SHOCK HEMODYNAMICS

Question 1

HEMODYNAMICS

PERFUSION IS PROPORTIONAL TO:

Answer 1

1. CO
2. Systemic vascular Resistance
3. OXYGEN CONTENT

Question 2

HEMODYNAMICS

CARDIAC OUTPUT IS EQUAL TO?

Answer 2

Stroke Vol x Heart Rate

Question 3

HEMODYNAMICS

Stroke Vol is affected by (4)

Answer 3

preload

afterload

Contractility

preload - afterload = SV

Question 4

HEMODYNAMICS

Systemic Vascular Resistance

most common way to increase resistance?

Answer 4

decrease diameter of the blood vessel

Question 5

HEMODYNAMICS

MAP by way of BP is equal to?

Answer 5

2/3 diastyloic - 1/2 systolic

Question 6

HEMODYNAMICS

MAP

Mean Arterial Pressure is equal to?

Answer 6

CO x SVR x CVP

CVP is usually so low you can drop it out of the equation

NOTE RELATIONSHIP AND HOW a pt in shock can have adequate BP but no perfusion

Question 7

HEMODYNAMICS

MAP= CO x SVR x CVP

Perfusion is proportional to CO, SVR, Oxygen content

Answer 7

This explains why there is often low BP and low tissue perfusion simmulatously

Question 8

HEMODYNAMICS

How do you assess/measure Heart Function?

Answer 8

1. BP
2. CO
3. SVR
4. Troponin
5. Echocardiogram
6. PCWP
7. CVP

Question 9

HEMODYNAMICS

BP =

Answer 9

BP=CO x SVR

Question 10

HEMODYNAMICS

CO =

Answer 10

CO = SV x HR

Question 11

HEMODYNAMICS

SV effected by 3 factors

Answer 11

1. Preload
2. Afterload
3. Contractability

Question 12

HEMODYNAMICS

SV =

Answer 12

SV = Preload - Afterload

Question 13

HEMODYNAMICS

Tissue Perfusion is proportional to (3)

Answer 13

CO

SVR systemic vascular resistance

Oxygen Content

Question 14

HEMODYNAMICS

MAP =

Answer 14

MAP = CO x SVR x CVP

CVP is so small it can ge dropped from the equation

Question 15

HEMODYNAMICS

1. What does elevated Troponin level indicate
2. What is normal level?
3. Troponin ALERT LEVEL?
4. How long does Troponin level stay increased?

Answer 15

1. Heart muscle damage
2. <0.35 ng/ml
3. >0.5 ng/ml
4. 3 weeks

Davis

Question 16

HEMODYNAMICS

Central Venous Pressure

1. Tells you what?
2. via Pulmonary Artery Catherer where is the monitor?

Evaluating the function of the heart and vessels

Answer 16

1. Pressure in RIGHT side Atrium Pressure
2. in the Superior Vena cava/Inferior just area before entering right side of heart

Question 17

HEMODYNAMICS

Pulmonary Cappillary Wedge Pressure

1. Tells you what?
2. via Pulmonary Artery Catherer where is the monitor?

Evaluating the function of the heart and vessels

Answer 17

1. Pressure in LEFT side Atrium Pressure
2. in the Cappillaries of the pulmonary artery

Question 18

HEMODYNAMICS

Cardiogenic Shock: Increase or decrease in PCWP? and WHY?

Answer 18

Increase PCWP because heart is not fxn properly and pushing blood forward, blood is pooling in the heart

Question 19

HEMODYNAMICS

Hypovolemic Shock: PCWP increase or decrease?

Why?

Answer 19

decrease because of the decrease in blood volume in the heart

Question 20

HEMODYNAMICS

How do you assess oxygen content in the blood?(3)

Answer 20

1. Pulse Oximetery
2. Arterial Blood Gases
3. via Pulmonary Arterial Cathether you can get ScvO2

Question 21

HEMODYNAMICS

S_cvO²

1. Measure what?
2. Why is this important?
3. Placed where?

Answer 21

1. Oxygen saturation of central venous (superior and inferior vena cave
2. Tells you oxygen content before entering the heart. If you have a increase ScvO2 then that means
3. via Pulmonary Artery Catheter monitor is in Superior vena cava area