N420 Med Surg III Quiz 2 with 100% Correct Answers 2024/2025

N420 Med Surg III Quiz 2 with 100% Correct Answers 2024/2025 4 components of a pressure monitoring system - answer-invasive catheter -transducer -flush system -bedside monitor Invasive catheter - answerattached to high pressure tubing which connects to the transducer Transducer - answer- converts the pressure coming from the artery or heart chamber into an electrical signal (waveform) - needs to be zeroed at least once a shift and when it is set up - must be at phlebostatic axis phlebostatic axis - answerlevel of right atrium; 4th intercostal space at mid-axillary line flush system - answerheparinized saline so line won't clot; maintained at 300 mmHg at 3-5 mL/hr Bedside monitor - answerdisplays the electrical signal into a waveform Arterial Line - answer- catheter inserted in radial or femoral artery - used for monitoring and data collection only (ABG blood; BP reading) - NEVER used for meds - assess for distal or collateral circulation using Allen Test - doctor must confirm before using the line Indications for an A-Line - answercritically ill patient with hypertension/hypotension or on vasoactive meds such as nipride, dobutamine (dopamine), epi/norepi, phenylephrine MAP of ___ to ___ is desirable, but ___ is bare minimum to perfuse vital organs (heart and brain) - answer70 to 105, but 60 Arterial waveform - answer- should have dicrotic notch indicating the closure of the aortic valve - if no notch - may not be in artery or there is some issue with the pressure reading system dampened arterial waveform - answer- causes: air bubbles, overly compliant, distensible tubing, catheter kinks, clots, low pressure flush bag, vessel spasm - this will UNDERESTIMATE blood pressure resonant arterial waveform - answer-causes: long tubing, overly stiff, non-compliant tubing, increased vascular resistance, not fully opened stop-cock - this will OVERESTIMATE blood pressure nursing management for an a-line - answer- evaluate circulation distal to the catheter (put pulse ox on that hand) - maintain continuous flush system - immobilize site to prevent dislodgment or kinking of the line Maintaining an A-line - answer- gentle flushing - re-zeroing the line - stop-cocks visible at all times - keep a-line visible at all times - keep alarm set and turned on - minimize blood loss - use papaverine/heparin/saline in line as ordered A-line complications - answer- hemorrhage - infection - hematoma - air embolism central venous pressure monitoring (CVP) - answer- direct measure of the pressure in the vena cava or right atrium (RAP) - can be single, double or triple lumen - measure preload (filling pressure) of right ventricle - NORMAL: 2-6 - looks at trends - CAN administer fluid, blood, meds, etc. - must have chest xray and verify by doc - goes through subclavian or internal/external jugular causes of a LOW CVP - answer- hypovolemia - vasodilation - gas tank is EMPTY causes of high CVP - answer- hypervolemia - vasoconstriction - HF - pulm HTN - cardiac tamponade - gas tank is FULL CVP complications - answer- infection - pneumothorax - air embolism CVP nursing interventions - answer- dry sterile occlusive dressing - confirm placement with CXR - monitor pressure trends - change dressing - frequency of measurements in accordance with pt's condition Pulmonary Artery Pressure Monitoring (PAP) - answer- aka Swan Ganz - balloon tipped, flow directed cath with distal and proximal lumens (4-5 lumens) pulmonary artery pressure (PAP) measurements - answer- R atrial pressure or CVP - pulmonary artery pressure