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If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: What is Hemodynamic - line insertion? Answer: Catheter is guided through a large vein, the right atrium and ventricle into the pulmonary artery. This catheter is called a balloon-tipped, flow-directed, pulmonary artery. Question: what are the 4 insertions in monitoring? Answer: 1. Internal jugular vein 2. artery. 3. Anti-cubital vein. 4. femoral vein. Question: In a Hemodynamics Monitoring where do we Locate the ? Answer: Location of Catheter:RA/Just - 2-6mmHg. RV:2-25mmHg. PA-12:25mmHg. Question: what are the for the insertion in Hemodynamic monitoring? Answer: Insert the ballon deflated. Advance &watch the pressure waveform on the monitor.Once in RA ballon is inflated &act as a sail, guiding catheter into RV &finally into PA.Once there ballon is deflated & Remain that way except when PCWP measurement is Question: In hemodynamic monitoring what are 4 of data collected? Answer: 1. CVP- venous pressure. 2. PAP - Pulmonary artery pressure. 3. PCWP - pulmonary capillary wedge pressure. 4. CO- cardiac output. Question: What are the goals of monitoring? Answer: to Determine conditions of 1)Right & Left heart 2)Vascular system of the lungs 3)Systemic system. Also the methdology of CVP,PAP,PCWP& Cardiac Output. Question: What is the methodology of Hemodynamic - CVP (BEFORE THE Right Heart) Answer: by looking@ the CVP before the right heart- If high make a note. It could be fluid overload. Question: What is the of Hemodynamic monitoring - PAP (AFTER the Right Heart) Answer: by looking@ the PAP AFTER the right heart- If high then the right must be OK because both CVP and PAP are high. If low, there must be a problem with the right heart. Question: What is the methodology of Hemodynamic - PCWP Answer: If high, then is a problem w/the lung. If PAP and PCWP is high then no problem w/the lung. If PAP is high and PCWP is low then problem is in the lung. Question: What is the methodology of Hemodynamic - CO Answer: If PCWP is high and CO is high then left heart is not the problem. If PCWP is hihg and CO is low then left heart is the . Question: What is & Defibrillation? Answer: Both are methods of changing cardiac rhythms through electrical stimuli. Cardioversion is a form of defibrillation only w/ the synchronization On. This the placement of paddles on the chest & applying shcok to the pt. Question: What type of heart problems does a Cardioversion ? Answer: For treating: NON-lethal 1)Atrial Fibrillation 2)Atrial Flutter 3) Ventricular Tachycardia (with pulse) Question: What does a cardioversion start? Answer: Start @ low voltage around 50-100 . Question: How do you a Cardioversion procedure? Answer: 1. O2. 2. have a bag-valve-mask ready @bedside. 3. Prepare for Oropharyngeal suctioning. Question: What should be done in a synchornization in a ? Answer: Synchronization must be ON. Synchronize cardioversion to the R Wave on ECG. It causes pt. to slip into a deadly rhythm like pulseless V-tach/V-fib. If so start defibrillation. It should be done w/ resuscitation equipment on-hand. Pt. sedation is Question: What type of heart does a Defibrillation treat? Answer: For treating: arrhythmias 1)Ventricular Fibrillation 2)Ventricular Flutter 3) Ventricular Tachycardia (with pulseless only) Question: What voltage does Defibrillation with? Answer: 360 . Question: What should be done in synchronization in a ? Answer: Synchronization must be set to OFF. Start at 360 joules, continue till successful. In emergency situation 100% O2 is appropriate. Must have , equipment on-hand. Question: What is Basic cardiac life (BCLS)? Answer: 1. Chest compression produce only about 30% of normal cardiac output. 2. Mouth-to-mouth ventilations will no more than 17% O2 (FIO2) Question: What is the effectiveness of CPR in cardiac life support (BCLS)? Answer: 1. Color of face & extremities. 2. Pulse can be felt compressions. 3. If carotid artery is not accessible, use femoral artery Question: cardiac life support (BCLS): What should we do when there is no pulse ? Answer: 1. No matter what the rhythm continue compressions if there is no pulse. 1)maybe pulseless electrical activity (PEA), 2) Formerly called -mechanical dysfunction(EMD) Question: cardiac life support (BCLS): what are the hazards of CPR? Answer: 1. Pneumothorax (from broken ribs) 2. Gastric Distension or rupture 3. Liver laceration 4. Aspiration 5. Cross-contamination 6. Contusion (bruising of the cardiac muscle) 7. Continue CPR regardless of above hazards. Question: cardiac life support (BCLS): What are the key procedural consideration? Answer: 1. look, listen, & feel for breathing for @least 10 seconds. Use Carotid pulse. Use current BLS compression /breath . Continue CPR if no pulse. Question: Basic cardiac life (BCLS): What are the ventilation rates? Answer: 1. Neonates upto 1 month - 40-60/min 2. infants&children upto 8 yrs old - 12-20/min 3. above 8 yrs old : 10-12/min Question: Basic cardiac life support (BCLS): What are the ratio(to breath)? Answer: 1.Neonate - 3 compressions then 1 ventilation (3:1), 2. &child= 15:2 3. Adult 30:2 Question: Advance cardiac Life (ACLS)? Answer: it is an exact Algorithm like BCLS it from time to time. Question: Advance Life support (ACLS): What are the 4 types of Ventricular Arrhythmias? Answer: 1. Ventricular (pulseless), 2. Ventricular Fibrillation 3. Bardycardia 4. Asystole. Question: Advance cardiac Life (ACLS): What is ventricular tachycardia(pulseless)? Answer: 1. Defibrilliate @ 360 joules - check pulse in between 2. if unsuccessful, administer epinephrine, , Amioderone. Question: cardiac Life support (ACLS): What is ventricular fibrillation? Answer: 1. Defibrilliate @ 360 joules - check pulse in between 2. if unsuccessful, administer epinephrine, Lidocaine, Amioderone.3.If pt. has metabolic acidosis by a reasoned ABG - sodium bicarbonate. Question: Advance cardiac Life support (ACLS): ventricular fibrillation-What is precordial ? Answer: It gives the pt. transitions to v-fib or pulseless v-tach - the transition witnessed as it . Question: Advance cardiac Life (ACLS): What is Bardycardia? Answer: Treat with Atropine, Epinephrine & may use an external Question: Advance cardiac Life support (ACLS): What is ? Answer: Must be confirmed in 2 leads - rules out lead . Treat w/ Epinephrine, Atropine Question: Advance cardiac Life support (ACLS): What Hypotension? Answer: 1. Poor of the heart 2. Vasodilation 3. Dehydration - most common. Question: Advance cardiac Life support (ACLS): In Hypotension How do you poor cardiac contractility related problems? Answer: 1. Digitalis (Crystodigin) 2. Digoxin ( ) Question: Advance cardiac Life support (ACLS): In Hypotension How do you treat Vasodilation related ?Answer: 1. . 2. Dopamine Question: Advance cardiac Life support (ACLS): In Hypotension How do you dehydration? Answer: 1. Administer Fluids 2. Normal saline & saline concentrations |
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