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Complete Real Exam 300 Questions And Correct
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DO2 (o2 delivery) is affected by 3 physiologic parameters
- the pump (is cardiac output adequate)
- the lungs ( is oxygenation adequate, excessive metabolic
demands?)
- the hemoglobin ( is there adequate o2 carrying capacity)
Pulmonary artery catheter contraindications
tricuspid or pulmonic prosthetic
valve right heart mass (thrombus or
tumor) tricuspid or pulmonic valve
endocarditis left BBB
,VO2 (increased oxygen consumption is affected by)
increased work of breathing
shivering
fever
infection
agitation
turning/mobility
nursing care
Pulmonary artery catheter guidelines
-measure at level of phlebostatic axis, 4th ICS &1/2 AP diameter ,
level of left atrium
-dynamic response , square wave testing (fast flush should see 1-
3 oscillatory waves following flush)
,Overdamped waveform
-sluggish, artifically round and blunted appearance
-SBP erroneously low and DBP erroneously high
- causes: large air bubbles, compliant tubing, loose/open
connections, low fluid level in bag
underdamped waveform
-over responsive, exaggerated, artificially spiked waveform
- SBP erroneously high, DBP erroneously low
- causes: small air bubbles, too long of tubing, defective transducer
Rules for measuring hemodynamic waveforms
- measure at end expiration
- interpret CVP and PAOP at mean of a-c wave
- ensure transducer is at phlebostatic axis
- ensure line is reliable (dynamic response test)
a wave
- upstroke of atrial systole
-produced after atrial depolarization; after PR interval
, c wave
- often not visible
- closure of tricuspid value for CVP and closure of mitral valve for
PAOP
v wave
-atrial diastole when tricuspid valve is closed
- produced after ventricular depolarization, QRS complex
Reading pulmonary artery catheter hemodynamics
- read the mean of "a" & "c" wave or the z point method
- z point method: read at the end of QRS complex
- z point method is the method used when patients are in
afib or junctional rhythm because they will not have an a
wave.
Complete Real Exam 300 Questions And Correct
Answers (Verified Answers) Already Graded A+ |
Guaranteed Success!! Newest Exam
DO2 (o2 delivery) is affected by 3 physiologic parameters
- the pump (is cardiac output adequate)
- the lungs ( is oxygenation adequate, excessive metabolic
demands?)
- the hemoglobin ( is there adequate o2 carrying capacity)
Pulmonary artery catheter contraindications
tricuspid or pulmonic prosthetic
valve right heart mass (thrombus or
tumor) tricuspid or pulmonic valve
endocarditis left BBB
,VO2 (increased oxygen consumption is affected by)
increased work of breathing
shivering
fever
infection
agitation
turning/mobility
nursing care
Pulmonary artery catheter guidelines
-measure at level of phlebostatic axis, 4th ICS &1/2 AP diameter ,
level of left atrium
-dynamic response , square wave testing (fast flush should see 1-
3 oscillatory waves following flush)
,Overdamped waveform
-sluggish, artifically round and blunted appearance
-SBP erroneously low and DBP erroneously high
- causes: large air bubbles, compliant tubing, loose/open
connections, low fluid level in bag
underdamped waveform
-over responsive, exaggerated, artificially spiked waveform
- SBP erroneously high, DBP erroneously low
- causes: small air bubbles, too long of tubing, defective transducer
Rules for measuring hemodynamic waveforms
- measure at end expiration
- interpret CVP and PAOP at mean of a-c wave
- ensure transducer is at phlebostatic axis
- ensure line is reliable (dynamic response test)
a wave
- upstroke of atrial systole
-produced after atrial depolarization; after PR interval
, c wave
- often not visible
- closure of tricuspid value for CVP and closure of mitral valve for
PAOP
v wave
-atrial diastole when tricuspid valve is closed
- produced after ventricular depolarization, QRS complex
Reading pulmonary artery catheter hemodynamics
- read the mean of "a" & "c" wave or the z point method
- z point method: read at the end of QRS complex
- z point method is the method used when patients are in
afib or junctional rhythm because they will not have an a
wave.
