Hemodynamic Monitoring and Management Flashcards
6 cards from real Acute Care Nurse Practitioner practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Hemodynamic Monitoring and Management flashcards as text
A patient in the ICU has a pulmonary artery occlusion pressure (PAOP) of 22 mmHg and a cardiac index of 1.8 L/min/m². Which condition does this most likely indicate?
Answer: Cardiogenic shock
Elevated PAOP with low cardiac index is the hallmark of cardiogenic shock, indicating pump failure with fluid backup.
Which hemodynamic parameter best reflects left ventricular preload?
Answer: Pulmonary artery occlusion pressure
PAOP (wedge pressure) reflects left atrial pressure and is the best clinical estimate of left ventricular preload.
A patient's arterial line waveform shows pulsus paradoxus. Which condition should the ACNP suspect first?
Answer: Cardiac tamponade
Pulsus paradoxus (>10 mmHg drop in systolic BP during inspiration) is a classic sign of cardiac tamponade due to pericardial compression.
Which ScvO₂ value indicates adequate oxygen delivery relative to consumption in a critically ill patient?
Answer: 70%
ScvO₂ ≥70% (or SvO₂ ≥65%) suggests adequate oxygen delivery; values below this indicate tissue hypoperfusion.
A patient receiving norepinephrine has an SVR of 1,800 dynes/s/cm⁻⁵ and MAP of 92 mmHg, but urine output is 15 mL/hr. What is the MOST appropriate next step?
Answer: Start dobutamine
With adequate MAP and high SVR but low urine output suggesting poor perfusion, adding dobutamine addresses low cardiac output and improves organ perfusion.
When interpreting a CVP waveform, prominent 'v' waves are associated with which condition?
Answer: Tricuspid regurgitation
Prominent 'v' waves on CVP waveform reflect regurgitant flow back into the right atrium during tricuspid regurgitation.