AHN 447 TEST #1

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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


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