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Hemodynamic Monitoring Review Cram, , ,Katie Wheeler RN BSN CCRN,Nurse Clinician Cardiac Surgery

Wellstar Kennestone Hospital. @ .Katie wheeler wellstar org

I. - Non Invasive Monitoring info about cardiac output

a. ,Pulse Assessment presence quality

b. ?, ,Neuro mentation LOC GCS

c. BP cuff BP has limitations

d. ?UOP adequate

.e /Skin Color temp

.i . . , , , ?i e pale cool clammy cyanosis

.II Invasive Monitoring

.a :Types

.i Arterial Pressure

.ii CVP

.iii PA

.iv PAOP

.III Terms

.a Preload

.b Afterload

.c Contractility

.IV :Indications for Invasive Monitoring

.a Shock States

.i Hypovolemic

.ii Cardiogenic

.iii Septic

.iv **Distributive

.V : Technical Considerations

.a Transducer Setup

.i No air bubbles

.ii Phlebostatic axis

.iii Considerations for transport

.iv Square wave test

.VI Arterial Lines

mailto:Katie.wheeler@wellstar.orgmailto:Katie.wheeler@wellstar.orgmailto:Katie.wheeler@wellstar.org

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.a Insertion Sites

.b Indications

.c Complications

.d Waveforms

.e Troubleshooting and considerations for air transport.VII /CVP Central lines

.a Insertion Sites

.b Indications

.c Complications

.d Waveforms

.e Troubleshooting and considerations for air transport

.VIII PA Catheters

.a Insertion Sites

.b Indications

.c Complications

.d Waveforms

.i /RAP CVP

.ii RV

.iii PA

.iv PAOP

.e Troubleshooting and considerations for air transport

.IX :Other data provided from the PA catheter.a /Cardiac Output Cardiac Index

.b /SVR SVRI

.c /PVR PVRI

.d /SV SVI

X. Pharmacology Use Hemodynamic Values to guide treatment

.a !!!Fluids first

.i Examples

1. NS

2. LR

3. albumin

4. blood

.ii Indications

.iii titration

.b Vasopressors

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.i , , ,Examples epi norepi dopamine neo

.ii Indications

.iii titration

.c Vasodilators

.i , ,Examples NTG Nipride Cardene

.ii Indications

iii. Titration

:IABP

.I Indications

.II What it is

.III What it does

.IV Setup

.V Monitoring

.a Triggers

.b !IABP console only

.c Monitored values

.i & .Unassisted sys dias

.ii & .Assisted sys dias

.iii Mean

.iv Augment

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.VI Considerations for Transport

.VII Complications

.a Rupture

.b IABP failure

.c Bleeding.d Arrest situations

.e Clotted line

.VIII Waveforms

.a Normal

.b Timing errors

.i *Early inflation

.ii Late inflation

.iii Early deflation

.iv *Late deflation