NR 341 Exam 2: Hemodynamics/ ABGs Study Guide
Questions and Answers
What does CVP stand for Ans- Central Venous Pressure
What does Preload mean? Ans- The VOLUME of BLOOD going INTO the HEART
during Diastole (AKA the Volume of blood in ventricles***)
What is the normal range of Preload? Ans- 2-6 L
What level normally is responsible for measuring Preload? Ans- CVP is
normally responsible
What does a CVP level of < 2 indicate is occurring? Ans- Fluid Volume Deficit
What does a CVP level of > 6 indicate? Ans- Fluid Volume Excess
What medication can be utilized to treat High (>6) CVP (or Preload)? Ans-
Albumin can be utilized to treat high preload
What level increases when CVP increases? Ans- The PAOP will also increase
If a patient has a CVP (Preload) < 2, what type of fluids would we utilize to
increase fluid volume in the patient? Ans- Isotonic Fluids
What are some Isotonic fluids that can increase CVP (preload) in a patient?
Ans- 0.9% Normal Saline
- Lactated Ringers (LRs)
What is the definition of Cardiac Output (CO)? AnsThe amount of blood
pumped out to the body (L/min)
What is the equation for Cardiac Output (CO)? AnsCO = Stroke Volume (SV) x
Heart Rate (HR)
Why is cardiac output (CO) very important? Ans- b/c it is responsible for
delivering everything (Oxygen, nutrients, etc), the organs/ tissues need to
survive
What is the definition of Cardiac Index (CI)? Ans- Utilized To determine how
precise the CO sufficiently is within the individual patients body
What is the equation for Cardiac Index (CI)? Ans- Cardiac Output (CO)/ Total
Body Surface Area
,What is the normal Cardiac Index (CI) levels? Ans- 2.8-4.2 L
Which is more accurate: Cardiac output (CO) or Cardiac Index (CI)? Ans-
Cardiac Index is more accurate b/c it is individualized to the person
If the Stroke volume of the patient is low, what increases? Ans- The patient
will have an increase in Heart Rate (HR) to accommodate the decrease in
Stroke Volume (SV)
What is the Stroke volume consist of? Ans- Preload
- Afterload
- Contractility
- Cardiac output
What do you need in order to measure Preload (CVP)? Ans- Central line
- Swans Ganz
What does a Central line give you, when assessing Preload(CVP)? Ans- The
Pressure of the Right Ventricle
What does a Swanz Ganz give you when assessing for Preload (CVP)? Ans-
PAOP (aka measures left ventricle)
What impacts Preload? Ans- Vasoconstriction
- Vasodilation
- Dehydration level
- Sepsis
What is the normal cardiac output (CO) level? Ans- 4-6 L/min
What level Preload do we expect with a patient with Congested Heart Failure
(CHF)? Ans- An increased (>6 L) Preload
What level Preload do we expect with a patient with Hypovolemic shock?
Ans- A decreased (<2 L) Preload
What medications can impact Preload? Ans- Diuretics (hydralazine)
- Venous Vasodilator (Nitroglycerine)
- Analgesics/Dilator (Morphine)
What is the definition of Afterload? Ans- The RESISTANCE the VENTRICLES
PUSHES AGAINST
What can impact Afterload? Ans- Blood Pressure
- Vasoconstriction
, - Vasodilation
How does Blood Pressure (BP) impact Afterload? Ans- Hypertension (HTN)
makes it harder to push against (increases CO/CI)
How does Vasoconstriction impact Afterload? Ans- Vasoconstriction causes
narrowing leading to harder work to pump blood (CO/CI)
How is Afterload measured? Ans- Systemic Vascular Resistance (SVR)
- Pulmonary Ventricle Resistance (PVR)
What does elevated Systemic Vascular Resistance (SVR) indicate? Ans-
Higher resistance of the ventricles
How does Ace inhibitors reduce afterload? Ans- prevents vasoconstriction
- relaxes the vessels
What is the definition of Stroke volume? Ans- How much the heart is
pumping with each beat of the heart
What does Contractility mean? Ans- How hard the heart is contracting
What does Contractility show? Ans- The strength of the cardiac cells to
contract/ shorten
What two types of medications improve contractility? Ans- Positive (+)
inotropes
- Positive (+) inotropes / Negative (-) Chronotropes
What two medications can be utilizes to IMPROVE contractility? Ans- Digoxin
or Digitalis (Positive + inotropes/ Negative - Chronotropes)
- Dobutamine
What medication can be given to decrease contractility? Ans- Betablockers
(Metroprolol)
How does Beta Blockers impact contractility? Ans- offers cardiac protection
- decreases contractility
- preserves Myocardial oxygen consumption
What drug would you administer to decrease the HR while improving the
contractility of the Heart? Ans- Digoxin (Digitalis)
Why does a patient with a Myocardial infarction (MI) need a negative (-)
inotrope (such as a beta-blocker)? Ans- The heart is tired
- The heart needs preserved
Questions and Answers
What does CVP stand for Ans- Central Venous Pressure
What does Preload mean? Ans- The VOLUME of BLOOD going INTO the HEART
during Diastole (AKA the Volume of blood in ventricles***)
What is the normal range of Preload? Ans- 2-6 L
What level normally is responsible for measuring Preload? Ans- CVP is
normally responsible
What does a CVP level of < 2 indicate is occurring? Ans- Fluid Volume Deficit
What does a CVP level of > 6 indicate? Ans- Fluid Volume Excess
What medication can be utilized to treat High (>6) CVP (or Preload)? Ans-
Albumin can be utilized to treat high preload
What level increases when CVP increases? Ans- The PAOP will also increase
If a patient has a CVP (Preload) < 2, what type of fluids would we utilize to
increase fluid volume in the patient? Ans- Isotonic Fluids
What are some Isotonic fluids that can increase CVP (preload) in a patient?
Ans- 0.9% Normal Saline
- Lactated Ringers (LRs)
What is the definition of Cardiac Output (CO)? AnsThe amount of blood
pumped out to the body (L/min)
What is the equation for Cardiac Output (CO)? AnsCO = Stroke Volume (SV) x
Heart Rate (HR)
Why is cardiac output (CO) very important? Ans- b/c it is responsible for
delivering everything (Oxygen, nutrients, etc), the organs/ tissues need to
survive
What is the definition of Cardiac Index (CI)? Ans- Utilized To determine how
precise the CO sufficiently is within the individual patients body
What is the equation for Cardiac Index (CI)? Ans- Cardiac Output (CO)/ Total
Body Surface Area
,What is the normal Cardiac Index (CI) levels? Ans- 2.8-4.2 L
Which is more accurate: Cardiac output (CO) or Cardiac Index (CI)? Ans-
Cardiac Index is more accurate b/c it is individualized to the person
If the Stroke volume of the patient is low, what increases? Ans- The patient
will have an increase in Heart Rate (HR) to accommodate the decrease in
Stroke Volume (SV)
What is the Stroke volume consist of? Ans- Preload
- Afterload
- Contractility
- Cardiac output
What do you need in order to measure Preload (CVP)? Ans- Central line
- Swans Ganz
What does a Central line give you, when assessing Preload(CVP)? Ans- The
Pressure of the Right Ventricle
What does a Swanz Ganz give you when assessing for Preload (CVP)? Ans-
PAOP (aka measures left ventricle)
What impacts Preload? Ans- Vasoconstriction
- Vasodilation
- Dehydration level
- Sepsis
What is the normal cardiac output (CO) level? Ans- 4-6 L/min
What level Preload do we expect with a patient with Congested Heart Failure
(CHF)? Ans- An increased (>6 L) Preload
What level Preload do we expect with a patient with Hypovolemic shock?
Ans- A decreased (<2 L) Preload
What medications can impact Preload? Ans- Diuretics (hydralazine)
- Venous Vasodilator (Nitroglycerine)
- Analgesics/Dilator (Morphine)
What is the definition of Afterload? Ans- The RESISTANCE the VENTRICLES
PUSHES AGAINST
What can impact Afterload? Ans- Blood Pressure
- Vasoconstriction
, - Vasodilation
How does Blood Pressure (BP) impact Afterload? Ans- Hypertension (HTN)
makes it harder to push against (increases CO/CI)
How does Vasoconstriction impact Afterload? Ans- Vasoconstriction causes
narrowing leading to harder work to pump blood (CO/CI)
How is Afterload measured? Ans- Systemic Vascular Resistance (SVR)
- Pulmonary Ventricle Resistance (PVR)
What does elevated Systemic Vascular Resistance (SVR) indicate? Ans-
Higher resistance of the ventricles
How does Ace inhibitors reduce afterload? Ans- prevents vasoconstriction
- relaxes the vessels
What is the definition of Stroke volume? Ans- How much the heart is
pumping with each beat of the heart
What does Contractility mean? Ans- How hard the heart is contracting
What does Contractility show? Ans- The strength of the cardiac cells to
contract/ shorten
What two types of medications improve contractility? Ans- Positive (+)
inotropes
- Positive (+) inotropes / Negative (-) Chronotropes
What two medications can be utilizes to IMPROVE contractility? Ans- Digoxin
or Digitalis (Positive + inotropes/ Negative - Chronotropes)
- Dobutamine
What medication can be given to decrease contractility? Ans- Betablockers
(Metroprolol)
How does Beta Blockers impact contractility? Ans- offers cardiac protection
- decreases contractility
- preserves Myocardial oxygen consumption
What drug would you administer to decrease the HR while improving the
contractility of the Heart? Ans- Digoxin (Digitalis)
Why does a patient with a Myocardial infarction (MI) need a negative (-)
inotrope (such as a beta-blocker)? Ans- The heart is tired
- The heart needs preserved
