Nursing Management
The nurse notes 2 thick dashes and 4 thin ones on a pulmonary artery catheter. The nurse notes the length as this.
What is 140cm
BP 82/48
CVP 1
PAOP 3
CO 3.0
SVR 900
Problem?
Intervention?
not enough fluids
give fluids
This is the pressure in the right atrium on a Swan-Ganz catheter.
What is Central venous Pressure (CVP)
This receives the physiologic signals from the catheter/tubing and converts it to electrical energy.
What is the transducer?
In order for CVP to be measured the patient must be in this position
What is supine with head of bed at 45 degrees?
The nurse notices that the transducer is lower than the phlebostatic axis, the nurse notes this and knows that the pressure reading from earlier was falsely__________
what is high?
BP 86/50
HR 118
CVP 10
PAOP 18
CO 2.2
SVR 1500
Problem?
Intervention?
Contractility problem
Give a positive inotrope
This is the assessment of left ventricular function
What is Pulmonary Artery Pressure?
The pressure bag is inflated to this amount of mmhg.
What is 300?
The nursse knows that these things can cause an increased PAOP
What is Left Ventricle Failure, hypervolemia, and mitral regurgitation.
True or false. in regards to PAOP, the catheter is left in a wedge position.
What is False?
MAP: 52
CVP: 4
PAOP: 8
CO: 5.5
SVR: 500
Resistance problem
Give a vasopressor
Signs of this include JVD, pulmonary congestion, crackles, and edema
What is increased preload?
When zeroing the invasive monitoring device this is what we do to the stopcock. This should be done during these times.
What is turn it open to room are AKA off to the patient?
When is during setup, at regular intervals, with movement, and anytime the values seem off.
The nurse performs a square box test and 5 oscillations are seen. The nurse knows it means this.
What is the pressure tubing is too long or a defective transducer
The nurse is performing an allens test and notes color return after 8 seconds, the nurse notes the flow as this.
What is impaired
MAP: 62
CVP: 16
PAOP: 24
CO: 2.4
SVR: 1700
Contractility
give positive inotrope
This is the location of the phlebostatic axis.
What is the 4th intercoastal space at the midaxillary line?
This is the amount of oscillations for a square wave test to be overdampened, underdampened, and normal.
what is less than 1.5 (over) more than 2 (under), and 1.5-2 (normal).
The nurse notes that this MAP is the minimum for proper kidney function.
What is 65?
True or false. The nurse should perform the injection for the thermodilution method at the end of expiration.
True
MAP: 78
CVP: 5
PAOP: 10
CO: 4.6
SVR: 1850
Resistance problem
Give Vasodilator
These medications are considered negative Inotropes.
What are calcium channel blockers and beta blockers?
These are some examples of what could be going on if the square box tests shows 1 oscillation
large air bubbles, loose connections, low/no flush solution, low pressure on flush bag, kinked catheter
The nurse notes that a patients HR is 45 beats per minute. The patient is hypotenive and complains of a headache and dizziness. The nurse determines their Cardiac Output is low. The nurse administers what medication per protocol.
Atropine