Hemodynamic Quiz 207/Unit4 (Exam 4)

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Increase in PAP

pulmonary hypercapnia

Mean PAP

10-20mmHg

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

15-30 seconds Correct

PAP

15-35/15-15mmHg

CVP

2-6mmHG

The normal value for CVP is

2-6mmHg

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

20 mm Hg

Cardiac output

4-8lpm

Pulse pressure

40mmHg

PAWP

5-12mmHg

Mean arterial pressure

70-100mmHg

Arterial blood pressure

90-140/60-90mmHg

A patient in the ICU has a chest X-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 3 mm Hg, pulmonary artery pressure (PAP) 21/10 mm Hg, and pulmonary artery occlusion pressure (PAOP) 8 mm Hg- These findings are consistent with which of the following?

Acute respiratory distress syndrome

Which of the following is not used to determine cardiac output

Blood pressure

Which measurement most accurately reflects preload?

CVP

Which of the following can cause an elevated right arterial pressure?

Cardiac tamponade

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

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

Chest X-ray

A MAP below 60 indicates what?

Compromised circulation to vital organs AND Poor tissue perfusion

15.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) 35, and the patient is not assisting-...

Decrease the PEEP incrementally and recheck hemodynamic measurements.

The sign of worsening backward heart failure that requires intervention is

Development of leg edema

Ventricular contractility can be estimated by which of the following?

Ejection fraction

CVP measures what?

Fluid levels

CVP of 15mmHG Answer 2

Fluid overload, right heart failure

Which of the following disorders can cause an increase in systemic vascular resistance?

Hypervolemia

My Hoyt, 72, is admitted with bilateral pneumonia. He has CAD. His BP si 110/90, HR 120, CO 4lpm and stroke volume 4lpm. What is the best approach to increase his cardiac output?

Increase fluid

Which of the following will cause an increase in systemic vascular resistance?

Increase left ventricular afterload.

PCWP is a measurement of what?

Left heart

PCWP of 20

Left heart failure, pulmonary edema

Systemic Vascular resistance

Measure the afterload of the left ventricle

Pulmonary vascular resistance

Measure the afterload of the right ventricle

Which of the following IV solutions could be considered treatment for hypovolemia?

Normal saline

A patient with CHF will have an increased what?

PCWP

What resistance must the right ventricle overcome to pump blood into the lungs?

PVR

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

A low CVP value is indicative of which of the following?

Shock, dehydration, hemorrhage

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 measurement is typically used to indicate right ventricular preload?

Right ventricular end-diastolic pressure (RVEDP)

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

Systemic vascular resistance

During the inspiratory phase of spontaneous breathing, what happens to the pulmonary artery (PA) waveform?

The PA waveform trend decreases.

An increase in pulmonary artery pressure is concerning for what?

The lungs

As the myocardium hypertrophies and heart failure develops, what happens to the value of the ejection fraction?

it gradually decreases

What would you see on a chest xray with a PCWP > 18mmHG?

The onset of pulmonary vascular congestion

A stroke volume of 100cc and a heart rate of 38 bpm produces a cardiac output with is a trained athlete

True

when heart rate increase to greater than 200 bpm there is a decrease in cardiac output because diastolic filling time decreases

True

what typically causes retrograde flow in the heart?

Valve dysfunction

What is the most determining factor for preload?

Venous return

Select the 4 main factors that influence th3e output of the right and left ventricle:

a. Preload b. Heart Rate c. Contractility and e. Afterload


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