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52 Cards in this Set
- Front
- Back
define hemodynamic
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the movement of blood
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purpose of arterial line
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most accurate form of getting a blood pressure
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arterial line insertion
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perform allen's test prior
insert in radial site |
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nursing assessments with A-Line
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hourly: color, pulse, temp, cap refill
cuff bp check q4h STAT bp if comes out |
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complications with A-line
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hemmorrhage if comes out
distal infarct air emboli infection |
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CVP
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central venous pressure
keep transducer level with the heart |
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purpose of CVP
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determines preload
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normal CVP
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<8, but look at the patient trends to determine increases or decreases
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normal CO
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4-8L/min
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ways to increase preload
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feet up, head down
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RAP
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R atrial Pressure
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RVP
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R Ventricular pressure
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PAP
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Pulmonary artery pressure
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PCWP
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Pulmonary Capillary Wedge Pressure
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CO
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Cardiac Output
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CI
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Cardiac Index
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SVR
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Systemic Vascular Resistance
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what to consider when doing a wedge pressure
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blow up balloon for no longer than 15 seconds
read monitor during exhale tells you what is happening on L side of heart |
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normal PCWP
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8-12
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normal CVP
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1-8
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SVO2
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Systemic Venous Oxygen Saturation
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normal SVO2
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60-80%
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indication of increased CVP
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R HF
tricuspid valve stenosis/regurge tamponade fluid volume overload atrial/septal defect |
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indication of decreased CVP
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dehydration
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indication of increased PAP
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pulmonary HTN
COPD or other pulmonary disease |
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Indications for decreased PAP
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dehydration
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indications for increased PCWP
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mitral stenosis/regurg
L HF aortic stenosis tamponade |
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indications of decreased PCWP
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hypovolemia
vasodilation |
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indication of increased SVO2 from a venous line
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anesthesia
overabundance of O2 given |
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indications of decreased SVO2 from a venous line
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Bodies demand for O2 is higher than supply:
fever sepsis high metabolic state |
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SVO2
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Systemic Venous Oxygen Saturation
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normal SVO2
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60-80%
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indication of increased CVP
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R HF
tricuspid valve stenosis/regurge tamponade fluid volume overload atrial/septal defect |
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indication of decreased CVP
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dehydration
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indication of increased PAP
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pulmonary HTN
COPD or other pulmonary disease |
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Indications for decreased PAP
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dehydration
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indications for increased PCWP
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mitral stenosis/regurg
L HF aortic stenosis tamponade |
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indications of decreased PCWP
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hypovolemia
vasodilation |
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indication of increased SVO2 from a venous line
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anesthesia
overabundance of O2 given |
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indications of decreased SVO2 from a venous line
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Bodies demand for O2 is higher than supply:
fever sepsis high metabolic state |
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nursing considerations for insertion
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equipment is air free
trendelenberg's position-->increases blood in vein documentation of initial readings and tolerance zero transducer prior to insertion |
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trendelenber's position
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flat on back, head down, feet up
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complications with insertion of lines
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*pneumothorax*
ventricular dysrythmias thrombus bleeding pulmonary rupture or infarct ruptured balloon-->air embolism |
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nursing responsibility post line insertion
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bedrest
HOB up 30 degrees Q1-4h pressure readings change dressing qweek bag and tubing changes q4days watch for infection |
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nursing responsibilities during removal of line
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deflate balloon
may need to culture tip deep breath and hold-->increases thoracic pressure and decreases air embolism watch for arrythmias documentation |
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interventions for low heart rate
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atropine, pacemaker
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interventions for high heart rate
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BB's CCB's
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interventions for low preload
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fluids
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interventions for high preload
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diuretics, vasodilators
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interventions for low afterload (SVR)
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vasopressors
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interventions for high afterload (SVR)
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arterial dilators
CCB's ACEI's |
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interventions for low contractility (CO, CI<50%,)
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inotropic agents:
digoxin, dopamine, debutamine |