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 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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