What is it?
What are some reasons we would use a PA Cath?
what is patients with complicated cardiac, pulmonary, and intravascular volume problems
What is the normal range for Cardiac Output (CO)?
What is 4-8L/min
Where is the Phlebostatic axis?
What is the intersection of the 4th intercostal space and the mid axillary line.
What is the easiest complication patients with PA Catheters have of obtaining?
What is Infection and sepsis
Measurements for PAWP should be taken at ___ ____________
What is End Expiration
What is the highest amount of mL the balloon on a PA Catheter should hold?
What is 1.5mL
What is a normal Cardiac Index (CI)?
What is 2.5-4.0L/min/m
What type of technique and dressing should be used with PA cath insertion, manipulation, and removal?
What is sterile technique and an occlusive dressing
What will you see if the balloon, on the end of the PA Catheter, bursts? What should the nurse do?
What is blood in the syringe and notify provider
Find the A wave after the QRS.
Measure the mean of the A wave (top and bottom of the a wave/2)
What is measuring PAWP?
What does the Thermistor lumen port do?
What is measures patients core temperature
What is the Normal Range for PA wedge pressure (PAWP)?
What is 6-12mmHg
How often does the nurse change the flush system?
What is every 96hours (4 days) or according to agency policy.
When are Dysrthmias most likely to occur when a patient has a pulmonary catheter?
What is on insertion and if the tip of the catheter migrates or gets pulled into the ventricle.
This is the resistance or pressure the ventricular heart muscle must overcome to open the aortic valve and eject volume.
What is afterload
Systemic vascular resistance
How should the patient be postioned when they are receiving a PA Catheter?
What is Supine with HOB flat
Causes for increased PAWP
Volume Overload
LV failure
MV/AV disease
Tamponade/Effusion
What kind of device do we use to ensure that a disconnection of tubing, leading to an air embolism or hemorrhage, does not occur?
What is Leur lock connections
What is a big reason for Pulmonary Infarction or PA rupture?
What is the balloon is inflated too long
What are some signs and symptoms of Cardiac Tamponade?
what is Muffled distant heart sounds,
tachycardia,
tachypnea,
hypotension,
& sense of impending doom.
If we are using Hemosphere to monitor the patients Cardiac Output and Cardiac Index what assessment data do we need to enter into the Hemosphere before hand?
What is Ht. & Wt.
Causes for Decreased PAWP
Hypovolemia
Arrhythmias
Loss of Atrial Kick
Vasodilation
a patient who has poor peripheral blood flow with cool clammy hands has an order for continuous pulse oximetry. What should the nurse do?
A. Tape the finger probe to the patents forehead
B. Utilize an earlobe probe
C. Ignore the order
D. Place the finger probe on finger anyway
What is B. Utilize an earlobe probe
If the nurse notices a Right Ventricle waveform reading on the monitor what should he/she do?
What is pull the catheter back until we see a Right Atrium wave form reading and then notify doctor.
Cause of falsely high PAWP
What is PEEP > 10cmH2O
•With PEEP >10 the pulmonary vasculature is compressed, the alveolar and intrathoracic pressure increased, thereby affecting the accuracy of the PAWP measurement