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
