ACNP Shock States: Questions & Precise Solutions
Central Venous Pressure Right Ans - A measure of the pressure exerted by
fluid in the right atrium; indicative of right sided heart function
Normal: 0-6
CVP Elevation Right Ans - Ex. Fluid overload, cardiogenic shock
Conditions that cause an increase in the amount of fluid in the R atrium
CVP Decreased Right Ans - Ex. Dehydration, Distributive shock
Conditions that cause a decrease in the amount of fluid in the R atrium
Pulmonary Artery Pressure Right Ans - a measure of the systolic and
diastolic pressures in the pulmonary artery
Normal: 15-25/5-15
PAP Elevation Right Ans - Ex. Hypervolemia, pulmonary HTN
Conditions that cause an increase in the amount of fluid in the pulmonary
artery OR conditions that decrease the elasticity of the pulmonary artery
PAP Decreased Right Ans - Ex. Hypovolemia
Conditions that cause a decrease in the amount of fluid in the pulmonary
artery
Mean Arterial Pressure Right Ans - Indicates the average driving force in
the arterial system throughout the cardiac cycle.
Normal: SBP + 2(DBP)/3
Pulmonary Capillary Wedge Pressure aka Pulmonary Artery Occlusion
Pressure Right Ans - Measure of the pressure in the L ventricle at end-
diastole (maximal stretch); indicative of left-sided heart function
-Reflection of the tendency to develop pulmonary edema. To optimize cardiac
performance and minimize tendency for pulmonary edema, the PCWP should
be kept at the lowest point at which cardiac performance is acceptable.
Normal 6-12
PCWP Elevation Right Ans - Ex. Increased fluid, decreased elasticity of
ventricle
Conditions that increase the pressure in the L ventricle at end diastole
, PCWP Decreased Right Ans - Ex. Hypovolemia
Conditions that decrease the pressure in the L ventricle at end diastole
Cardiac Output Right Ans - The amount of fluid in liters per minute that the
heart pumps into systemic circulation. Product of HR x SV
Normal 4-8
CO Elevation Right Ans - Ex. Inotropic agents, excess fluid
Factors that increase the HR or increase the amount of blood that the heart
puts out with each beat
CO Decreased Right Ans - Ex. Drugs that decrease contractility,
hypovolemia
Factors that decrease HR or decrease the amount of blood that the heart puts
out with each beat
Cardiac Index Right Ans - The cardiac output/body surface area; more
accurate measure than CO because this value takes body surface area into
account
Normal 2.5-4 L/min
Systemic Vascular Resistance Right Ans - The resistance provided by the
systemic circulation against which the L ventricle must pump blood;
calculated by the following formula: MAP- mean CVP x 80)/CO
Normal 800-1200 dynes/sec/cm-5
Mixed Venous O2 Saturation (SvO2) Right Ans - Continuous display of
mixed venous oxygen saturation by the pulmonary artery catheter; assesses
the effectiveness of peripheral oxygen delivery
Normal 60-80%
SvO2 Decreased Right Ans - Implies increased tissue extraction of O2; the
patient has tapped the venous reserve of O2
Causes: decreased O2 supply (decreased CO, decreased FiO2, anemia) or
increased O2 demande (Fever, shivering, increased WOB)
SvO2 Elevation Right Ans - Implies decreased tissue extraction of oxygen;
high return of O2 is often a most early indicator of patient status changes
Central Venous Pressure Right Ans - A measure of the pressure exerted by
fluid in the right atrium; indicative of right sided heart function
Normal: 0-6
CVP Elevation Right Ans - Ex. Fluid overload, cardiogenic shock
Conditions that cause an increase in the amount of fluid in the R atrium
CVP Decreased Right Ans - Ex. Dehydration, Distributive shock
Conditions that cause a decrease in the amount of fluid in the R atrium
Pulmonary Artery Pressure Right Ans - a measure of the systolic and
diastolic pressures in the pulmonary artery
Normal: 15-25/5-15
PAP Elevation Right Ans - Ex. Hypervolemia, pulmonary HTN
Conditions that cause an increase in the amount of fluid in the pulmonary
artery OR conditions that decrease the elasticity of the pulmonary artery
PAP Decreased Right Ans - Ex. Hypovolemia
Conditions that cause a decrease in the amount of fluid in the pulmonary
artery
Mean Arterial Pressure Right Ans - Indicates the average driving force in
the arterial system throughout the cardiac cycle.
Normal: SBP + 2(DBP)/3
Pulmonary Capillary Wedge Pressure aka Pulmonary Artery Occlusion
Pressure Right Ans - Measure of the pressure in the L ventricle at end-
diastole (maximal stretch); indicative of left-sided heart function
-Reflection of the tendency to develop pulmonary edema. To optimize cardiac
performance and minimize tendency for pulmonary edema, the PCWP should
be kept at the lowest point at which cardiac performance is acceptable.
Normal 6-12
PCWP Elevation Right Ans - Ex. Increased fluid, decreased elasticity of
ventricle
Conditions that increase the pressure in the L ventricle at end diastole
, PCWP Decreased Right Ans - Ex. Hypovolemia
Conditions that decrease the pressure in the L ventricle at end diastole
Cardiac Output Right Ans - The amount of fluid in liters per minute that the
heart pumps into systemic circulation. Product of HR x SV
Normal 4-8
CO Elevation Right Ans - Ex. Inotropic agents, excess fluid
Factors that increase the HR or increase the amount of blood that the heart
puts out with each beat
CO Decreased Right Ans - Ex. Drugs that decrease contractility,
hypovolemia
Factors that decrease HR or decrease the amount of blood that the heart puts
out with each beat
Cardiac Index Right Ans - The cardiac output/body surface area; more
accurate measure than CO because this value takes body surface area into
account
Normal 2.5-4 L/min
Systemic Vascular Resistance Right Ans - The resistance provided by the
systemic circulation against which the L ventricle must pump blood;
calculated by the following formula: MAP- mean CVP x 80)/CO
Normal 800-1200 dynes/sec/cm-5
Mixed Venous O2 Saturation (SvO2) Right Ans - Continuous display of
mixed venous oxygen saturation by the pulmonary artery catheter; assesses
the effectiveness of peripheral oxygen delivery
Normal 60-80%
SvO2 Decreased Right Ans - Implies increased tissue extraction of O2; the
patient has tapped the venous reserve of O2
Causes: decreased O2 supply (decreased CO, decreased FiO2, anemia) or
increased O2 demande (Fever, shivering, increased WOB)
SvO2 Elevation Right Ans - Implies decreased tissue extraction of oxygen;
high return of O2 is often a most early indicator of patient status changes
