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31 Cards in this Set
- Front
- Back
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a waves indicate:
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Atrial cx
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c waves indicate:
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Isovolumetric cx; TV elevation
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x descent indicates:
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Downward displacement of the TV during systole
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v waves indicate:
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Venous return against a closed TV (systolic filling of atrium)
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y descent indicates:
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TV opening
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In this rhythm you have an absent a wave and a more prominent c wave
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A fib
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Tall canon a wave, atria contract at same time as ventricles.
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Junctional
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Wide tall c wave, v wave obliterates x wave (regurgitant flow)
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Tricuspid regurg
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Prominent a wave, mean CVP elevated (more pressure required to force blood thru valve)
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Triscupid stenosis
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PA monitoring is appropriate and necessary in select surgical pts undergoing ______ procedures; or in pts with advanced _______ disease.
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High risk; cardiopulmonary
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Pt factors, surgical procedure, practice setting
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3 variables that must be looked at when considering PA catheter placement
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Pulmonary dz pt factors for using a PA catheter
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ARDS, severe COPD
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Pt risk factor for using a PA catheter in respect to complex fluid management
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Shock, ARF, hemorrhagic pancreatitis, active burns
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CAD with recent MI or LV dysfx; vavular heart disease, and heart failure.
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Cardiac disease pt factors with placing a PA catheter
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Tricuspid or pulmonary stenosis - could further obstruct
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Absolute contraindications for placing a PA catheter
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RA/RV mass
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Absolute contraindications for placing a PA catheter
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Tetralogy of Fallot - sensitive RVOF tract
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Absolute contraindications for placing a PA catheter
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Complete LBBB, WPW syndrome, bacteremia, prone to hypercoagulation
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Relative contraindications for placing a PA catheter
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Complications thought to be more common with PA catheterization than with central venous catheterization
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PA rupture, pulmonary infarction, valvula/endocardial vegetations or endocarditis, death
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Symtom of PA catheter knotting - coiling in RV
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Dampened tracing, difficult flushing distal port
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Complication of PA insertion: complete ____
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HB
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Complication of PA insertion: ______ d/t mechanical trauma
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RBBB
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Complication of PA insertion: must have temporary pacing ability for pts with_____
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LBBB
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Complication of PA insertion: dysrhythmias - transient _____ are common
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PVCs
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To place a PA catheter, you must have a ______ introducer sheath.
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7.5-9Fr
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The PA catheter has ____ lumens and is _____ long
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5; 110cm
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One common step forgotten when preparing the catheter for insertion is to:
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Place sterile sleeve over catheter
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You inflate the balloon with ____ ml
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1.5
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You advance the catheter _____ cm before you inflate the balloon. This should place the tip at the SVC - RA junction.
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15-20
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You should reach a PA waveform tracing around ______ cm. Do not advance past ____ cm.
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35-45; 60
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Insert the catheter thru the introducer sheath with the natural curve of the catheter pointing ____
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Towards the heart
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