Term Notes
Acyanotic -Left to right shunts -Oxygenated blood from left shunted to the right causing increased pulmonary blood flow
Cyanotic -Right to left shunt -Deoxygenated mixing and entering the systemic circulation
Patent Ductus Arteriosus (PDA) -Wide muscular blood vessel joining the pulmonary artery to the aorta – Continuation of fetal circulation -Compliance drops in kids -Tx: Indomethacin, Hemoclip, Coil
Atrial Septal Defects -Left to right shunt -Patent foramen ovaley -2nd most common -Usually closes on it’s own, otherwise not prevalent til pt is in 30s -Tx: Diuretics, Inotropes, Afterload reducers, Ductal occluder, Patch
Ventricular Septal Defect -Left to right shunt -Most located just under the aortic valve -Many close on their own
Question Answer
What are the Normal Systolic, Diastolic, and Mean Blood Pressures in an Adult? Systolic – 120 mm/Hg (torr) Diastolic – 80 mm/Hg (torr) Mean – 93 mm/Hg (torr)
How do you calculate the Mean arterial pressure? Map = (2 x diastolic)+ Systolic/3
Diastolic, Systolic, and mean arterial pressures (MAP) are monitored continuously by using this device? By using an indwelling arterial catheter with a pressure transducer (strain-gauge).
How do you calculate the “cardiac Index”? The “cardiac Index” is the cardiac output divided by the body surface area of the patient.
What is a Normal Cardiac Index? Normal cardiac index (CI) is 2-4 L/min./m2
What is the abbreviation for Cardiac Index? CI
The output of the left ventricle is measured in ____________________ and is called the ________________. measured in LPM and is called the Cardiac Ouput
The abbreviation for Cardiac output is? Qt
Normal Cardiac output is? 4-8 LPM
From the left atrium the blood passes through the __________valve and into the left ventricle. Bicuspid or Mitral
The blood in the pulmonary veins moves into the left atrium where the pressure has dropped to about ______________ 4-12 mm/Hg
From the pulmonary arteries the blood now passes through the lungs where the capillary pressure is normally about? 8-10 mm/Hg
From the right ventricle the blood moves through the _______ valve into the pulmonary artery where the pressure is normally ________ The mean pressure here is around ___________ 1) pulmonic valve 2) 25/8 mm/Hg 3) 14 mm/Hg.
Blood in the right atrium passes through the __________ valve into the right ventricle where the pressure is normally ___________. 1) tricuspid valve 2) 25/0 mm/Hg
The systemic venous blood flow moves slowly back to the right heart. As the venous return enters the right atrium, the pressure is now only ________ mm/Hg or _______cmH20 1) 2-6 mm/Hg 2) 4-6 cmH20
Inside the capillary the pressure is __________. As blood leaves the capillaries to enter the systemic veins, the pressure becomes ____________. 1) 20 mm/Hg 2) 10 mm/Hg
The mean pressure in the systemic arteries is normally ____________ and decreases to ____________ before it enters the capillary. 1) 90 mm/Hg 2) 30 mm/Hg
Beginning with the left ventricle the pressure is normally ___________, blood leaves the heart through the __________ valve and enters the systemic arterial system 1) 120/0 mm/Hg 2) Aortic
The heart has ________ separate chambers Four
Hemodynamics refers to these two life functions? circulation and perfusion
The word “hemo” means _________ and “dynamic” means _________ or ____________. Hemodynamics means the ___________ of blood or ________/____________ of blood 1) blood 2) motion or movement 3) movement of blood 4) circulation/perfusion of blood
Blood movement and (circulation/perfusion) occurs because of? blood pressures
This term refers to the monitoring of blood pressures Hemodynamics
This condition can strain the heart and can eventually cause heart failure High Blood Pressure
What are the three (3) factors that control blood pressures: 1) changes in the heart (rate and strength) 2) Blood (amount of fluid/blood) 3) vessels (condition of the vessels ie, constriction and dilation)
What will happen to blood pressure if heart rate or strength is increased? If it is decreased? 1) Blood pressure will increase 2) BP will decrease
What will excessive fluids in the blood due to blood pressure? What will loss of fluids do? 1) Would increase blood pressure 2) would decrease blood pressure
What will vessel constriction do to blood pressure? What will dilation do? 1) increase BP 2) decrease BP
The Left Ventricle serves which of the four circulatory branches? the systemic arteries
The Right Atrium serves which of the four circulatory branches? Systemic Veins
The Right Ventricle serves which of the four circulatory branches? Pulmonary Arteries
The Left Atrium serves which of the four circulatory branches? Pulmonary Veins
True or False: Since the heart spends twice as much in diastole than systole, the formula for mean arterial pressure is 2 parts diastole plus 1 part systole, divide by 3 True
How will the blood pressure read if the A-line transducer is placed too low (placed below the right atrium)? What if it is placed too high (above the right atrium)? 1) the pressure will read higher; 2) the pressure will read lower.
CVP measurements are used to monitor these two things? 1) the systemic venous drainage (Fluid levels) and the 2( function of the right heart
To measure CVP, Where is a catheter normally inserted through, where is it located, and what are the normal measurements? 1) through a peripheral vein 2) located in the right atrium 3) normally measures 2-6 mmHg (4-12 cmH2O)
The CVP pressure should be read at the tip of the? superior vena cava
What are five names that CVP’s may also be referred to? 1. Right atrial pressure 2. Right atrial filling pressure 3. Right side pre-load 4. Right ventricular filling pressure 5. Right ventricular end-diastolic pressure
How is a transducer/manometer placed when measurements are taken The transducer/manometer is placed at the level of the right atrium
What happens to CVP pressures with patients experiencing the following clinical problems? 1) Hypovolemia? 2) Hemorrhage? 3) Vasodilation? 4) Hypervolemia? 5) Right Heart Failure? 1) Hypovolemia – Decreased 2) Hemorrhage – Decreased 3) Vasodilation – Decreased 4) Hypervolemia – Increased 5) Right Heart Failure – Increased
What is the greatest hazard of CVP (a catheter) insertion? Pneumothoraz
What does PAP refer to? Pulmonary Artery Pressure
What does PAP monitor? the blood moving into the lungs
How is PAP measured? The PAP is measured with a balloon-tip, flow directed, pulmonary artery catheter (Swan-Ganz) with the balloon deflated.
Where is a PAP Catheter directed and positioned? The catheter is directed through the right side of the heart and is positioned in the pulmonary artery
True or False: The catheter will use a pressure transducer (strain-gauge) to monitor the PAP. True
True or false: The pulmonary artery is a poor choice in drawing Mixed venous blood samples False
What effects do these three clinical problems have on PAP: 1) COPD 2) Pulmonary Hypertension 3) Pulmonary Embolism All three of these conditions would result in an increase in PAP