Hemodynamics

Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 9 g%, arterial oxygen saturation (SaO2) = 96%, arterial partial pressure of oxygen (PaO2) = 97 mm Hg.

11.9 vol% Formula: CaO2=(Hgb x 1.34 x SaO2)+ (PaO2 x 0.003)

Calculate the ejection fraction of a female patient with a stroke volume of 40 mL and an end-diastolic volume of 125 mL.

0.32 40ml/125ml=0.32

Which of the following statements is true concerning the insertion of a radial arterial line? 1. The catheter tip must face upstream. 2. The catheter tip must face downstream. 3. The transducer must be higher than the catheter tip. 4. The transducer must be level with the catheter tip.

1 and 4 only

A pulmonary artery (Swan-Ganz) catheter can be used for which of the following? 1. Measuring cardiac output 2. Arterial blood sampling 3. Measuring left atrial pressure 4. Measuring pulmonary artery pressure

1, 3, 4

Calculate a 90-kg patient's cardiac index with the following measurements: cardiac output 3.8 L/min, body surface area 3 m2.

1.3 L/min/m2

The following hemodynamic measurements were obtained from a patient in the intensive care unit: pulmonary artery pressure (PAP) = 67/25 mm Hg, pulmonary artery occlusion pressure (PAOP) = 18 mm Hg, blood pressure (BP) = 100/50 mm Hg, central venous pressure (CVP) = 17 mm Hg, cardiac output (C.O.) = 5.7 L/min, and heart rate (HR) = 75 beats/min. Calculate this patient's systemic vascular resistance (SVR).

1165 dyne x S x cm^-5

Which of the following is the range for the time a pulmonary artery catheter should be inflated?

15-30 s

A patient with the hemodynamic values below has a cardiac output of which of the following? Oxygen consumption 380 mL/min Arterial oxygen content 23.2 vol% Mixed venous oxygen content 10.3 vol%

2.9 mL/min

A patient with a mitral valve stenosis is most likely to have which of the following pulmonary artery occlusion pressure (PAOP) values?

20mm Hg

Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 17 g%, arterial oxygen saturation (SaO2) = 93%, arterial partial pressure of oxygen (PaO2) = 64 mm Hg.

21.4 vol% Formula: CaO2=(Hgb x 1.34 x SaO2)+ (PaO2 x 0.003)

Calculate the pulmonary vascular resistance (PVR) given the following measurements obtained during a hemodynamic study: pulmonary artery pressure (PAP) = 40/22 mm Hg, pulmonary artery occlusion pressure (PAOP) = 12 mm Hg, blood pressure (BP) = 156/80 mm Hg, central venous pressure (CVP) = 19 mm Hg, cardiac output (C.O.) = 4.8 L/min, and heart rate (HR) = 68 beats/min.

267 dyne x S x cm^-5

The following hemodynamic measurements were obtained from a patient in the intensive care unit: pulmonary artery pressure (PAP) = 67/25 mm Hg, pulmonary artery occlusion pressure (PAOP) = 18 mm Hg, blood pressure (BP) = 100/50 mm Hg, central venous pressure (CVP) = 17 mm Hg, cardiac output (C.O.) = 5.7 L/min, and heart rate (HR) = 75 beats/min. Calculate this patient's pulmonary vascular resistance (PVR).

295 dyne x S x cm^-5

Calculate cardiac output using the Fick principle for the following values: Oxygen consumption 280 mL/min Arterial oxygen content 19.5 vol% Mixed venous oxygen content 12 vol%

3.7 L/min

Calculate the cardiac index using the following data: Cardiac output = 4.6 L/min Body surface area = 1.2 m2

3.8 L/min/m^2

A patient with an oxygen consumption of 340 mL/min, arterial oxygen content of 17.3 vol%, and mixed venous oxygen content of 12.8 vol% has a cardiac output of which of the following?

7.6 mL/min

Absolute confirmation of placement of a central venous pressure catheter is done with which of the following?

CXR

A patient in the ICU has a chest X-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 24/13 mm Hg, and pulmonary artery occlusion pressure (PAOP) 21 mm Hg. These findings are consistent with which of the following?

Cardiogenic pulmonary edema

Which of the following measurements can be used to estimate right ventricular preload?

Central venous pressure

Which of the following is the hemodynamic measurement that is indicative of a patient with right heart failure?

Central venous pressure (CVP) = 16 mm Hg

The dicrotic notch recorded in the aorta immediately follows what mechanical event of the cardiac cycle?

Closure of the aortic valve

Which of the following is the function of the transducer in the invasive vascular monitoring system?

Convert the fluid pressure to an electrical signal.

An intubated patient with no known history of congestive heart failure is in the ICU. The patient is comatose and currently receiving mechanical ventilation via volume-controlled continuous mandatory ventilation (VC-CMV), set rate 12 breaths/min, set tidal volume (VT) 400 mL, positive end-expiratory pressure (PEEP) 18 cm H2O, fractional inspired oxygen (FIO2) 0.35, and the patient is not assisting. Hemodynamic measurements show the following: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 33/20 mm Hg, and pulmonary artery occlusion pressure (PAOP) 16 mm Hg. Arterial blood gas (ABG) results are: pH 7.43, arterial partial pressure of carbon dioxide (PaCO2) 38 mm Hg, arterial partial pressure of oxygen (PaO2) 90 mm Hg. The physician asks for recommendations to improve this patient's hemodynamics. The most appropriate recommendation for this patient is which of the following?

Decrease the PEEP incrementally and recheck hemodynamic measurements.

Ventricular contractility can be estimated by which of the following?

Ejection fraction

Which of the following can be used to estimate the contractility of the ventricles?

Ejection fraction

Which of the following is not a complication that may occur during the insertion of a central venous pressure line?

Infection

Which of the following describes the filling pressure of the ventricle at the end of ventricular diastole?

Preload

Advancing a pulmonary artery catheter into a smaller artery may cause which of the following complications?

Pulmonary infarction

Calculate the stroke volume (SV) and the stroke volume index (SI) using the following information: cardiac output = 4.5 L/min, heart rate = 110 beats/min, and body surface area = 1.3 m2.

SV = 41 mL; SI = 31.5 mL/m^2 Stroke volume (SV) = cardiac output (C.O.)/heart rate (HR) and stroke index (SI) = stroke volume (SV)/body surface area (BSA)

While attempting to draw blood from an indwelling arterial catheter, the respiratory therapist notices a dampened waveform and has difficulty withdrawing blood for sampling. What should the respiratory therapist's immediate action be?

Remove the catheter.

Which of the following is an indication of left ventricular afterload?

Systemic vascular resistance

The period of relaxation in the cardiac cycle is known as:

diastole

A central venous pressure (CVP) catheter is used to:

monitor right ventricular function

The stretching of the ventricle before the next contraction is called:

preload

Calculate the cardiac index for a patient with the following data: heart rate = 80 beats/min, stroke volume = 55 mL, and body surface area = 2.8 m2.

c. 0.57 L/min/m^2 Cardiac index (CI) = cardiac output (C.O.)/body surface area (BSA) and cardiac output (C.O.) = stroke volume (SV) × heart rate (HR).

The amount of blood ejected by the heart per unit of time is called:

cardiac output