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CCRN Cardiovascular
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Cardiac Output - answer-HR x SV Younger children tend to have a higher CO because their HR is faster. Cardiac Index - answer-More specific indicator of hemodynamic status than cardiac output (includes body surface area in equation). CO is normally 4-8 L/min, however CI is 2.5-4.0 L/min/m2. ...

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  • September 16, 2024
  • 13
  • 2024/2025
  • Exam (elaborations)
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CCRN Cardiovascular exam

Cardiac Output - answer-HR x SV

Younger children tend to have a higher CO because their HR is faster.

Cardiac Index - answer-More specific indicator of hemodynamic status than
cardiac output (includes body surface area in equation). CO is normally 4-8
L/min, however CI is 2.5-4.0 L/min/m2.

CI=CO/BSA

MAP (mean arterial pressure) - answer-The mean pressure that takes into
account the fact that the diastolic phase represents 2/3 of the cardiac cycle.
MAP=2(DBP) + (SBP)/3

Patients should maintain a MAP of at least 60 mmHg to ensure adequate
perfusion to the brain and kidneys.

Ejection Fraction - answer-The ejection fraction should be over 50%. The is
the amount of blood ejected from the left ventricle compared to the total
amount available in the ventricle.
An ejection fraction of 35% or less indicates a problem with contractility,
outflow, or filling.

The ejection fraction most closely represents left ventricular end-diastolic
pressure. The LVEDP is the volume of blood under pressure left at the end of
contraction.

Tetralogy of Fallot - answer--Includes: VSD, overriding aorta, pulmonary
stenosis, and right ventricular hypertrophy.

-Condition results in low oxygenation of blood due to the mixing of
oxygenatated, and deoxygnenated blood in the left ventricle via the VD, and
mixing of blood from both ventricles through the aorta because of the
obstruction to flow through the pulmonary valve.

-End result is a right to left shunt.

-Primary symptom of TET is a low blood oxygen saturation, with or without
cyanosis, from birht or developing in the first year of life.

, -Other symptoms include a harsh systolic murmur with a thrill, difficulty in
feeding, failure to gain weight, retarded growth, and physical development.
Polycythemia may be present with dyspnea on exertion, along with clubbing.

-Children may have tet spells--results from a transient increase in resistance
to blood flow to the lungs along with increased flow of desaturated blood to
the body. May be precipitated by activity and are characterized by
paroxysms of hyperpnea, irritability, prolonged crying, increasing cyanosis,
and decreasing intensity of heart murmur. Maye result in hypoxic brain
injury and death.

Older children may squat which cuts off circulation to the legs. The squatting
position raises intrathoracic pressure and systemic vascular resistance,
thereby improving blood flow to the brain and vital organs.

Diastolic phase - answer-At birth, diastole represents half of the cardiac
cycle, shortly after birth, the diastolic phase lengthens so that it represents
2/3 of the cardiac cycle. An increase in cardiac output decreases diastole.

Reflex tachycardia - answer-Caused by the stretch of right atrial receptors.
Known as the Bainbridge reflex. The Bainbridge reflex is believed to occur to
speed up the HR if the right side because overloaded and help equalize
pressures in both sides.

Pulmonary Artery occlusive pressure (PAOP) - answer-Pressures in the left
side of the heart and pulmonary filling pressures are represented by the
PAOP.

Balloon of the pulmonary artery catheter is inflacted, it eventually wedges in
the pulmonary artery. The turbulence behind the balloon is blocked and it
senses what is in front of it--the pulmonary vascular bed and left side of the
heart. The normal value should be 5-12 mmHg.

Left atrial pressure - answer-A normal LAP is 8 mmHg. A high LAP would
indicate mitral valve dysfunction.

High right atrial pressures would be increased by either pulmonary stenosis
or tricuspid regurgitation.

S4 - answer-The fourth heart sound disappears after the first 24 hours of life
and if it stays indicates a decreased ventricular compliance.

The heart sound is produced when an atrial contraction fills up the ventricle .

If heard in a newborn, sounds like a clicking sound right before S1.

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