Hemodynamics final

hemodynamics is: 1. the dynamics of blood flow 2. the forces which circulate blood throughout the body 3. the term used to describe the intravascular pressure and flow that occurs when the heart muscle contracts ad pumps blood throughout the body

all of the above

potential complications associated with arterial lines include 1. hemorrhage 2. air emboli 3. infection 4. altered skin integrity 5. impaired circulation

all of the above

primary pt assessment of the CHF pt will likely demonstrate which of the following 1. tachypnea 2. orthopnea 3. cyanosis 4. crackles and rhonchi 5. pedal edema 6. anxiety

all of the above

the CXR of a pt in left ventricular failure (heart failure) may display 1. bat wings 2. alveolar edema 3. kerley b lines 4. cardiomegaly

all of the above

which of the following are associated with CHF 1. pink frothy secretions 2. tachypnea 3. pedal edema 4. jugular venous distention

all of the above

which of the following are pathological indications for invasive hemodynamic monitoring 1. deficit or loss off cardiac function 2. cardiogenic shock 3. congestive heart failure 4. hemorrhage 5. burns

all of the above

which of the following are risk factors for heart failure 1. hypertension 2. coronary artery disease 3. MI 4. diabetes 5. congenital heart defects 6. NSAIDS

all of the above

which of the following lines monitor systemic blood pressure and SVR and is most commonly placed in the radial artery

arterial line

which of the following monitors systemic blood pressure and systemic vascular resistance and is most commonly placed in the radial artery

arterial line

which of the following medications may be used to treat bradycardia in a pt with heart failure

atropine

property of myocardial cells to depolarize spontaneously

automaticity

coreg (carvedilol) is an example of a

beta blocker

square meters of surface area of body

body surface area

amount of blood from ventricles/min

cardiac output

the modified fick equation is used to calculate

cardiac output

which of the following lines measures right atrial pressure and cardiac function and is placed into a central vein

central venous line

affecting the rate of a contraction

chronotropic

inotropic state of muscle

contractility

the strength of the cardiac muscle to push blood from the ventricles against the SVR of the pt is the

contractility

what is the most frequently used inotropic drug for patients with heart failure

digitalis

which of the following medications is an inotropic

digoxin

furosemide is a/ an

diuretic

portion of blood ejected from the ventricle per beat

ejection fraction

up to a certain point, the heart will pump whatever blood is delivered too it on a beat to beat basis

frank-starling law

which of the following is NOT an indication for a pulmonary artery catheter

frequent ABGs

idiopathic and drug induced pulmonary hypertension are classified as

group 1

pulmonary hypertension caused by left heart disease is classified as

group 2

pulmonary hypertension resulting from lung diseases or hypoxia such as one would see with COPD, is classified as

group 3

pulmonary hypertension secondary to blood clots is classified as

group 4

pulmonary hypertension caused by sarcoidosis, polycythemia and metabolic disorders is classified as

group 5

what disease process occurs when the myocardial tissue no longer pumps well enough to meet the needs of the body

heart failure

study of blood flow

hemodynamics

low CVP may be associated with

hypovolemia

the average pressure in a pt's arteries during one cardiac cycle refers to the:

mean arterial pressure (MAP)

what disease process occurs when oxygen/blood supply to the myocardial tissue is blocked

myocardial infarction

CHF pts often require replacement of what two electrolytes

potassium and sodium

pressure in LV as it fills passively during diastole

preload

the volume required to stretch the cardiac muscle fibers in the atria and ventricles is the

preload

the determinants of stroke volume include

preload, afterload and contractility

a CVP of 10 mmHg is most likely associated with

right sided heart failure

an elevated jugular venous pressure, visualized as jugular venous distention, is indicative of

right sided heart failure

which of the following is a diuretic

spironolactone and bumetanide

amount of blood ejected by the ventricle at each beat

stroke volume

the amount of blood pumped by the left ventricle of the heart in one contraction is the

stroke volume

which of the following lines measures left heart preload and cardiac output

swan ganz line

contraction

systole

device that converts one type of energy into another

transducer

T or F: pulmonary hypertension is three times more common in women than men

true

which of the following is not a pathological indication for a pulmonary artery catheter

use of vasoactive drugs

tension developed by LV during systole

afterload

the resistance or pressure the ventricular heart muscle must overcome to open the aortic valve and eject volume is the

afterload

which of the following are associated with an increase in central venous pressure 1. right heart failure 2. pulmonary valvular stenosis 3. pulmonary embolism 4. dehydration

1, 2, and 3

hemodynamic monitoring provides info about: 1. blood volume 2. fluid balance 3. neurological status 4. cardiac function

1, 2, and 4 only

pharmacologic treatment of the pt in heart failure likely includes which of the following classes of drugs 1. diuretics 2. vasodilators 3. bronchodilators 4. inotropic

1, 2, and 4 only

hemodynamic monitoring provides info about: 1. blood volume 2. traditional vital signs 3. fluid balance 4. cardiac function

1, 3, and 4 only

the most common invasive hemodynamic monitoring device includes 1. arterial lines 2. PICC lines 3. central venous lines 4. intra venous lines 5. swan ganz lines

1, 3, and 5 only

what is th normal approximate value for O2 consumption

250 ml/min

what methods are used to measure O2 consumption 1. fick method 2. analysis of inspired and expired gases 3 V/Q scans

1 and 2 only

what two factors determine cardiac output 1. stroke volume 2. heart rate 3. cardiac index 4. arterial oxygen content

1 and 2 only

which of the following factors affect cardiac performance 1. preload 2. afterload 3. contractility 4. cardiac output

1, 2 and 3 only

risk factors for pulmonary hypertension include: 1. sickle cell disease 2.family history of pulmonary hypertension 3. a parasitic infection 4. HIV

1, 2, 3, 4

which of the following drugs may be used to manage heart failure 1. diuretics 2. vasodilators 3. inotropics 4. coagulants 5. beta blockers

1, 2, 3, and 5 only

Which of the following are often associated with the CXR in heart failure pts 1. bat wings 2. Kerley b lines 3. ground glass infiltrates 4. pleural effusion 5. cardiomegaly

1, 2, 4, and 5 only

list three most common invasive hemodynamic monitoring devices

1. arterial line 2. central venous line 3. pulmonary artery catheter

list three factors that will decrease afterload

1. decreased circulating volume 2. aortic insufficiency 3. decreased cardiac output

list three factors that will increase preload

1. heart failure 2. increased circulating volume 3. mitral valve insufficiency

list three conditions as discussed in class which will decrease cardiac output

1. left heart failure 2. mitral valve stenosis 3. CHF

list three factors which will increase PCWP

1. left heart failure 2. mitral valve stenosis 3. CHF

list six factors as discussed in class which will increase PAP

1. lung disorders 2. pulmonary embolism 3. pulmonary hypertension 4. air embolism 5. left heart failure 6. mitral valve stenosis

list five factors which will increase CVP

1. right heart failure 2. cor pulmonale 3. tricuspid valve stenosis 4. hypervolemia 5. lung disorders

which of the following heart rate indicates tachycardia

115 bpm

what is the normal mixed venous oxygen content

12-16 %vol

the normal mean pulmonary artery pressure (PAP) is

14 mmHg

what is the normal mean pulmonary artery pressure in adults

14 mmHg

choose the normal CaO2

17-20 %vol

what is the normal arterial oxygen content

17-20 %vol

what is the normal central venous pressure reading

2 to 6 mmHg

which of the following are used to determine a patients neurologic status 1. measuring VD/VT ratio 2. pupillary response and eye movement 3. corneal and gag reflex 4. respiratory rate and pattern

2, 3, and 4 only

what is the normal range for adult pulmonary capillary wedge pressure

4 to 12 mmHg

what is the normal range for cardiac output

4 to 8 L/min

what is the normal arterial venous oxygen content difference

4-5 %vol

choose the normal cardiac output

4-8 L/min

what is the normal pulse pressure

40 mmHg

a pts heart rate is 100 beats/minute and his cardiac output is 5 l/min. calculate the stroke volume

50 ml

which of the following heart rates indicates bradycardia

55 bpm

choose the normal heart rate

60-100 bpm

what is the normal arterial pressure

90 mmHg

what is the normal pulmonary vascular resistance

<2.5 mmHg/l/min and 200 Dynes/sec/cm-5

pulmonary hypertension is defined as a pulmonary artery pressure

>25 mmHg at rest

pulmonary arterial hypertension (PAH) indicates a mean PAP of _____ at rest or _____during exercise

>25 mmHg; >30 mmHg

which lab is the gold standard test for congestive heart failure, is increased in pt with heart failure and measurements are closely correlated with the heart failure classification

BNP

the pressure measured near the right atrium of the heart which allows us to monitor fluids in the body is the

CVP

assesses right ventricular function

PA systolic pressure

pressure when PA catheter wedges in PA branch

PCWP

the pressure measured when the PAC balloon is inflated in a branch of the pulmonary artery is the

PCWP

which of the following is measure by inflating the balloon on a Swan-Ganz catheter

PCWP

what is the best single measure of effective ventilation in the intensive care unit patient

PaCO2

when calculating the arterial oxygen content (CaO2), the first set of calculations (Hb x 1.34 x SaO2) estimates the O2 in the _______ and the second set (PaO2 x 0.003) estimates the O2 in the _____P_

RBCs; plasma

the pressure gradient across the systemic circulation divided by the cardiac output is the

SVR

what parameter is best used to assess left ventricular afterload

SVR