Cardiovascular ICU || with complete solution.
what is an ECG used for correct answers monitor heart electrical activity
why should you assess as chest x-ray? correct answers -verify position of ETT
-verify correct position of swan-ganz catheter
-check position of all other tubes and drains
- check for pneumo
-check for lobar collapse, atelectasis, effusions, pulmonary edema.
what are cardiac catheterizations used for? correct answers visualization of the coronary arteries
Echocardiogram correct answers sound waves to produce images of your heart
Transesophageal Echocardiogram (TEE) correct answers Provides a close look at the heart's
valves and chambers, without interference from the ribs or lungs, allows for detailed view of the
heart structures (really good for valves)
Post op requires oropharyngeal suctioning with a french catheter to help remove lubricant used
for procedure.
should you use PEEP on a cardiac patient ? correct answers no, have incisions on the heart and
this can be detrimental.
How do we monitor Acid-Base balance in these patients? correct answers -ABG's
-keep cardiac patients alkalotic, acidosis results from hypoxemia and low cardiac output causing
significant tissue hypo perfusion.
-Hyperventilate post op patients and use larger Vt.
what lab values are monitored in these patients? correct answers -Electrolyte= prevent
dysrhythmias
-H&H
-Coagulation parameters (PLT, PT, PTT, INR, ACT)
-Cardiac/bio markers- used to evaluate heart function.(CPK, CPK-MB, and troponins)
what type of line does every cardiac patient get? correct answers - an arterial line
what lines are used to monitor these patients hemodynamic stability ? correct answers central
line, swan ganz(right heart catheter or pulmonary artery catheter), cardiac output and index
(stroke volume, preload, contractility, after load), SVR, PVR, mixd venous oxygen saturation
when your CVP (normal 2-6) drops what should you do in this unit? correct answers usually
don't give fluid unless it drops below 2 but for these patients we are concerned with perfusion so
if the CVP falls below 8 we will have a decrease in flow (from the drop in pressure) give these
patients fluid to bring pressure back up.
, what should you do if mean arterial blood pressure falls below 65 mmHg? correct answers give
pt vasopressor support medication.
what should you do if your patients central venous oxygen monitoring falls below 70%? correct
answers Give hematocrit
what should you do if your patients hematocrit falls below 30? correct answers blood transfusion
what are some common pharmacological agents used in this unit? correct answers Inotropes
(Adrenergic like catecholamine), Phosphodiesterase inhibitors, Vasopressors, Peptides,
Diuretics, Digitalis, Hypertension medication, Anticoagulants, Antiplataelet drug therapy.
When is sedation used in the ICU correct answers -used in the agitated, ventilated and for
procedure discomfort
-avoid self extubation and removal of catheters
-NM blockade mandates analgesia and sedation
-control pain before sedation
- all have side effects- dose dependent
analgesics are not sedatives/ sedatives are not analgesics
Intravenous medicines commonly used in CVICU correct answers sedation= ativan, versed,
propofol, precedex
analgesia= morphine, fentanyl, dilaudid, toradol
why do we paralyze? correct answers > decrease O2 demand (ARDS)
> prevent patient-ventilator dysynchrony (Bivent)
> prevents shivering in hypothermia patients
> Open chest
Rass Assessment correct answers +4- combative, violent, danger to self/stff
+3- very agitated, pulls lines, tubes, aggressive
+2- agitated frequent non-purposeful movement, fights the vent
+1 Restless/ Anxious but not aggressive or vigorous
0- Alert and calm
-1- drowsy, not fully alert but can stay awake, eyes open to voice for >10 sec
-2 - light sedation, wake and makes eye contact for less than 10 seconds
-3 moderate sedation, moves/open eyes to voice but no eye contact
-4 deep sedation
-5 unarousable
Coronary artery bypass graft correct answers known as a CABG
- most common, improves blood flow to the heart (contractility)
depending on how many vessels are used it can be categorized as single all the way to quadruple.
LIMA Bypass correct answers CABG from Aorta to LAD.
what is an ECG used for correct answers monitor heart electrical activity
why should you assess as chest x-ray? correct answers -verify position of ETT
-verify correct position of swan-ganz catheter
-check position of all other tubes and drains
- check for pneumo
-check for lobar collapse, atelectasis, effusions, pulmonary edema.
what are cardiac catheterizations used for? correct answers visualization of the coronary arteries
Echocardiogram correct answers sound waves to produce images of your heart
Transesophageal Echocardiogram (TEE) correct answers Provides a close look at the heart's
valves and chambers, without interference from the ribs or lungs, allows for detailed view of the
heart structures (really good for valves)
Post op requires oropharyngeal suctioning with a french catheter to help remove lubricant used
for procedure.
should you use PEEP on a cardiac patient ? correct answers no, have incisions on the heart and
this can be detrimental.
How do we monitor Acid-Base balance in these patients? correct answers -ABG's
-keep cardiac patients alkalotic, acidosis results from hypoxemia and low cardiac output causing
significant tissue hypo perfusion.
-Hyperventilate post op patients and use larger Vt.
what lab values are monitored in these patients? correct answers -Electrolyte= prevent
dysrhythmias
-H&H
-Coagulation parameters (PLT, PT, PTT, INR, ACT)
-Cardiac/bio markers- used to evaluate heart function.(CPK, CPK-MB, and troponins)
what type of line does every cardiac patient get? correct answers - an arterial line
what lines are used to monitor these patients hemodynamic stability ? correct answers central
line, swan ganz(right heart catheter or pulmonary artery catheter), cardiac output and index
(stroke volume, preload, contractility, after load), SVR, PVR, mixd venous oxygen saturation
when your CVP (normal 2-6) drops what should you do in this unit? correct answers usually
don't give fluid unless it drops below 2 but for these patients we are concerned with perfusion so
if the CVP falls below 8 we will have a decrease in flow (from the drop in pressure) give these
patients fluid to bring pressure back up.
, what should you do if mean arterial blood pressure falls below 65 mmHg? correct answers give
pt vasopressor support medication.
what should you do if your patients central venous oxygen monitoring falls below 70%? correct
answers Give hematocrit
what should you do if your patients hematocrit falls below 30? correct answers blood transfusion
what are some common pharmacological agents used in this unit? correct answers Inotropes
(Adrenergic like catecholamine), Phosphodiesterase inhibitors, Vasopressors, Peptides,
Diuretics, Digitalis, Hypertension medication, Anticoagulants, Antiplataelet drug therapy.
When is sedation used in the ICU correct answers -used in the agitated, ventilated and for
procedure discomfort
-avoid self extubation and removal of catheters
-NM blockade mandates analgesia and sedation
-control pain before sedation
- all have side effects- dose dependent
analgesics are not sedatives/ sedatives are not analgesics
Intravenous medicines commonly used in CVICU correct answers sedation= ativan, versed,
propofol, precedex
analgesia= morphine, fentanyl, dilaudid, toradol
why do we paralyze? correct answers > decrease O2 demand (ARDS)
> prevent patient-ventilator dysynchrony (Bivent)
> prevents shivering in hypothermia patients
> Open chest
Rass Assessment correct answers +4- combative, violent, danger to self/stff
+3- very agitated, pulls lines, tubes, aggressive
+2- agitated frequent non-purposeful movement, fights the vent
+1 Restless/ Anxious but not aggressive or vigorous
0- Alert and calm
-1- drowsy, not fully alert but can stay awake, eyes open to voice for >10 sec
-2 - light sedation, wake and makes eye contact for less than 10 seconds
-3 moderate sedation, moves/open eyes to voice but no eye contact
-4 deep sedation
-5 unarousable
Coronary artery bypass graft correct answers known as a CABG
- most common, improves blood flow to the heart (contractility)
depending on how many vessels are used it can be categorized as single all the way to quadruple.
LIMA Bypass correct answers CABG from Aorta to LAD.
