Deck 9: Hemodynamic Monitoring

Question 1

When should the pulmonary artery pressure be measured?

A) Measured at end diastole
B) Measured during systole
C) Measured at end exhalation
D) Measured during a premature ventricular contraction

Answer 1

Measured at end diastole

Question 2

Once the pressure in the pulmonary artery equals the pressure in the right ventricle,the pulmonic valve closes,causing a small dip in the pressure tracing called the _____________.

A) central venous pressure.
B) diastolic pressure.
C) dicrotic notch.
D) pulmonary artery pressure.

Answer 2

dicrotic notch.

Question 3

Mixed venous samples are important clinically in that they are used to determine ______________

A) oxygen consumption.
B) cardiac output.
C) the clinical shunt fraction.
D) a and c

Answer 3

a and c

Question 4

What is defined as a device that converts one form of energy to another?

A) Transducer
B) Thermister
C) Phlebostatic axis
D) Catheter

Question 5

Where in the vascular system does the distal tip of a central venous catheter rest when placed properly?

A) Right ventricle or pulmonary artery
B) Vena cava or right atrium
C) Left ventricle or aorta
D) Right or left carotid artery

Question 6

Where should the distal tip of the pulmonary artery catheter rest when properly placed in the vascular system?

A) Pulmonary artery
B) Vena cava or right atrium
C) Left ventricle
D) Coronary artery

Question 7

The proximal lumen of the pulmonary artery catheter,when positioned properly,is positioned __________________

A) in the pulmonary artery.
B) in the aorta.
C) in the right atrium.
D) in the left ventricle.

Question 8

The application of Pascal's law helps to determine all of the following from indwelling catheters EXCEPT ______________

A) arterial pressure.
B) right atrial pressure.
C) cardiac output.
D) left ventricular end-diastolic pressure.

Question 9

A patient has a CVP catheter inserted.The patient is then placed on CPAP to maintain oxygenation.What will happen to the patient's CVP reading?

A) It will decrease.
B) It will not change.
C) It will increase.
D) It will either increase or decrease.

Question 10

The thermistor on the pulmonary artery catheter at the thermistor lumen is used to measure the __________________

A) central venous pressure.
B) dicrotic notch.
C) pulmonary capillary wedge pressure.
D) cardiac output.

Question 11

The pulmonary artery should always be measured _____________.

A) at end diastole.
B) during systole.
C) during a premature ventricular contraction.
D) at end exhalation.

Question 12

During diastole when the ventricles are filling,the tricuspid valve is open,allowing the pressure in the right ventricle to be reflected back to the vena cava.Which law does this represent?

A) Starling's law
B) Pousieille's law
C) Dalton's law
D) Pascal's law

Question 13

What are the 2 main concepts in Pascal's law?
I.Cardiac output = stroke volume X rate.
II.The pressure of a fluid in a closed container is equal at all points within the container.
III.The pressure acts perpendicularly against the walls of the container.
IV.The pressure of the systemic vessels is proportional to the viscosity of the fluid.

A) II and IV
B) I and III
C) I and IV
D) II and III

Question 14

Hemodynamic monitoring provides important clinical information regarding all of the following EXCEPT___________.

A) Cardiac preload and afterload
B) Blood pressure
C) Heart rate
D) Fluid volume

Question 15

Which catheter is a 'flow directed' catheter?

A) Central venous catheter
B) Pulmonary artery catheter
C) Radial artery catheter
D) a and b

Question 16

The proximal lumen of the pulmonary artery catheter measures the ______________.

A) central venous pressure.
B) pulmonary capillary wedge pressure.
C) cardiac output.
D) left ventricular end-diastolic pressure.

Question 17

PEEP _________________________________

A) increases the PCWP reading.
B) Increases the CVP reading.
C) increases cardiac output.
D) increases the CVP and PCWP reading.

Question 18

A patient has a CVP reading of 12 mmHg.What does this indicate?

A) Hypervolemia
B) Hypovolemia
C) Decreased right ventricular preload
D) Increased left atrial preload

Question 19

What happens if the right ventricular preload is increased too much?

A) The cardiac output is optimized.
B) The myocardium loses efficiency.
C) Oxygen consumption decreases.
D) Deadspace ventilation increases.

Question 20

What are the most commonly used veins or arteries for the insertion of a central venous catheter?
I.Antecubital fossa
II.Basilic vein
III.Internal jugular vein
IV.Subclavian vein

A) I, II, III, and IV
B) III and IV
C) I and II
D) I, III, and IV

Question 21

Normal mean pulmonary artery pressure is _________________.

A) 6-12 mmHg
B) 10-22 mmHg
C) 0-6 mmHg
D) 80-120 mmHg

Question 22

Normal pulmonary artery wedge pressure is ______________.

A) 6-12 mmHg
B) 10-22 mmHg
C) 0-6 mmHg
D) 80-120 mmHg

Question 23

Common causes of increased pulmonary artery pressures include _________________.

A) left atrial failure.
B) left ventricular failure.
C) hypovolemia.
D) reduced venous return.

Question 24

The hemodynamic data are recorded from a pulmonary artery catheter on a patient who is being mechanically ventilated.
Cardiac Output 6.0 L/min
PAP 44/22 mmHg
PCWP 18 mmHg
CVP 7 mmHg
HR 105/min
How would the practitioner interpret this data and what treatment should be recommended?

Question 25

The hemodynamic data are recorded from a pulmonary artery catheter on a patient who is being mechanically ventilated.
Cardiac Output 2.5 L/min
PAP 22/10 mmHg
PCWP 2 mmHg
CVP 1 mmHg
HR 125/min
How should the practitioner interpret this data and what treatment should be recommended?

Question 26

Increased pulmonary artery pressure can be caused by: I.Hypervolemia
II.Left ventricular failure
III.Mitral stenosis

A) I only
B) II and III only
C) I and II only
D) I, II, and III

Question 27

When interpreting a fall in the CVP,how should the fluid volume be correlated to confirm the relevance of the value?

A) The CVP should be correlated with the systolic blood pressure.
B) The CVP should be correlated with the diastolic blood pressure.
C) The CVP should be correlated with the fluid intake and output.
D) The CVP should be correlated with the PCWP.

Question 28

The hemodynamic data are recorded from a pulmonary artery catheter on a patient who is being mechanically ventilated.
Cardiac Output 7.0 L/min
PAP 50/30 mmHg
PCWP 12 mmHg
CVP 3 mmHg
HR 125/min
How would the practitioner interpret this data and what should be recommended?