NUR 241 - Critical Care I
Questions with complete verified
solutions(GRADED A+)
what is hemodynamic monitoring - answer measure of pressure,
flow, and oxygenation within the cardiovascular system - assess
heart function, fluid balance and effects of drugs on CO
what is systemic vascular resistance (SVR) or pulmonary vascular
resistance (PVR) - answer opposition to blood flow by systemic and
pulmonary vasculature (high = tight, low = loose)
what determines stroke volume (SV) - answer preload, after load
and contractility
what needs to be done when using equipment of invasive pressure
monitoring - answer it needs to be referenced and zeroed out and
the dynamic response characteristics need to be optimized
how is the invasive pressure monitoring system referenced/zeroed
out - answer place the transducer so the zero-reference point is at
the level of the atria of the heart (phlebostatic axis) - open the
stopcock to room air then close
where is the phlebostatic axis - answer 4th intercostal space at
midline - at level of the atria
what does zeroing confirm - answer confirms that when pressure in
system is zero, the monitor will read zero. allows us to be sure
readings are most accurate
,when does the equipment need to be zeroed out - answer whenever
the patient is moved, when something changes, or when we think
the reading is not accurate
how is arterial blood pressure monitored - answer non tapere teflon
catheter is used to cannulate the peripheral artery - the HCP
sutures it in place and then site is immobilized
what does arterial blood pressure monitoring tell us - answer MAP /
how well organs are being perfused
what are risks/complications of arterial pressure monitoring -
answer hemorrhage, infection, thrombus formation, neurovascular
impairment, loss of limb
describe the continuous flush irrigation system with an arterial line -
answer delivers 1-3 mL of saline per hour. this maintains line
patency and limits thrombus formation
how often do we need to assess neurovascular status when a
patient has an arterial line - answer every hour need to assess the
site distal to the arterial line
what is arterial pressure based CO monitoring (APCO) - answer
calculates continuous CO and CCI - used to assess pt ability to
respond to fluids
describe pulmonary artery pressure monitoring - answer guides
management of patients with complicated cardiopulmonary
problems - allows for precise manipulation of preload
what do pulmonary artery diastolic (PAD) and pulmonary artery
wedge pressures (PAWP) tell us - answer they are sensitive
indicators of heart function and fluid volume status
, describe a pulmonary artery flow-directed catheter - answer has a
balloon inflated tip to measure PAWP, 2 proximal lumens to measure
CPV, CO, draw blood and give fluids/drugs, also has a temperature
sensor at the tip
what does the pulmonary artery wedge pressure (PAWP) tell us -
answer reflects the left ventricular end diastolic pressure
what does the central venous pressure (CVP) tell us - answer
reflects the right ventricular end diastolic pressure
what do we do with the catheter to determine the pulmonary artery
wedge pressure - answer inject up to 1.5 cc of air and then retract it
to get the PAWP
what is used to determine the central venous pressure - answer a
central venous catheter or a pulmonary flow directed catheter
what is the normal CVP - answer 2-8
increased - RV failure, volume overload
decreased - hypovolemia, vasodilation
what is the normal pulmonary artery wedge pressure - answer 6-12
increased: LV failure, hypervolemia, mitral regurgiation
decreased: hypovolemia
what does systemic vascular resistance and arterial pressure
indicate - answer left ventricular after load
Questions with complete verified
solutions(GRADED A+)
what is hemodynamic monitoring - answer measure of pressure,
flow, and oxygenation within the cardiovascular system - assess
heart function, fluid balance and effects of drugs on CO
what is systemic vascular resistance (SVR) or pulmonary vascular
resistance (PVR) - answer opposition to blood flow by systemic and
pulmonary vasculature (high = tight, low = loose)
what determines stroke volume (SV) - answer preload, after load
and contractility
what needs to be done when using equipment of invasive pressure
monitoring - answer it needs to be referenced and zeroed out and
the dynamic response characteristics need to be optimized
how is the invasive pressure monitoring system referenced/zeroed
out - answer place the transducer so the zero-reference point is at
the level of the atria of the heart (phlebostatic axis) - open the
stopcock to room air then close
where is the phlebostatic axis - answer 4th intercostal space at
midline - at level of the atria
what does zeroing confirm - answer confirms that when pressure in
system is zero, the monitor will read zero. allows us to be sure
readings are most accurate
,when does the equipment need to be zeroed out - answer whenever
the patient is moved, when something changes, or when we think
the reading is not accurate
how is arterial blood pressure monitored - answer non tapere teflon
catheter is used to cannulate the peripheral artery - the HCP
sutures it in place and then site is immobilized
what does arterial blood pressure monitoring tell us - answer MAP /
how well organs are being perfused
what are risks/complications of arterial pressure monitoring -
answer hemorrhage, infection, thrombus formation, neurovascular
impairment, loss of limb
describe the continuous flush irrigation system with an arterial line -
answer delivers 1-3 mL of saline per hour. this maintains line
patency and limits thrombus formation
how often do we need to assess neurovascular status when a
patient has an arterial line - answer every hour need to assess the
site distal to the arterial line
what is arterial pressure based CO monitoring (APCO) - answer
calculates continuous CO and CCI - used to assess pt ability to
respond to fluids
describe pulmonary artery pressure monitoring - answer guides
management of patients with complicated cardiopulmonary
problems - allows for precise manipulation of preload
what do pulmonary artery diastolic (PAD) and pulmonary artery
wedge pressures (PAWP) tell us - answer they are sensitive
indicators of heart function and fluid volume status
, describe a pulmonary artery flow-directed catheter - answer has a
balloon inflated tip to measure PAWP, 2 proximal lumens to measure
CPV, CO, draw blood and give fluids/drugs, also has a temperature
sensor at the tip
what does the pulmonary artery wedge pressure (PAWP) tell us -
answer reflects the left ventricular end diastolic pressure
what does the central venous pressure (CVP) tell us - answer
reflects the right ventricular end diastolic pressure
what do we do with the catheter to determine the pulmonary artery
wedge pressure - answer inject up to 1.5 cc of air and then retract it
to get the PAWP
what is used to determine the central venous pressure - answer a
central venous catheter or a pulmonary flow directed catheter
what is the normal CVP - answer 2-8
increased - RV failure, volume overload
decreased - hypovolemia, vasodilation
what is the normal pulmonary artery wedge pressure - answer 6-12
increased: LV failure, hypervolemia, mitral regurgiation
decreased: hypovolemia
what does systemic vascular resistance and arterial pressure
indicate - answer left ventricular after load
