PCCN Certificate Exam
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Exam Sets Included
,PCCN Exam
What is the function of the cardiovascular system ✔✔ to drive O2 to the cell so that the
cell can make ATP for energy production
What is the formula for CARDIAC OUTPUT ✔✔ Stroke volume x Heart Rate
CO = HR X SV ( Preload + Afterload + Contractility)
What is the term for the amount of blood that is pumped out of the ventricle each
MINUTE? ✔✔ Cardiac Output ( approximately 4 - 8 LPM )
What is the term for the amount of blood that is pumped out of the ventricle each
BEAT? ✔✔ Stroke Volume
What is the term for the number of contractions / minute? ✔✔ Heart Rate
IMPORTANT RELATIONSHIPS TO KNOW ✔✔ 1. CO DECREASED -> HR
INCREASES ( to maintain adequate stroke volume )
2. CO INCREASED -> HR DECREASES ( as stroke volume decreases )
3. HR DECREASED -> SV DECREASES and CO DECREASES
4. HR INCREASES ( > 150 ) -> SV DECREASES and CO DECREASES
5. SV DECREASES -> CO DECREASES and HR INCREASES
6. SV INCREASES -> CO INCREASES and HR DECREASES
What is the term for the volume of blood ejected from the ventricle per minute adjusted
for body size ✔✔ Cardiac Index
What is a normal cardiac index? ✔✔ Normal = 2.5 to 4.4 L/min/m2
**Always utilize CI values on exam (especially for bigger patients)
What is a normal amount (mL/beat) for stroke volume? ✔✔ 60 to 100 mL
What is the term for the end-diastolic volume stretching the ventricle? ✔✔ Preload
,( increased fluid = increased stroke volume )
What is the term for the pressure that the ventricle must OVERCOME in order to eject
blood into the circulatory system? ✔✔ Afterload
What is the term for the inotropic state the cardiac muscle ✔✔ Contractility
(how well the heart is contracted)
Preload is the function of which part of the circulatory system? ✔✔ VEINS
FUNCTION OF VEINS = PRELOAD
What is the RIGHT VENTRICLE PRELOAD assessed by? ✔✔ CVP (Central venous
pressure)
(Normal is approx. 2 - 8 mmhg)
What is a normal central venous pressure ? ✔✔ Approximately 2 - 8 mmhg
What is the LEFT VENTRICLE PRELOAD assessed by? ✔✔ PAOP (Pulmonary artery
occlusion pressure) / PAW pulmonary artery wedge pressure
-Swans ganns in placed wedge pressure (PA)
What are the signs and symptoms of an altered preload? ✔✔ 1. Dehydration
(decreased preload)
2. Fluid overload (increased preload)
What are some causes of a low preload? ✔✔ 1. Hemorrhage
2. Dehydration
3. Burns
4. Over-diuresis
5. Third spacing (fluid moving into spaces they shouldn't be)
What are some causes of high preload? ✔✔ 1. Hypervolemia
2. Heart failure
3. Renal failure
4. Pulmonary HTN
5. Tamponade
6. Tension pneumothorax
(most likely seen in right ventricle preload)
What are the venous dilating drugs? ✔✔ 1. NITRO (given to drop preload)
2. ACE I/ARB
, 3. Ca-Channel blocker
Which venous dilating drug is given to drop the preload amount? ✔✔ Nitro
What are some causes that can alter the vascular space? ✔✔ 1. Sepsis
2. Neurogenic shock
3. Anaphylaxis
4. Warming after cardiac surgery
5. Venous dilating drugs
What part of the circulatory system determines the afterload? ✔✔ Arteries
Afterload determines the functions of the __________ ✔✔ ARTERIES
RIGHT VENTRICLE AFTERLOAD is assessed by ✔✔ PVR (pulmonary vascular
resistance)
Normal is 20 - 200 dynes /sec/cm2
What is a normal range for pulmonary vascular resistance ✔✔ Normal is 20 - 200 dynes
/ sec / cm2
What is the LEFT VENTRICLE AFTERLOAD assessed by? ✔✔ SVR (systemic
vascular resistance)
Normal is 800 - 1600 dynes / sec / cm2
What is a normal range for systemic vascular resistance ✔✔ Normal is 800 - 1600
dynes / sec / cm2
What are the S/S of increased afterload? ✔✔ 1. CVP > 8
2. s/s of fluid overload **
3. CO < 4 LPM ---
4. signs of cardiogenic shock
5. PA wedge > 12 mmhg
6. EF fraction < 60 %
7. MAP < 60 mmhg --- 8. SVR > 1600 dynes / sec / cm5
9. Decreased urine output --- 10. LV hypertrophy
**LEFT VENTRICLE HYPERTROPHY
**SYSTEMIC HTN
What are the main signs of increased afterload? ✔✔ Left ventricle hypertrophy
Systemic HTN
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