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Hemodynamic Mntrng
hemodynamic monitoring notes for nursing school
| Question | Answer |
|---|---|
| Definition Cardiac Output: | Volume of blood pumped by the heart in one minute |
| Definition Cardiac Index: | Measurement of cardiac output adjusted for body size |
| Definition Stroke Volume | Volume of blood ejected wtih each heart beat |
| Definition Stroke Volume Index | Measurement of SV adjusted for body size |
| Definition Systemic Vascular Resistance (SVR) | Resistance encountered by the left ventricle (opposition of blood flow offered by the vessels of the body). Left ventricle pumps blood to the body. |
| Definition Pulmonary Vascular Resistance (PVR) | Opposition/resistance encountered by the right ventricle. Right ventricle pumps to the lungs. |
| Definition Preload: | Amount of stretching of muscle in the ventricles. Measured by the blood left in the ventricle at the end of diastole (heart at rest, filling with blood). |
| What pressures are used to estimate preload? | PAWP (pulmonary artery wedge pressure), this reflects left ventricular preload CVP (central venous pressure), measured in the right atrium or vena cava, this reflects right ventricular preload |
| What does PAWP (pulmonary artery wedge pressure) estimate? | Amount left ventricular preload, measurement of pulmonary capillary pressure. Pulmonary-left, because this is the blood coming from the lungs into the left side of the heart to be pumped out to the body. |
| What does CVP (central venous pressure) estimate? | Amount of right ventricular preload, because this is the blood coming FROM the body into the right side of the heart to be pumped to the lungs. |
| What are ways to increase preload? | Fluid administration can increase preload--because this causes more fluid=more blood filling up in heart during diastole. |
| What are ways to decrease preload? | diuresis ex: lasix |
| What is Afterload? | Amount of pressure the left ventricle must work against to pump blood into circulation, the greater this resistance, the harder the heart has to work to pump blood. |
| What is used to estimate afterload in the left ventricle? | SVR (systemic vascular resistance) and arterial pressure reflect the left ventricular afterload (This is because the left ventricle is pumping to the body, so the resistance it is meeting is systemic) |
| What is used to estimate afterload in the right ventricle? | Pulmonary vascular resistance (PVR). This is because the right side of the heart is pumping blood to the lungs, so the resistance it is meeting is pulmonary. |
| What is contractility? | Strenght of the contraction. It is only increased when preload is not changed, yet heart contracts more forcefully. |
| How do you know contractility is altered? | If preload, HR, and afterload remain constant, yet cardiac output changes. Contractility is diminished in heart failure. |
| What increases afterload? | stenosis of heart valves, increased blood viscosity, hypertension |
| What drugs increase afterload? | Ace Inhibitors (prils), lower peripheral resistance |
| What drugs affect contractility? | drugs that make the heart pump better/increase contractility, ex: digoxin |
Created by:
anjelina55
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