BKAT ICU POST TEST| ICU BKAT EXAM
QUESTIONS AND ANSWERS TESTED AND
APPROVED NEWLY MODIFIED
Pulmonary artery wedge pressure (PAWP) -- ANSWER--Normal PAWP: 8-12
mmHg LA measure; estimates L end diastolic pressure and LV function.
PAWP is normally 1-4 mmHg lower than the PAD if there is no lung disease
present.
Systemic Vascular Resistance (SVR) -- ANSWER--Normal SVR: 800-1200
How to calculate SVR; SVR=(MAP-CVP)x80/CO
MAP= 70-110
CVP= 2-8
CO= 4-8
SVR is the assessment of afterload on the L heart.
Increase SVR (increased LV workload): hypovolemia, hypothermia, low CO,
catecholamies.
Decreased SVR (decresed LV workload): vasodilation therapy, hyper-dynamic
phase of sepsis, anaphylaxis and neurogenic shock
Pulmonary vascular resistance (PVR) -- ANSWER--Normal PVR: 40-150
PVR is the assessment of afterload on the R heart; resistance to pulmonary
vasculature from PA to LA.
Page 1 of 54
,Increased PVR (increased RV workload): PE, pulmonary edema, pHTN, sepsis,
acidemia, hypoxemia.
Decreased PVR (decreased RV workload): Vasodilation therapy, correction of
hypoxemia, alkalosis.
Mixed venous oxygen sat (SVO2) -- ANSWER--Normal SVO2: 60-75%; <60
and >80 indicates tissue hypoxemia.
SVO2 measures the % of O2 bound to hgb in the blood returning to the right
side of the heart; reflects tissue oxygenation and supply/demand balance.
A decrease is SVO2 is one of the earliest indicators of threat to tissue
oxygenation. Caused by
Changes in O2 delivery: hypovolemia, shock, hemorrhage, MI, arrythmias,
increased PEEP, pulm edema, R->L shunt, decreased FiO2, ARDS, anemia.
Changes in O2 consumption: pain, tachypnea, anxiety, agitation, tachycardia,
shivering, hyperthermia, burns, sxn.
Coronary perfusion pressure (CPP) -- ANSWER--Normal CPP: >50 mmHg
To calculate CPP; CPP= DBP-PAWP (8-12 mmHg) CPP reflects coronary
blood flow.
Alpha -- ANSWER--Site: blood vessels
Stimulation: vasoconstriction
Beta 1 (think 1 heart for beta 1) -- ANSWER--Site: heart (myocardium)
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,Stimulation: increases HR (chronotropic), increases contractility (inotropy),
increases conduction speed.
Beat 2 (think 2 lungs for beta 2) -- ANSWER--Site: relaxation/diation of
smooth muscle; lungs(bronchi); immune system; GI tract
Stimulation: bronchodilator, vasodilator
Dopaminergic -- ANSWER--Site: Blood vessels, renal, gut
Stimulation: Vasodilation, increases motility
Norepinephrine (Levophed) [vasopressor] -- ANSWER--Terminal 1/2 life: 3
mins
Alpha 1/Alpha 2 (+++); Beta 1 (+)
MORE ALPHA THAN BETA
Hemodynamic effect: Vasoconstriction= increase SVR, HR and contractility
Clinical use: Septic shock (1st line treatment), severe hypotension,
undifferentiated shock
Contractility (squeeze) -- ANSWER--SV: 60-100 ml/min
EF: >40%
Contractility is the inotropic state of the myocardium; depends on healthy
muscle, intact cardiac cell membrane and normal electrolyte balance (Mg, K,
Ca) Increased: sympathetic stimulation (fight vs flight), vasoactive meds.
Page 3 of 54
, Decreased: myocardial hypoxia/ischemia, negative intropic medications.
Low contractility: Inotropes; dobutamine, milrinone
High contractility: antidysrhthmics; BB, Ca+ blockers.
Cardiac Index (CI) -- ANSWER--CI= 2.0-4.0
To calculate CI; CI=CO (4-8)/BSA
Cardiac index is the cardiac output in relation to the body size; assessment of
blood flow.
Stroke volume (SV) -- ANSWER--SV= 60-100 mL/beat
To calculate SV; SV=CO (4-8)/HR
Stroke volume is the amount of blood ejected per beat; assessment of pump
function.
Ejection fraction (EF) -- ANSWER--Normal EF: >40%
To calculate EF; EF= amount of blood ejected (SV)/amount of blood available
(EDV) Ejection fraction is the % of available preload that is ejected as stroke
volume with each beat; efficiency of LV as a pump.
Mean arterial pressure (MAP) -- ANSWER--Normal MAP: 70-110 mmHg
To calculate MAP; SBP+2(DBP)/3
MAP is the average BP throughout the cardiac cycle; used to titrate gtts;
consistent throughout arterial circulation regardless of location.
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QUESTIONS AND ANSWERS TESTED AND
APPROVED NEWLY MODIFIED
Pulmonary artery wedge pressure (PAWP) -- ANSWER--Normal PAWP: 8-12
mmHg LA measure; estimates L end diastolic pressure and LV function.
PAWP is normally 1-4 mmHg lower than the PAD if there is no lung disease
present.
Systemic Vascular Resistance (SVR) -- ANSWER--Normal SVR: 800-1200
How to calculate SVR; SVR=(MAP-CVP)x80/CO
MAP= 70-110
CVP= 2-8
CO= 4-8
SVR is the assessment of afterload on the L heart.
Increase SVR (increased LV workload): hypovolemia, hypothermia, low CO,
catecholamies.
Decreased SVR (decresed LV workload): vasodilation therapy, hyper-dynamic
phase of sepsis, anaphylaxis and neurogenic shock
Pulmonary vascular resistance (PVR) -- ANSWER--Normal PVR: 40-150
PVR is the assessment of afterload on the R heart; resistance to pulmonary
vasculature from PA to LA.
Page 1 of 54
,Increased PVR (increased RV workload): PE, pulmonary edema, pHTN, sepsis,
acidemia, hypoxemia.
Decreased PVR (decreased RV workload): Vasodilation therapy, correction of
hypoxemia, alkalosis.
Mixed venous oxygen sat (SVO2) -- ANSWER--Normal SVO2: 60-75%; <60
and >80 indicates tissue hypoxemia.
SVO2 measures the % of O2 bound to hgb in the blood returning to the right
side of the heart; reflects tissue oxygenation and supply/demand balance.
A decrease is SVO2 is one of the earliest indicators of threat to tissue
oxygenation. Caused by
Changes in O2 delivery: hypovolemia, shock, hemorrhage, MI, arrythmias,
increased PEEP, pulm edema, R->L shunt, decreased FiO2, ARDS, anemia.
Changes in O2 consumption: pain, tachypnea, anxiety, agitation, tachycardia,
shivering, hyperthermia, burns, sxn.
Coronary perfusion pressure (CPP) -- ANSWER--Normal CPP: >50 mmHg
To calculate CPP; CPP= DBP-PAWP (8-12 mmHg) CPP reflects coronary
blood flow.
Alpha -- ANSWER--Site: blood vessels
Stimulation: vasoconstriction
Beta 1 (think 1 heart for beta 1) -- ANSWER--Site: heart (myocardium)
Page 2 of 54
,Stimulation: increases HR (chronotropic), increases contractility (inotropy),
increases conduction speed.
Beat 2 (think 2 lungs for beta 2) -- ANSWER--Site: relaxation/diation of
smooth muscle; lungs(bronchi); immune system; GI tract
Stimulation: bronchodilator, vasodilator
Dopaminergic -- ANSWER--Site: Blood vessels, renal, gut
Stimulation: Vasodilation, increases motility
Norepinephrine (Levophed) [vasopressor] -- ANSWER--Terminal 1/2 life: 3
mins
Alpha 1/Alpha 2 (+++); Beta 1 (+)
MORE ALPHA THAN BETA
Hemodynamic effect: Vasoconstriction= increase SVR, HR and contractility
Clinical use: Septic shock (1st line treatment), severe hypotension,
undifferentiated shock
Contractility (squeeze) -- ANSWER--SV: 60-100 ml/min
EF: >40%
Contractility is the inotropic state of the myocardium; depends on healthy
muscle, intact cardiac cell membrane and normal electrolyte balance (Mg, K,
Ca) Increased: sympathetic stimulation (fight vs flight), vasoactive meds.
Page 3 of 54
, Decreased: myocardial hypoxia/ischemia, negative intropic medications.
Low contractility: Inotropes; dobutamine, milrinone
High contractility: antidysrhthmics; BB, Ca+ blockers.
Cardiac Index (CI) -- ANSWER--CI= 2.0-4.0
To calculate CI; CI=CO (4-8)/BSA
Cardiac index is the cardiac output in relation to the body size; assessment of
blood flow.
Stroke volume (SV) -- ANSWER--SV= 60-100 mL/beat
To calculate SV; SV=CO (4-8)/HR
Stroke volume is the amount of blood ejected per beat; assessment of pump
function.
Ejection fraction (EF) -- ANSWER--Normal EF: >40%
To calculate EF; EF= amount of blood ejected (SV)/amount of blood available
(EDV) Ejection fraction is the % of available preload that is ejected as stroke
volume with each beat; efficiency of LV as a pump.
Mean arterial pressure (MAP) -- ANSWER--Normal MAP: 70-110 mmHg
To calculate MAP; SBP+2(DBP)/3
MAP is the average BP throughout the cardiac cycle; used to titrate gtts;
consistent throughout arterial circulation regardless of location.
Page 4 of 54
