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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.

Alice Edwards
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LOS ANGELES COUNTY + UNIVERSITY OF SOUTHERN CALIFORNIA MEDICAL CENTERNURSING EDUCATION AND CONSULTING SERVICESCORE CRITICAL CARE PROGRAMTOPIC:HEMODYNAMIC MONITORINGDESCRIPTION:This course discusses the basic components of cardiovascular function and theirclinical indicators. The pulmonary artery catheter is reviewed including:indications for use, components, set-up, cardiac and pulmonary pressuremeasurements, 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 rightand left sides of the heart.5.Differentiate between cardiac output and cardiac index.6.List factors the increase and factors that decrease preload, afterload, andcontractility.7.State the normal values of the following hemodynamic components and list theirrelationship 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 Index8.Discuss common chambers during systole and diastole cycle by state whichvalves are open and which valves are closed.9.Discuss the Frank-Starling Law.10.State the effects of a stimulated sympathetic nervous system and parasympatheticnervous system and how it relates to hemodynamics.11.Identify each port of the pulmonary artery catheter and the exit location of eachlumen 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 beadministered in each lumen.
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