Question

The critical care nurse is mentoring a new nurse on hemodynamic mentoring at the bedside of a critical ill patient. the patient has a right radial intra arterial line and a right sub clavian pulmonary artery pressure monitoring system with a thermodilution catheter. the critical care nurse meet with new nurse demonstrates proper management of the invasive hemodynamic monitoring lines to the new nurse and obtains the order paramiter (mean arterial pressure (map) central venous pressure (cvp) oulmonary artery systolic (pas) pulmonary artery diastolic (pad) pulmonary artery wedge pressure (pawp) cardiac output (co) and cardiac index (ci) measurement)   the critical care nurse the critical care nurse meet with the new nurse afterwards at the nurses station and encourage the new nurse to share what the new nurse understand in eegards to the invasive hemodynamic monetering .the new nurse is currently taking critical care classes on hemody namic monitering                                                                
                                                                                          A. what are the indications for the carious homodynamic monitering methods ( intra artirial line) and the pulmonary arteryd pressure monitoring system.                                                         

B.   what are the various ordered perameters use for in the case study
              
C. what are the nursing responsibilities when caring for the patient with hemodynamic monitoring.

of what potential complication
should the nurse be aware when caring for thre patient with hemodynamic monitoring

Answer 1

A) Hemodynamic monitoring is checking the blood pressure inside blood vessels and heart .This kind of monitoring is used in the management of complicated myocardial infraction,to rule out the cause of dyspnoea and hypoxia,management of crtically ill patients with existing cardiac diseases,to determine prognosis of crtically ill patients,to evaluate cardiac response to drugs and to diagnose and teat cardiac dysrthymias.Pulmonary artery monitoring is used to measure right heart and indirect lefy heart pressures and this helps to rule out pulmonary hypertension,pulmonary odema and so on.

B.1) Mean arterial pressure(MAP):An approoximation of the average pressure in the systemic circulation throughout the cardiac cycle,used in hemodynamic monitoring.MAP must be between 60 to 70 mmHg for adequate perfusion.

2)Central Venous Pressure(CVP):The CVP pressure within the superior venacava .It reflects the pressure under which blood is returned to the superior venacava and right atrium.

3)Pulmnonary Artery Systolic Pressure (PAS):Normal pulmonary artery systolic pressure is 15 to 25 mmHg

4) Pulmonary artery diastolic pressure(PADP):Normal PADP is 5 to 15 mmHg

5)Pulmonary Artery WEdge Pressure:It normally ranges between4 and 2 mmHg and the elevations may indicate left venticular failure,hypovolemia and so on.The measurement is obtained during momentary balloon inflation of the pulmonary artery catheter and is reflective of left venticular end diastolic pressure.

6)Cardiac Output: It is the amount of blood ejected from the left ventricular into the aorta each minute.

7)Cardiac Index Meaurement:To calculate Cardiac Index Measurement is Cardiac Otput divided by thr patients body surface area.

C)1.Complications:

Risk for infection,Thrombosis,pneumothorax,pulmonary artery rupture,pulmonary infraction.

2.Nursing Responsibilities:

a.Assess the catheter insertion site for any infection.

b.Cover the area with sterile dressing.

c.Assess for proper catheter placement,position

d.Montor heart rate and rhythm.

e.Maintain sterility of the ports.

f.Chang iv tubing as per policy

g.Document all values accuretly

h.Monitor for complications