Flow of blood through the heart - ANSWERInferior vena cava and superior vena cava
(deoxygenated)
Right atrium
tricuspid valve
right ventricle
pulmonary valve
pulmonary artery ( to lungs)
pulmonary veins (oxygenated)
Left atrium
mitral valve
left ventricle
aortic valve
aorta (body/oxygenated blood)
Cardiac Output - ANSWERVlm of blood ejected form the heart/min
CO= HR x SV
Normal CO - ANSWER4-8
Stroke Volume - ANSWERVlm of blood ejected with each beat
Ejection Fraction - ANSWERFraction of blood ejected with each beat
Normal Ejection Fraction - ANSWER60-70%
Stroke Vlm is influenced by - ANSWERPreload
,Afterload
Preload - ANSWER"filling a ballon"
-LFT ventricular end-diastole pressure
-Degree of stretch at end of diastole which determines how much blood is in the
ventricles prior to contraction
Inc in blood return to the heart results in? - ANSWERInc SV
Dec in blood return to the heart results in? - ANSWERDec SV
Factors that Dec Preload - ANSWERHypovolemic Shock
Impaired atrial contraction
How to DEC a pts preload ( HF pt) - ANSWERDiuretic therapy
Venousvasodialator (dec vlm headed in)
-nitro
How to inc preload (hypovolemic shock pt) - ANSWERFluids (inc vlm)
Afterload - ANSWERPressure or resistance against flow of blood exiting the ventricle
"opening door against the wind"
Related to lumen size and viscocity
-Systemic vascular resistance (force overcome by lF vent upon contraction)
-Pulmonary vascular resistance
(Force overcome by right ventricle upon contraction)
Factors that inc afterload? - ANSWERAortic Stenosis
Systemic hypertension
Factors that dec afterload? - ANSWERAny process that lower blood pressure (meds
etc)
Mitral regurgitation
How to Dec pt afterload ? (pt hypertension) - ANSWERAce-inhibiters (dialates vessel)
-"pril" meds
-anything that dec BP
,How to Inc afterload in pts? (distributive shock pt- systemic vasodilation) -
ANSWERVasopressin meds
-Any meds inc BP
SV: contractility - ANSWERStrength of the myocardial muscle fiber shortening during
systole
-How effectively the the heart can squeeze the blood out
-Inc in contractility = inc in SV
Factors that INC contractility - ANSWERCatecholamines
- Adrenaline
How is contractility influenced by preload? - ANSWEROptimizing preload ensures
maximal strength of myocardial fibers for contraction
Clients at inc risk for inc/ dec ?? - ANSWERStenosis or regurgitation of valves
Regurgitation - ANSWERValves don't close properly
-blood flows backwards
Stenosis - ANSWERValves don't open completely
-blood flow reduced
Mitral regurgitation - ANSWERMitral valve doesn't close properly and blood back flows
into the left atrium
, -can lead to HF
-can be chronic or acute
-Dec after load
-Inc Preload
Mitral stenosis - ANSWERReduced blood flow from left atrium into left ventricle
-Valve thickens and narrows causing increased resistance
-LF atrium less able to push blood into LF ventricle
-overtime causes LF atrial hypertrophy and dilation
-Dec CO
-Inc pulmonary vein pressure
A client is undergoing diagnostic testing for mitral stenosis. What statement by the client
during the nurse's interview is most suggestive of this valvular disorder? -
ANSWERWhenever I do any form of exercise I get terribly SOB
Aortic Regurgitation - ANSWERBack flow of blood into left ventricle form aorta during
diastole
-overtime causes left ventricular hypertrophy
Aortic Stenosis - ANSWERNarrowing of orifice between left ventricle and aorta
-Causes gradual Lf ventricular wall hypertrophy
-Inc after load
Invasive hemodynamic line ex? - ANSWERArterial line
Central venous catheter
Pulmonary artery catheter
What are the components of Hemodynamic monitoring - ANSWERInvasive catheter
noncompliant pressure tubing
transducer & stopcocks
Flush system
Bedside monitor
Accuracy in hemodynamic monitoring - ANSWERLevel = phlebostatic axis
-Fourth intercostal space, midaxillary line
-Approximately level of right atrium
Zero reference
-negative atmospheric pressure
- zeroing out stopcock is leveled at phlebostatic axis and "zeroed"
Dynamic response testing
-sqaure wave test
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