Cardiac Monitoring

  1. What does a Swan-Ganz/pulmonary artery catheter measure?
    Measures CVP, PAP, PCWP; allows for aspiration of mixed venous blood from pulmonary artery- best determinant of tissue oxygenation/O2 consumption
  2. Troubleshooting: arterial line transducer is above the level of the heart, what happens to the pressure reading?
    Pressure reading will read lower than actual pressure
  3. Troubleshooting: arterial line transducer is below the level of the heart, what happens to the pressure reading?
    Pressure reading will be higher than actual pressure
  4. What is the dicrotic notch on the arterial waveform?
    Closing of aortic valve; if not visible, the pressure is most likely inaccurate
  5. Pulse pressure
    40 mm Hg
  6. Diastolic
    60-90 mmHg
  7. Systolic
    90-140 mmHg
  8. What does cardiopulmonary stress testing (CPET) measure?
    Ability of heart and lungs during exercise, O2 consumption and CO2 production
  9. What does exercise stress testing measure?
    Cardiopulmonary reserve capacity
  10. What does indirect calorimetry measure?
    Energy expenditure by measurement of VCO2 and VO2; helps assess metabolic state and nutritional needs
  11. Normal respiratory quotient (RQ)
  12. Normal VO2 (O2 consumption)
    150-275 mL/min
  13. What does PVR measure?
    Afterload of right ventricle
  14. What does SVR measure?
    Resistance that the left ventricle must overcome to eject its volume of blood AKA preload
  15. SV
    60-120 mL/beat
  16. CI
    2.5-4.0 L/min/m^2
  17. What causes increased intrapulmonary shunting?
    PNA, PTX, pulmonary edema, ATX
  18. Decreased C(a-v)O2
    Decreased QT/CO
  19. Increased C(a-v)O2
    Increased QT/CO, septic shock, anemia
  20. C(a-v)O2
    4-6 mL/dL
  21. CaO2 equation
    • CaO2 = (1.34 x Hb x SaO2) + (PaO2 x 0.003)
    • CaO2 = O2 bound to Hb + O2 dissolved in plasma
    • *Replace with SvO2 and PvO2 for venous content
  22. Thermodilution technique
    Measure of QT (CO) through the pulmonary artery catheter, uses Fick equation
  23. PCWP>18 mmHg indicates..
    Cardiogenic pulmonary edema
  24. PCWP
    5-10 mmHg
  25. PCWP measures..
    Left atrium pressure, left ventricular end-diastolic pressure
  26. What reflects tissue oxygenation?
  27. Where is mixed venous blood sampled from?
    Pulmonary artery
  28. PvO2
    35-45 mmHg
  29. Diastolic PAP
    5-15 mmHg
  30. Systolic PAP
    20-35 mmHg
  31. Mean PAP
    10-20 mmHg
  32. CVP measures..
    Right atrial pressure, systemic venous return, right ventricular preload
  33. CVP
    2-6 mmHg
  34. Where is PCWP measured?
    Distal branch of pulmonary artery
  35. Treatment for third-degree heart block
  36. Third-degree heart block looks like..
    No determinable PR interval
  37. Treatment for second-degree heart block
    Isoproterenol, atropine, pacemaker
  38. Second-degree heart block looks like..
    QRS complex is preceded by two to four P waves
  39. Treatment for first-degree heart block
    Atropine, isoproterenol
  40. First-degree heart block looks like..
    PR interval longer than 0.20 sec
  41. Treatment for V-fib
    Defibrillation, CPR
  42. Treatment for V-tach
    Lidocaine, defibrillation, CPR
  43. Treatment for A-fib
    Cardioversion, propranolol, digitalis
  44. Bigeminy
    Every other beat is a PVC- dangerous arrhythmia
  45. Treatment for atrial flutter
    Cardioversion, carotid artery massage, procainamide, digitalis, tranquilizers
  46. PVC on ECG looks like..
    QRS complex is abnormal and wider than 0.12 sec
  47. Treatment for PVC
    If more than 6 PVCs per minute, use lidocaine, procainamide, propranolol
  48. Treatment for PAC
    If more than 6 PACs per minute, use lidocaine
  49. Inconsistent R to R intervals on ECG represent..
    Sinus arrthythmia
  50. Treatment for sinus tachycardia
    Stop underlying cause, digitalis, beta blockers
  51. Treatment for sinus bradycardia
    Atropine, pacemaker
  52. Normal QRS complex
    0.06-0.12 sec
  53. Normal PR interval
    0.12-0.20 sec
  54. Prolonged PR interval on ECG represents..
    First or second degree heart block
  55. Abnormal ST segment on ECG represents..
    Cardiac ischemia; sign of coronary artery disease
  56. Inverted T wave on ECG represents..
    Presence of coronary artery disease
  57. Widened QRS on ECG represents..
    Right bundle-branch block and PVCs
  58. QRS complex on ECG represents..
    Ventricular depolarization/contraction
  59. P wave on ECG represents..
    Atrial depolarization/contraction
  60. MAP
    80-100 mmHg
Card Set
Cardiac Monitoring
TMC study notes