NR 341 Critical Care Exam 2 Review

NR 341 Critical Care Exam 2 Review Chapter 8: Hemodynamics ● Central Venous Pressure (CVP) ○ How assessed ■ Need central line that goes into right atrium ■ Arterial lines are placed in the radial (most common), brachial, or femoral artery. ■ The integrity of the arterial waveform should be assessed to verify the accuracy of blood pressure readings. ■ Monitor circulation in the limb with the arterial line (capillary refill, temperature, color). ■ Assesses preload of the right side of the heart. ○ Normal levels ■ CVP/ Right atrial pressure (RAP) ● 2-6 ■ Cardiac output (CO) ● HR x SV ● 4-8 ■ Stroke Volume ● 60 - 130 ■ SVR ● 770 - 1500 ○ Causes of abnormal levels ■ Low CVP = dehydration, hypovolemia, vasodilation from medications, rewarming, or sepsis. ■ High CVP = hypervolemia, severe vasoconstriction, mechanical ventilation, pulmonary hypertension, HF. ○ Treatment ● to prevent venous air embolisms-place patient in trendelenburg to increase CVP and ask them to bear down, (valsalva manuver) while the catheter system is open to air ● pulmonary hypertension - oxygen first ● hypervolemia -with chlorothiazide (diuril) or Amiloride