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NUR 415 exam 1
flashcards for cardiology and pulmonary
| Question | Answer |
|---|---|
| What is hemodynamic monitoring | Measurement of pressure, flow, & oxygenation within the cardiovascular system. Utilizes both invasive & non-invasive techniques and are measured in the ICU. |
| What are some common values that are measured? | Systemic & pulmonic arterial pressuresCVP (Central Venous Pressures)PAWP (Pulmonary artery wedge pressure)CO (cardiac output & indexStroke volume & indexSaO2 (O2 Sats of hemoglobin in arterial bld)SvO2 (o2 Sats of hemoglobin in venous bld) |
| What is the difference between cardiac output & cardiac index? | Basicaly the same measurement. However, indexing is adjusting based on the size of the body and is more accurate. |
| What is blood pressure? | It is the pressure exerted onto the walls of the vessels. It is composed of the opposing blood floow & cardiac output. |
| What is SVR | Systemic vascular resistanceOpposition to the pumping of the left ventricle. |
| What is PVR | Pulmonary Vascular resistanceOpposition to the pumping of the right ventricle |
| What is preload? | The volume within the ventricle at the end of diastole. |
| What is PAWP? | Pulmonary Arterial Wedge Pressure. Pressure taken when a central catherter introduces a wedge that obstructs flow and measures the pressure. It reflects the mean left atrial pressure. |
| what is afterload? | The forces opposing ventricular ejection:Systemic arterial pressure, Aortic valvular resistance, Mass & density of the blood to be moved.Increased afterload = decreased CO |
| How do you determine stroke volume (Sv), & what s the normal value range? | SV = CO/HRThe normal range is 60-150 ml/beat |
| How do you determine SV index, and what is the normal range? | SVI = CI/HRNormal range is 30-65 ml/beat/m2 |
| What is the normal HR? | 60-100 BPM |
| What is the normal CO? What is the calculation? | 4-8 L/minCO = SV X HR |
| What drugs inprove contractility? (Positive inotropes) | EpinephrineNorepinephrine (Levophed)dopaminedobutamine (Dobutrex)digitalis like drugsCalciummitrinome (Primacor) |
| What drugs diminish contractility? (Negative inotropes) | barbituatesalcoholcalcium channel blockersb-adrenergic blockers |
| Arterial line uses and purpose? | Central arterial pressure monitoringsystolic BPDiastolic BPMean Arterial Pressure (MAP) BP |
| Complications of arterial lines | hemorrhage - monitor pressureinfection - change tubing every 96 hoursThrombus - Allen test (both ulnar and radial blocked and observe refill.)Neurovascular impariment - emergencyloss of limb - caused by newovascular impairment |
| Hemodynamic nursing assessment | Baseline dataApprearance - TiredLOC - mental changesSkin color - pallortemp - coolvital signsperipheral pulses - decreasedurine output - decreased kidney perfusion |
| CVP Abnormal values | Fluid volume statusDecreased CVP is hypovolemiaincreased CVP - right ventricle failure or volume overload |
| PAWP abnormal values | Indicator of cardiac function and fluid volume.Increased PAWP - heart failure & fluid overloadDecreased PAWP - fluid depletion |
| What is MAP? | Mean arterial pressureMAP = (SBP + 2(DBP))/3 |
| MAP abnormal values | less that 60 = hypovolemia (Med. emergency)BleedingdehydrationDecreased HR, decreased CO, decreased SV |
| Left sided failure | Most common, Blood backs up into pulmonary system and left atrium. Increase pumonary pressure causes fluid extravasation into the interstitium & into the alveoli. This presents as pulmonary congestions and edema. |
| Digitalis toxicity | GI - anorexia,nausea, vomitingVisual - blurred vision, colored vision, visual halos around dark objectsCNS - fatigue & drowsinessCardio - Dysrythmias (afib, vfib, heartblock), brady and tachycardia, apical/radial pulse deficit, heart failure. |
| Signs and Symptoms of decreased Cardiac Output (CO) | Increased HR, Pallor, fatigue, dizziness, syncope |
| Signs and Symptoms of cardiogenic shock | decreased cap refill, tachypnea, cyanosis, crackles\rhonchi, Increase Na & H2O, Decreased renal perfusion, decreased urine output, pallor, cool, clammy skin, decreased cerebral perfussion, anxiety/confusion, agitiation, decreased bowel sounds, N/V |
| Right sided heartfailure | murmrs, JVD, edema, weight gain, Increased HR, Ascites, anasarca (Massive edema) |
Created by:
mpabner
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