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Essential Guide to Hemodynamic Monitoring in Criti

LOS ANGELES County + USC Medical Center Core CC Program: Hemodynamic Monitoring—covers CV physiology, pulmonary artery catheter use (setup, pressures, waveforms, CO measurement) and related clinical indicators.

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    LOS ANGELES COUNTY + UNIVERSITY OF SOUTHERN CALIFORNIA MEDICAL CENTER NURSING EDUCATION AND CONSULTING SERVICES CORE CRITICAL CARE PROGRAM TOPIC: HEMODYNAMIC MONITORING DESCRIPTION: This course discusses the basic components of cardiovascular function and their clinical indicators. The pulmonary artery catheter is reviewed including: indications for use, components, set-up, cardiac and pulmonary pressure measurements, waveforms, troubleshooting, measurement of the cardiac output, and charting. OBJECTIVES: Upon completion of this class the R.N. will be able to: 1. Define mean arterial blood pressure and its two primary determinants. 2. Define stroke volume. 3. Define preload, afterload, and contractility. 4. State the clinical identifiers of preload, afterload, and contractility for the right and left sides of the heart. 5. Differentiate between cardiac output and cardiac index. 6. List factors the increase and factors that decrease preload, afterload, and contractility. 7. State the normal values of the following hemodynamic components and list their relationship to maintain a mean arterial pressure: a. Right Atrial Pressure (RAP) b. Systemic Vascular Resistance (SVR) c. Pulmonary Vascular Resistance (PVR) d. Right Ventricular Stroke Work Index (RVSWI) e. Left Ventricular Stroke Work Index (LVSWI) f. Pulmonary Artery Wedge Pressure (PAWP) g. Cardiac Output/Cardiac Index 8. Discuss common chambers during systole and diastole cycle by state which valves are open and which valves are closed. 9. Discuss the Frank-Starling Law. 10. State the effects of a stimulated sympathetic nervous system and parasympathetic nervous system and how it relates to hemodynamics. 11. Identify each port of the pulmonary artery catheter and the exit location of each lumen when the distal catheter tip is positioned in the pulmonary artery. 12. Describe the correct set-up to monitor the PA catheter and what can or cannot be administered in each lumen.

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