unit 2 study guides

Question 1

goal of hemodynamic monitoring-2

Answer 1

maintain adequate tissue perfomance, watch trends

Question 2

cardiac output

Answer 2

amt of bld ejected by heart each min

Question 3

cardiac output determined by

Answer 3

HR and stroke vol

Question 4

stroke vol

Answer 4

amt of bld put out by the left vent in 1 contraction

Question 5

preload

Answer 5

degree of vent stretch before contraction

Question 6

afterload

Answer 6

amt of resistance the ventricles must overcome to deliver the stroke vol into receiving vasculature

Question 7

why use art line-3

Answer 7

assess the efficiency of vasoactive meds, frequent ABG analysis, continuous monitoring

Question 8

why use CVP line-5

Answer 8

est fl status, measure rt heart filling, guide fl resuscitation, administer large vol fl resuscitation, incompatable meds

Question 9

why use pulmonary artery catheter-3

Answer 9

identify and treat cause of hemodynamic instability, assess pulmonary artery pressure, directly measure cardiac output

Question 10

why use invasive hemodynamic monitoring-4

Answer 10

cardiogenic shock, hypovolemic shock, cardiac tamponade, low cardiac output

Question 11

3 RN diagnoses-3

Answer 11

ineffective tissue perfusion, decreased cardiac output, fluid vol excess or deficit

Question 12

complications of invasive hemodynamic monitoring-5

Answer 12

thrombosis, hematoma, infection, bleeding, pneumothorax

Question 13

4 components of validating accuracy of hemodynamic monitoring

Answer 13

position pt, zero transducer, level the air-fluid interface, assess dynamic responsiveness

Question 14

RN implications for art line-4

Answer 14

document assessment q 2 hrs, keep wrist in neutral position, apply pressure when diccontinued, never administer meds in art line

Question 15

what does O2 bind to in RBC

Answer 15

Hgb

Question 16

what are some factors that affect oxygen binding-2

Answer 16

temperature and pH

Question 17

if CVP is low?

Answer 17

give IV fluids

Question 18

assessment of successful fluid resuscitation

Answer 18

UOP

Question 19

when ventilation reduced, PaCO2 does what

Answer 19

increase

Question 20

cause of respiratory failure

Answer 20

hypoventilation

Question 21

what happens w CO2 in hypoventilation

Answer 21

accumulates and not blown off, respiratory acidosis

Question 22

age related factors for elderly and ARDS-8

Answer 22

calcification of costal and sternal cartilage, osteoporosis, spinal degeneration, kyphosis, flattening diaphragm, diminished cough, low immune response, decreased pulmonary blood flow

Question 23

interventions for ARF-5

Answer 23

maintain patent airway, optimize O2 delivery, minimize O2 demand, treat cause, prevent complications

Question 24

interventions for COPD-7

Answer 24

reduce exposure to irritants, stop smoking, air conditioning, vaccines, bronchodilators, inhaled glucocorticosteroids, O2

Question 25

pulmonary embolism

Answer 25

accumulation of solids, liquids, or air that enters venous circulation and lodges in pulmonary vessels

Question 26

S/S of PE-9

Answer 26

sudden dyspnea, sharp/stabbing chest pain, cough, hemoptysis, tachypnea, crackles, pleural rub, diaphoresis, low grade fever

Question 27

priority problems for pt w PE-3

Answer 27

hypoxemia due to VQ mismatch, hypotension due to inadequate circulation, potential for bleeding r/t anticoagulants

Question 28

indicators of adequate tissue perfusion-4

Answer 28

ABGs w/n normal limits, pulse ox 95+, unimpaired cognitive status, absence of pallor/cyanosis

Question 29

antidote for heparin, warfarin, fibrinolytic therapy

Answer 29

protamine sulfate, vit K, FFP

Question 30

what triggers ARDS

Answer 30

huge inflammatory response

Question 31

SIRS

Answer 31

wide spread inflammation

Question 32

sepsis

Answer 32

infection associated with SIRS

Question 33

MODS

Answer 33

2 or more organ fail