5 to 5.6
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| CVP | Central venous pressure
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| CVP Norm | 4 to 10
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| Where is CVP measured? | Right atrium
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| What does CVP measure? | Right atrium pressure
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| What does increase CVP indicate? | High blood volume & increase venous tone = decrease R ventricular contractitliy
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| What instrument do you need for CVP? | Artline....no need for swan, but swan can measure it if in place.
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| CO | 4L to 8L/min of bloodflow
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| How many beats per min is a normal HR? | 60 to 80
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| How much blood flow per min is normal for stroke volume? | 60 to 70ml
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| Calculation that determines CO | HR x SV =
Number of heart beats/min x the amount of ml of blood per min
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| What measures the CO? | The swan
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| Where is CO measured? | Right atrium
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| Example of HR x SV = ??? 80 bpm x 70ml/min = | CO 5600 ml/min or 5.6 L/min
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| Cardiac index normal? | 2.8 to 4.2 L/min
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| What measures CI | swan ganz
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| Where is it measured? | R atrium
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| Why is CI better than CO? | Heart is based on clients weight and height.
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| SCV02 | Central venous oxygen saturation
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| what does swan measure SCVO2? | oxygen saturation rate, the oygen reserve (oxygen not used by the body)
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| normal value for SCVO2? | ~ 70%
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| what devices measures SCVO2? | artline, not swan
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| SvO2 is measured with what? | Swan
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| Normal SvO2? | 60 to 80%
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| What does <60% of SvO2 indicate? | Decreased oxygen is being delivered to the body.
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| What causes <60% of Sv02 | Body is consuming more oxygen because of decreased CO, decreased Hgb, decreased vent support,
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| What does >80% Sv02 indicate? | Body is not taking in the blood d/t shunting. Body is not getting enough oxygen
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| PA or (PAP)normal | 25/10 mmHg
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| what instrument measures the PAP? | Need swan
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| What does PAP measure? | Left preload and R Afterload
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| What causes an increase in PAP? | Respiratory disorders (pneumonia, ARDS, emphysema) fluid, atelectasis, chest, trauma and pulmonary htn
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| PCWP | 6 to 10 mmHG
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| This is measured when balloon is inflated and is needs swan ganz? | PCWP
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| When balloon is inflated, what does PCWP measure? | Right afterload and Left preload
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| When PCWP is >10 mmHg, this indicates? | Left sided heart failure r/t pressure or high fluid.
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| MAP normal | 70 to 90 mmHg
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| In some cases, what value is okay for MAP? | < 65 mmHg
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| What value of MAP indicuated underperfusion? | <60 mmHg
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| MAP is measured? | Art line
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| SVR measures ? | Systemic vascular resistance, via an artline or B/P
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| SVR norm | 900 to 1600
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| What does SVR measure | Left side afterload.
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