...cardiac output as the major parameter of...
...and care of the catheter. 4. Apply...
...measurements obtained using the PA catheter. 5....
...catheter. 5. Describe right atrial and right...
...right atrial and right ventricular pressures, including...
...ventricular pressures, including the purposes, measurement, waveform...
...pressure ), including the purposes, measurement, waveform...
...that refers to the forces involved in...
...forces involved in the flow of blood...
...it circulates through the cardiovascular system. 2....
...measured by obtaining the blood pressure (using...
...Cardiac output is the amount of blood...
...blood pumped by the heart each minute:...
...Heart rate is the first determinant of...
...measured parameter. 2. The heart rate is...
...is dictated by the heart’s pacemaker sites,...
...with influence from the sympathetic and parasympathetic...
...D. Stroke volume—is the amount of blood...
...1. Preload a) The pressure or stretch...
...stretch exerted on the walls of the...
...the walls of the ventricle by the...
...the ventricle by the volume of blood...
...of blood filling the ventricle at the...
...the ventricle at the end of diastole...
...2. Afterload a) The resistance to ventricular...
...ventricular contraction. b) The pressure the ventricle...
...b) The pressure the ventricle must overcome...
...overcome to open the aortic or pulmonic...
...blood out of the ventricle into the...
...the ventricle into the systemic or pulmonary...
...it circulates through the cardiovascular system Measured...
...Measured by obtaining the blood pressure heart...
...temperature Dictated by the heart’s pacemaker sites...
...complications associated with the PA catheter. 2....
...current to measure the resistance to electrical...
...flow velocity in the vessel. a) Helps...
...venous return to the heart, total blood...
...(1) Facilitates monitoring the patient’s blood pressure...
...basis, which allows the nurse to monitor...
...nurse to monitor the patient’s response to...
...having to disturb the patient to take...
...b) Insertion of the arterial access line...
...access line (1) The nurse typically is...
...for setting up the equipment for catheter...
...catheter insertion, calibrating the equipment to ensure...
...readings, and assisting the physician with the...
...the physician with the procedure. c) Arterial...
...is related to the cardiac cycle (Fig....
...contour analysis (1) The use of the...
...The use of the pulse contour analysis...
...is based on the principle that the...
...the principle that the SV may be...
...measured by assessing the beat-to-beat changes in...
...beat-to-beat changes in the amplitude of the...
...the amplitude of the pulse pressure as...
...as displayed on the waveform. e) Mean...
...(1) MAP represents the average pressure in...
...average pressure in the systemic circulation throughout...
...systemic circulation throughout the cardiac cycle. (2)...
...(2) MAP represents the average pressure in...
...average pressure in the systemic circulation throughout...
...systemic circulation throughout the cardiac cycle. (3)...
...complications associated with the PA catheter. 2....
...flow velocity in the vessel Helps to...
...line Insertion of the arterial access line...
...PA catheters 1. The pulmonary artery (PA)...
...tool used for the following purposes: a)...
...purposes: a) Determining the pressures within the...
...the pressures within the right heart and...
...pressures within the right heart and PA...
...venous blood from the PA e) Infusing...
...hemodynamic assessment with the PA catheter: a)...
...assessment, integrated with the data collected from...
...nursing interventions and the manipulation of potent...
...a) Terminates in the proximal heart chamber,...
...proximal heart chamber, the right atrium. b)...
...heart chamber, the right atrium. b) Proximal...
...usually imprinted on the hub or tubing...
...a) Terminates in the right atrium b)...
...Terminates in the right atrium b) White...
...c) Used as the “central line” for...
...cardiac output if the proximal injectate is...
...a) Terminates in the PA. b) Distal...
...usually imprinted on the hub or tubing...
...continuous monitoring of the PA pressure (PAP)...
...that terminates near the catheter tip b)...
...blood flowing from the PA c) Detects...
...end connects to the cardiac output–monitoring device...
...a) Located near the small balloon at...
...small balloon at the distal end of...
...distal end of the catheter. b) Can...
...be left in the passive position. E....
...energy sensed by the catheter into electrical...
...energy, displayed on the monitor screen as...
...waveform. a) Leveling the Transducer corrects for...
...above and below the heart. b) Zeroing...
...heart. b) Zeroing the Transducer corrects for...
...used to overcome the pressure within the...
...the pressure within the pulmonary artery and...
...backing up into the pressure tubing. F....
...catheters. These have the standard design properties...
...family education a) The patient may be...
...be awake when the catheter is inserted,...
...include information about the procedure. 2. Insertion...
...2. Insertion of the PA catheter a)...
...PA catheter a) The ibsertuib if a...
...operating rooms. b) The insertion of a...
...Post-procedure management a) The nurse assumes responsibility...
...measurements a) Repositioning the patient is an...
...Bolus Thermo dilution Method—the traditional method of...
...thermodilution CO requires the use of injectate,...
...is injected through the proximal injectate port...
...injectate port of the PA catheter into...
...PA catheter into the right atrium. b)...
...catheter into the right atrium. b) Continuous...
...a part of the PA catheter wall....
...PA catheter measurements, the right atrial pressure...
...catheter measurements, the right atrial pressure (RAP)...
...pressure (RAP) and the pulmonary artery wedge...
...education Insertion of the PA catheter Postprocedure...
...wedge pressure (PAWP) Right arterial pressure (RAP)...
...index (VSWI) V. Right Atrial and Ventricular...
...Ventricular Pressures A. Right atrial pressure 1....
...An estimate of right ventricular preload (volume...
...(volume status of the right heart) 2....
...status of the right heart) 2. An...
...An estimate of right ventricular end-diastolic pressure...
...Measurements a) Normal right atrial waveform b)...
...to interventions. B. Right ventricular pressure is...
...during insertion of the catheter. 1. Waveform...
...PowerPoint Slides 1. Right Atrial Pressure An...
...An estimate of right ventricular preload An...
...An estimate of right ventricular end-diastolic pressure...
...wave produced by the rise in atrial...
...by closure of the mitral valve at...
...mitral valve at the initiation of ventricular...
...wave forms as the left atrium fills...
...decreased volume in the left atrium after...
...descent results from the pressure drop in...
...pressure drop in the left atrium when...
...left atrium when the mitral valve opens...
...passive emptying of the left atrium. 4....
...decreased RAP 6. Right Ventricular Pressure Waveform...
...normally reflects both right and left heart...
...pressure. 1. Waveform analysis—the PA waveform pattern...
...notch formed by the closure of the...
...the closure of the pulmonic valve. b)...
...pulmonic valve. b) The dicrotic notch is...
...is lost when the catheter tip retreats...
...tip retreats into the right ventricle. c)...
...retreats into the right ventricle. c) Knowing...
...ventricle. c) Knowing the waveform positions helps...
...condition that increases the afterload of the...
...the afterload of the right ventricle, such...
...afterload of the right ventricle, such as...
...pulmonary hypertension. (1) Right heart failure—distended neck...
...and ascites. (2) Right ventricular lift. (3)...
...with conditions of the left heart (1)...
...Mitral stenosis (5) Left-to-right intracardiac shunts c)...
...venous return to the left heart B....
...are obtained through the distal port of...
...distal port of the PA catheter. 2....
...2. PAWP Waveform Analysis—the normal range is...
...PAWP a) Observe the waveform constantly b)...
...constantly b) Use the smallest inflation volume...
...inflation d) Obtain the PAWP at end...
...vary according to the degree of elevation....
...Normally reflects both right and left heart...
...a dicrotic notch. The dicrotic notch lost...
...tip retreats into the right ventricle. Knowing...
...retreats into the right ventricle. Knowing waveform...
...an increase in the afterload of the...
...the afterload of the right ventricle 4....
...afterload of the right ventricle 4. Elevated...
...PAS Pressure—Clinical Findings Right heart failure Right...
...Right heart failure Right ventricular lift S3...
...with conditions of the left heart Angina...
...overload Mitral stenosis Left-to-right intracardiac shunts 6....
...failure can cause the following signs and...
...Bilateral crackles in the lungs 7a. Elevated...
...venous return to the left heart 9....
...Obtaining PAWP Observe the waveform constantly Use...
...waveform constantly Use the smallest inflation volume...
...Maintain inflation Obtain the PAWP at end...
...vascular resistance are the major means of...
...SVRI may be the result of hypothermia,...
...an estimate of right ventricular afterload. 1....
...volume 1. Determining the SV can provide...
...is influenced by the pressure the heart...
...by the pressure the heart beats and...
...heart beats and the volume the ventricle...
...and the volume the ventricle must pump...
...pump forward. 2. Right Ventricular Stroke Work...
...Work Index is the amount of work...
...moving blood in the right ventricle with...
...blood in the right ventricle with each...
...SVRI may be the result of hypothermia,...
...Stroke Work Index Right Ventricular Stroke Work...
...Review Figure 13-5—a right atrial waveform with...
...atrial waveform with the a and v...
...identified. Discuss how the waveforms are produced,...
...ways to prevent the catheter tip from...
...from moving into the RV. Suggestions for...
...catheter tip in the RV with the...
...the RV with the clinical educator of...
...clinical educator of the acute care nursing...
...nurses can develop the bedside critical-thinking skills...