AHN 447 TEST #1
Normal CVP range
1-8 mmHg
Normal PAP range
15/5-26/15
Normal cardiac index
2.8-4.2 L/min
Normal PCWP range
4-12 mmHg
Normal CO range
4-7 L/min
Where is the phelbostatic axis?
4th ICS, mid axillary line, RA
Normal EF
60-70%
Normal SVR range
800-1200 dynes
Cardiac output
Amount of blood ejected from left ventricle with each heartbeat SV x HR=CO
Preload
Amount of blood returning to right atrium...how much blood is coming back from the body
How do you measure preload
CVP
What does a pulmonary artery catheter do?
Central line that shows continuous CO to tell us how heart is working. Also shows very accurate internal temp
What controls the AV valves? (Mitral and tricuspid)
Chordae tendinae
What does the diacritic notch in A-line waveform represent?
Closure of semilunar valves
What does an A line do?
Continuous BP monitoring and easy access for blood draws
PTT
Heparin Blood thick= low PTT
What influences preload?
Hypovolemia Hypervolemia Venous obstruction
After load
Indicator of the force or resistance the heart must overcome to empty oxygenated blood into the aorta (how much resistance the heart must overcome)
What does right atrial pressure show?
Info about blood volume and effectiveness of heart as a "pump" Assesses the right side of the heart
Where is a pulmonary artery catheter placed?
Jugular, subclavian, femoral (rare)
Pulmonary capillary wedge pressure measures
Left side heart filling/function
Cordia introducer
Lg central line with one port used in emergency situations to put a large amount of fluid in a short amount of time
Myoglobin
Muscle protein Earliest marker available Not clinically useful
What can you infuse into an A line?
Nothing, except normal saline that is in the pressure bag
What are the 5 "p's" or neurovascular assessments?
Pain Pallor Paresthesia Paralysis Pulselessness
When is an A line useful?
Patient in low flow state (shock) or hypotensive or for pt that is severely hypertensive
Where should the transducer be placed for accurate measure of pressure?
Phelbostatic axis
How often should you observe an A-line site?
Q1h
Troponin I
Released with any myocardial damage "Gold standard" Results available within 15 min Any elevation above 0.1 is abnormal
How do you measure after load?
SVR
How do you measure MAP?
Systolic BP + (2 x diastolic bp) / 3
Starling's law
The SV or the heart increases in response to an increase in the volume of blood in the ventricles, before contraction (end of diastolic volume), when all other factors remain constant The more volume a pt has, the higher the R atrial pressure will be
Why is a heart cath used?
To see if you have good coronary artery perfusion Strictly diagnostic
Normal lipid profile
Total: <200 HDL (good): men: >45; women: >55 LDL (bad): men: <160; women: <135
What does pulmonary artery pressure measure?
Very specific indicator of overall volume status (usually post open heart surgery, HF pt, on cardiac units, etc) Pressure in lungs or pulmonary system Looks at function of left side of heart
INR
Warfarin, Coumadin Thick blood = low INR
