Critical Care Exam 2 – cardiac UPDATED
Exam Questions and CORRECT Answers
All cardiovascular problems can be related to? - CORRECT ANSWER 1. the pump
(contractility)
2. the pipes (afterload)
3. the fluid (preload)
stroke volume - CORRECT ANSWER the amount of blood pumped out with each beat of
the heart
contractility, afterload, and preload all relate to _______________. - CORRECT
ANSWER stroke volume
For adequate perfusion, we need decent ______________. - CORRECT ANSWER cardiac
output
cardiac output - CORRECT ANSWER determines survival, determines the perfusion of
the cells of the body
how is cardiac output calculated? - CORRECT ANSWER stroke volume x heart rate
normal cardiac output - CORRECT ANSWER 4-8 liters/min
cardiac index - CORRECT ANSWER cardiac output divided by BSA (height in cm and
weight in kg)
why is cardiac index important? - CORRECT ANSWER because the number gives you an
idea if the cardiac output is adequate for the patient size (i.e. if it would be okay if a small adult
only pumped 2L/min)
,Pulmonary Artery Catheter (Swan-Ganz) - CORRECT ANSWER direct measurement of
the right side cardiac function which reflects left sided heart function through the use of PCWP
measurements
why wouldnt you measure the left side of the heart directly? - CORRECT
ANSWER because you dont want to stick things into the left side of the heart
how does a swan-ganz catheter work? - CORRECT ANSWER the catheter goes out into
the pulmonary artery and has a balloon at the end, if you blow up the balloon it floats out and
hits blood vessels, when it hits a small blood vessel it gets wedged in there and the pressure
going through the vessel hits the balloon and it measures the left ventricle performance
normal central venous pressure (CVP) - CORRECT ANSWER 3-10 mmHg; preload
normal pulmonary capillary wedge pressure (PCWP) - CORRECT ANSWER 6-12
mmHg; preload
Pre load - CORRECT ANSWER *pressure/volume of blood in the ventricle at the end of
diastole*
heart fills from the venous system, loading the heart with blood pre contraction
pre load is associated with which system? - CORRECT ANSWER venous, because its the
veins that fill the heart
pre load is sometimes called? - CORRECT ANSWER filling pressure
causes of decreased preload? - CORRECT ANSWER - hypovolemia (not enough
fluid/blood in the body)
- vomitting
, - GI bleed
- NPO
- anything that inhibits venous return
- venous vasodilation
what can inhibit venous return? - CORRECT ANSWER *anything that stops blood from
returning to the heart*
- positive pressure ventilation (why BP may drop)
- a tumor pressing on the inferior vena cava
- fetus in the 8th month pressing on the inferior vena cava (why we turn preg ladies on their left
side)
what causes venous vasodilation? - CORRECT ANSWER *smooth muscle in the vein
relaxes, causing vasodilation*
- morphine (vasodilator, decreases BP)
- vasoactive drips
- cardiac medications
- nitroglycerin (venous dilator, drops BP)
what happens when veins vasoconstrict and vasodilate? - CORRECT ANSWER during
vasoconstriction, BP increases, sending more blood back to the heart, during vasodilation, BP
decreases and blood becomes trapped in the venous system, keeping it from returning to the heart
when would vasodilation be a positive thing? - CORRECT ANSWER if you want less
blood to return to the heart, i.e. with a patient who has CHF
what can dramatic vasodilation cause? - CORRECT ANSWER sepsis
treatment for decreased preload - CORRECT ANSWER fluids/volume
Exam Questions and CORRECT Answers
All cardiovascular problems can be related to? - CORRECT ANSWER 1. the pump
(contractility)
2. the pipes (afterload)
3. the fluid (preload)
stroke volume - CORRECT ANSWER the amount of blood pumped out with each beat of
the heart
contractility, afterload, and preload all relate to _______________. - CORRECT
ANSWER stroke volume
For adequate perfusion, we need decent ______________. - CORRECT ANSWER cardiac
output
cardiac output - CORRECT ANSWER determines survival, determines the perfusion of
the cells of the body
how is cardiac output calculated? - CORRECT ANSWER stroke volume x heart rate
normal cardiac output - CORRECT ANSWER 4-8 liters/min
cardiac index - CORRECT ANSWER cardiac output divided by BSA (height in cm and
weight in kg)
why is cardiac index important? - CORRECT ANSWER because the number gives you an
idea if the cardiac output is adequate for the patient size (i.e. if it would be okay if a small adult
only pumped 2L/min)
,Pulmonary Artery Catheter (Swan-Ganz) - CORRECT ANSWER direct measurement of
the right side cardiac function which reflects left sided heart function through the use of PCWP
measurements
why wouldnt you measure the left side of the heart directly? - CORRECT
ANSWER because you dont want to stick things into the left side of the heart
how does a swan-ganz catheter work? - CORRECT ANSWER the catheter goes out into
the pulmonary artery and has a balloon at the end, if you blow up the balloon it floats out and
hits blood vessels, when it hits a small blood vessel it gets wedged in there and the pressure
going through the vessel hits the balloon and it measures the left ventricle performance
normal central venous pressure (CVP) - CORRECT ANSWER 3-10 mmHg; preload
normal pulmonary capillary wedge pressure (PCWP) - CORRECT ANSWER 6-12
mmHg; preload
Pre load - CORRECT ANSWER *pressure/volume of blood in the ventricle at the end of
diastole*
heart fills from the venous system, loading the heart with blood pre contraction
pre load is associated with which system? - CORRECT ANSWER venous, because its the
veins that fill the heart
pre load is sometimes called? - CORRECT ANSWER filling pressure
causes of decreased preload? - CORRECT ANSWER - hypovolemia (not enough
fluid/blood in the body)
- vomitting
, - GI bleed
- NPO
- anything that inhibits venous return
- venous vasodilation
what can inhibit venous return? - CORRECT ANSWER *anything that stops blood from
returning to the heart*
- positive pressure ventilation (why BP may drop)
- a tumor pressing on the inferior vena cava
- fetus in the 8th month pressing on the inferior vena cava (why we turn preg ladies on their left
side)
what causes venous vasodilation? - CORRECT ANSWER *smooth muscle in the vein
relaxes, causing vasodilation*
- morphine (vasodilator, decreases BP)
- vasoactive drips
- cardiac medications
- nitroglycerin (venous dilator, drops BP)
what happens when veins vasoconstrict and vasodilate? - CORRECT ANSWER during
vasoconstriction, BP increases, sending more blood back to the heart, during vasodilation, BP
decreases and blood becomes trapped in the venous system, keeping it from returning to the heart
when would vasodilation be a positive thing? - CORRECT ANSWER if you want less
blood to return to the heart, i.e. with a patient who has CHF
what can dramatic vasodilation cause? - CORRECT ANSWER sepsis
treatment for decreased preload - CORRECT ANSWER fluids/volume
