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)? AnsAlbumin 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)? AnsCardiac 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)? AnsPAOP (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? AnsHigher 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 typ