Hemodynaics Quiz.txt

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Hemodynaics Quiz.txt
2012-06-28 13:44:11

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  1. The Movement of blood. This is the measurement of the force (pressure) exerted by the blood as it moves through blood vesseld or heart chanmbers during systole and diastole.
  2. What are the three things that blood pressure is a crucial measurement of?
    O2 delivery, perfusion, and integrity of cardiovascular tone.
  3. What are the 3 factors that control BP?
    Heart, Blood, and vessels
  4. Name three non-invasive hemodynamic monitoring.
    Heart rate, blood pressure, and perfusion
  5. Name three invasive hemodynamic monitoring.
    Pulmonary artery catheter, arterial line, central venous pressure.
  6. The pressure that stretches the ventricular walls at onset of ventricular contraction
  7. Forcefulness of the heart muscle contracting under a constant load
  8. The load against which the ventricles must contract
  9. Number of cardiac contractions per minute
  10. Pressure exerted against the vessel walls during systole and diastole
  11. Average amount of pressure exerted by the blood in the vessels
  12. The venous pressure of the right atrium
  13. Pressure in the pulmonary artery
  14. Average amount of pressure exerted in the pulmonary artery
    Mean PAP
  15. An indirect indication of left atrial pressure
  16. The amount of blood pumped out the left ventricle and into the systemic circulation
  17. Amount of blood ejected by the ventricle with every contraction
  18. The volume of blood pumped by the heart in a unit of time divided by the body surface area
  19. Pressure against which the heart must push to pump blood to the body
  20. Pressure against which the heart must push to pump blood to the lungs
  21. Indicates contractility of right ventricular cardiac muscle compared to PVR
  22. Indicates contractility of left ventricular cardiac muscle compared to SVR
  23. HR normal
    60-100 bpm
  24. BP Normal
    90-150/60-90 mmHg
  25. MAP normla
    70-110 mmHg
  26. CVP normal
    0-8 mmHg
  27. PAP normal
    20-35/5-15 mmHg
  28. Mean PAP normal
    10-20 mmHg
  29. PCWP normla
    5-12 mmHg
  30. QT normal
    4-6 L/M
  31. SV normal
    60-120 ml/beat
  32. CI normal
    3-4 L/M per m2
  33. SVR normal
    900-1500 Dyne sec/cm -5
  34. PVR normal
    80-250 Dyne sec/cm -5
  35. RSVWI normal
    7-12 g/m2
  36. LSVWI normal
    40-60 g/m2
  37. Liquids are not compressible. Pressures at any given point within a liquid are transmitted equally. whose principle?
  38. When a closed system is filled with liquid the pressure exerted at one point can be measured accurately at any other point at the
    same level
  39. Hemodyn. is performed to:
    evluate intravascular fluid vol., cardia and vascular func., and identify sudden changes in the pt's hemodyn. status
  40. What kind of PT's would need hemodyn.?
    Severe hypo and hypertension, frquent ABG's, and shock/resp. failure
  41. AKA swan-ganz catheter, flow-directed, balloon topped catheter
    Pulmonary artery catheter
  42. What part of the pulmonary artery catheter: Measure pulmonary artery pressures, Aspirate mixed venous samples, Inject medications, Continuous monitoring of SvO2
    Distal lumen
  43. What is the max inflation vol. of the balloon and the swanz?
  44. What part of the pulmonary artery catheter: Temperature sensing device, Used during thermodilution QT measurements, Measures core temperature
  45. This is the most common technique: A bolus of solution of known volume and temp. is injected into the R. atrium, and the resultant change in blood temp. is detected by a thermistor previously placed in the pulmonary artery w/ a catheter. The degree of temp. change between the prox. port and distal tis is a function of this.
    Measuring the QT w/ thermaldilution
  46. The normal cardic output curve looks like?
    a rapid smooth upstroke and a gradula downstroke.
  47. The small area under the cardiac curve indicates?
    a high cardiac output.
  48. A large area under the cardiac curve indicates?
    a low cardiac output
  49. Cardiac output is ________ proportional to the area ubder the cardiac curve.
  50. lies in the right ventricle. Measure CVP. Inject medications. Aspirate blood samples. Inject thermal bolus for thermal dilution CO measurements
    Proximal lumen
  51. What are some indications for pulmonary artery catheter.
    Hemodynamically unstable patients, Complex-acute heart disease, Acute-severe pulmonary disease, Shock of all types if severe or prolonged, Severe multisystem trauma or large-area burn injury, Major systems dysfunction undergoing extensive operative procedures
  52. What are some common uses for a pulmonary artery catheter?
    Measure CVP, PAP, and PCWP. Collect mixed venous blood samples, Monitor mixed venous O2 saturation, Measure cardiac output, Provide cardiac pacing
  53. Where is the Pulmonary artery catheter inserted?
    Subclavian or internal jugular vein, superior vena cava, right atrium.
  54. What is the normal pressure of the right atrium?
    0-8 mmHg
  55. What is the normal pressure of the right ventricle?
    20-39 mmHg
  56. What is the normal pressure for the pulmonary artery?
    20-35 mmHg
  57. What is the normal "wedge" pressure?
    5-12 mmHg
  58. What are some complications of the Pulmonary artery catheter?
    Infection, bleeding, pneumothorax, pulmonary artery hemorrhage, pulmonary infraction, air embolism, cardiac arrhythmias
  59. When doe the pulmonary artery pressure decrease?
    Volume of blood ejected by the right ventricle decreases � (�afterload� of the RV). Pulmonary vasculature relaxes or dilates
  60. When would the pulmonary artery pressure increase?
    Pulmonary blood flow increases. Pulmonary vascular resistance increases
  61. What are some things that would casue the pulmonary vascular resistance to increase?
    Constriction, obstruction, and compression
  62. is also referred to as: Pulmonary artery occlusion pressure (PAOP), Pulmonary artery wedge pressure (PAWP), Left atrial pressure, Left side preload, Left ventricular end-diastolic pressure, Left ventricular filling pressure
  63. What can be used to estimate PCWP is some situations
    PAP diastolic
  64. A comparison of PCWP and PAP can be used to differentiate between
    cardiac and non-cardiac pulmonary edema. Increased PCWP and PAP = cardiac. Normal PCWP and Increased PAP = Non-cardiac
  65. What Causes Pulmonary Capillary Wedge Pressure to Decrease?
    Right heart failure, Cor pulmonale, Pulmonary embolism, Pulmonary hypertension, Air embolism, Hypovolemia
  66. What Causes Pulmonary Capillary Wedge Pressure to Increase?
    left heart failure, mitral valve stenosis, CHF/ pulmonary edema, high PEEP effects, hypervolemia
  67. What are the two common uses of the arterial catheter?
    Measureing systemic artery pressure and collect ABG samples
  68. Where the inserion site of the arterial catheter?
    Radial (can be placed brachial, femoral, dorsalis pedis, umbilical neonates)
  69. Add picture 38 and 39
    should have done it by now
  70. Normal BP?
    120/80 mmHg
  71. Sytolic (contraction) range
    90-150 mmHg
  72. Diastolic (relaxation) range
    60-90 mmHg
  73. normal Mean arterial pressure range
    79-110 mmHg
  74. Causes of Decreased Arterial Pressure
    Absolute and relative hyovolemia and cardiac failure. Improvement in circulatory volume and function, Sympathetic stimulation, Vasoconstriction, Administration of vasopressors
  75. What is absolute hypovolemia?
    blood loss and dehydration
  76. What is relative hypovolemia?
    shock and vasodilation
  77. is the product of stroke volume and vascular resistance. Therefore, changes in either parameter can affect it.
    Arterial pressure
  78. is the difference between arterial systolic and diastolic pressure.
    Pulse pressure (pulse = syst - dias)
  79. This is an early sign of hypovolemia, decreased stroke volume(hypovoemia), increased blood vessel compliance(shock), and tachycardia all cause this.
    Decreased Pulse pressure
  80. This is an early sign of vol. restoration. Increased stroke vol.(hypervolemia), decreased vessel compliance(arteriosclerosis), and bradycardia all cause this
    Increased pulse pressure
  81. How do you calculate cardiac output?
    QT= HRXSV or QT= (130XBSA)/[C(a-v)O2X10] or QT = VO2/[c(a-v)O2 X10]
  82. What is the noral QT?
    406 L/M
  83. THis is used to normalize QT measurement among Pt's of varying body size.
    Cardiac Index (CI)
  84. What is the formula for CI?
  85. what is the normal CI
  86. CI valuse between 1.8- and 2.5 L/min/m^2 indicate?
  87. CI< 1.8 L/min/m^2 may indicative of?
    cardiogenic shock
  88. This is a measurment of the average QT per one heartbeat.
    Strove Volume (SV) = QT/HR
  89. What is the normal SV?
    60-120 mL
  90. Used to normalize stroke volume measurements among patients of varying body size.
    Stroke Volume Index (SVI)
  91. Normal SVI?
    33 � 47 mL/m2 (SV/BSA)
  92. Digoxin (Lanoxin), Dobutamine (Dobutrex), Epinephrine (Adrenalin), Dopamine (Intropin), Isoproterenol (Isuprel), Digitalis, Amrinone (Inocor) are what kind of drugs and what do they do to contractility?
    Positive Inotropic Drugs (? contractility)
  93. Septic shock (early stages), Hyperthermia, Hypervolemia, ? vascular resistance can do what to contractility?
  94. Propanolol (Inderal), Metoprolol (Lopressor), Atenolol (Tenormin) are what kind of drugs and what do they do to contractility?
    Negative inotropic drugs and decrease contractility.
  95. Septic shock (late stages), CHF, Hypovolemia, Pulmonary emboli, ? vascular resistance, MI can do what to contractility?
    decrease contractility
  96. what will happen if Transducer or catheter higher than site?
    fales low pressure reading
  97. What will happen if Transducer or catheter lower than site?
    false high pressure reading
  98. What are 3 complications of arterial catheters?
    Ischemia, hemorrhage, and infection
  99. is pressure of the blood in the Vena cava, Right atrium, and Right ventricle. It is also referred to as Right atrial pressure (RAP), right side preload, and Right ventricular end-diastolic pressure
    Central Venous Catheter (CVP)
  100. measures right heart function and fluid levels
  101. what is the normal CVP by TRANSDUCER?
    0-8 (<8 mmHg)
  102. What is the normal CVP by MANOMETER?
    4-12 cmH2O
  103. What are the three uses of a CVP?
    Assement of R ventric. func. & intravasculad vol. status. Admin. of fluids, nutrition, blood, or drugs. Emergency route for pacemaker insertion.
  104. Common indications of CVP?
    Measure central venous pressure, Administer fluid, blood, or medications, Aspiration of blood samples
  105. Where is the insertion site of CVP?
    subclavian or internal jugular vein
  106. Where is the CVP located?
    superior vena cava near right atrium or withing right atrium
  107. Decreased venous return (VOLUME!) Absolute hypovolemia, Blood loss - Hemorrhage, Dehydration) or Relative hypovolemia (Shock, Vasodilation) have what effect on CVP?
  108. What can increase CVP?
    Increased Venous retiurn, hypervolemia, increased intrathoracic pressure, Right heart failure, increased pulmonary vascular resistance, and compression around the heart
  109. CVP is ideally read at the end of expiration because?
    Spontaneous insp. causes CVP to fall and mechanical vent. causes CVP to rise
  110. What are three complications for CVP?
    infection, bleeding, and pneimothorax( greatest hazard)
  111. When the monitor does not show a sharp waveform, no dicrotic notch. can be caused by Catheter can be obstructed or kinked.
    Pressure dampening
  112. Is an Inadequate tissue perfusion resulting in a hypoxic insult and causing widespread abnormal cell metabolism and membrane dysfunction.
  113. A decrease in the effective circulating blood volume. cause by hemorrhage or non-hemorrhage ( dehydration and third space fluid space)
    Hypovolemic shock
  114. Is Systemic hypoperfusion due to profound heart failure and/or the ability to meet metabolic needs. End stage of heart disease caused by: MI, Myocarditis, Cardiac tamponade, and Severe valve dysfunction
    Cardiogenic Shock
  115. Shock associated with any infectious disease which causes relative hypovolemia. Caused by many infectious agents, Predisposing factors, Invasive procedures, Organ damage, and Immunocompromised
    Septic shock
  116. A severe illness caused by over whelming infection of the bloodstream by toxin-producing bacteria.
  117. Dysfunction of the sympathetic nervous system resulting in massive peripheral vasodilation and systemic hypoperfusion. Etiology: Brain or spinal cord trauma, Spinal anesthesia, and Drugs
    Neurpgenic shock
  118. Systemic reaction causing circulatory failure and biochemical abnormalities. Etiology: Drugs, Blood products, Foods, Pollens, and Venoms
    Anaphylactic Shock