- Information
- AI Chat
RN 231 Hemodynamic case study
Advanced Medical /Surgical Nursing 2 €“ Theory (RN231)
Carrington College
Preview text
Case Study, Assessment of Cardiovascular Function/Hemodynamic Monitoring
The critical care nurse is mentoring a new nurse on hemodynamic monitoring at the bedside of a critically ill patient. The patient has a right radial intra-arterial line, and a right subclavian pulmonary artery pressure monitoring system with a thermodilution catheter. The critical care nurse demonstrates proper management of the invasive hemodynamic monitoring lines to the new nurse and obtains the ordered parameters (mean arterial pressure [MAP], central venous pressure [CVP], pulmonary artery systolic [PAS], pulmonary artery diastolic [PAD], pulmonary artery wedge pressure [PAWP], cardiac output [CO], and cardiac index [CI] measurement). The critical care nurse meets with the new nurse afterward at the nurses’ station and encourages the new nurse to share what the new nurse understands in regard to invasive hemodynamic monitoring. The new nurse is currently taking critical care classes on hemodynamic monitoring.
a. What are the indications for the various hemodynamic monitoring methods (intra- arterial line), CVP line, and the pulmonary artery pressure monitoring system? What are the differences?
b. What are the Normal values for MAP, CVP, PAS, PAD, PAWP, CO, amd CI? DO NOT COPY AND PASTE: What are the critical values and when would you perform an ordered intervention (give an example for each) and when would you contact physician if you don’t have an order?
c. What are the nursing responsibilities when caring for the patient with hemodynamic monitoring?
d. Of what potential complications should the nurse be aware when caring for the patient with hemodynamic monitoring?
e. What is zeroing? What is a square wave test? Where is the phlebostatic axis located?
f. What do you need to do every time you change the patient position in a patient who is on continuous hemodynamic monitoring?
g. Your patient does not have invasive lines but has a Cheetah Nicom. What information do you get from the Nicom? Again do not copy and paste, Why would you use the Nicom, is there anything you would do with the Nicom to determine your interventions?
h. What is the SV and what is the importance of monitoring the SV (stroke volume)?
i. What values would you expect to see for a patient in septic shock both early and late?
j. What values would you expect to see for a patient in cardiogenic shock?
k. What values would you expect to see for a patient in neurogenic shock?
RN 231 Hemodynamic case study
Course: Advanced Medical /Surgical Nursing 2 €“ Theory (RN231)
University: Carrington College
