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INTRODUCTION
The challenge of hemodynamic monitoring is complex
and multifaceted, and constitutes a major component of critical care
nursing practice. Since hemodynamic data often form the basis for
clinical decision-making, meticulous attention to detail and optimal
practice are essential in assuring accuracy. This seminar focuses on
practical aspects of hemodynamic monitoring, with emphasis on the
bedside nurse's role in managing invasive monitoring systems and
obtaining hemodynamic parameters.
Maintenance of patient safety and
prevention of complications are also included.
Please note:
Prospective participants are asked to review the sample questions
prior to registration. While some topics presented in this program are
similar to those from "Hemodynamics: Physiology &
Application," offered previously through Barbara Clark Mims
Associates by Laura E. Luecke, this seminar has been developed in response
to numerous requests for a more basic seminar.
A sample of the
type of questions to be answered during this one-day program includes:
 | In a patient with pulmonary disease, what
hemodynamic parameter best reflects volume status?
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| Which hemodynamic parameter best reflects the
pressure in the left ventricle?
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| In a patient who is receiving Nipride and having
thermodilution cardiac outputs measured via a 5 lumen V.I.P. catheter,
which lumen should be used for infusing the Nipride?
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| What safety measures should be used to avoid
pulmonary artery rupture in a patient with a pulmonary artery
catheter?
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| Which hemodynamic parameter best reflects right
ventricular afterload?
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| Why is the proximal injectate port not used for
infusing inotropic or vasoactive drugs in a patient having cardiac
output measured by thermodilution?
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| Through which port of a pulmonary artery catheter
is a mixed venous blood sample drawn?
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| How does a continuous cardiac output catheter
work?
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| What type of drug therapy is indicated in a
patient with a normal CVP, normal PCWP, high SVR, and low CO?
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| Which port of a triple lumen CVP catheter should
be used to obtain blood samples?
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| How much blood should be discarded prior to
obtaining a blood sample from a CVP catheter?
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| Is it safe to administer fluid via the port of a triple lumen CVP
catheter which flushes easily but has no blood return?
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| At what point during the respiratory cycle should the wedge
pressure be measured in a patient on pressure control ventilation?
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| How can you tell if a pulmonary artery catheter floats backward
into the right ventricle?
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| How does the PA waveform change when the pulmonary artery catheter
floats from the right ventricle into the pulmonary artery?
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| Which parameter should have the higher value, pulmonary capillary
wedge pressure or pulmonary artery diastolic pressure? Why?
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| What can the critical care nurse do to minimize catheter-related
infections?
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| If a patient's arterial blood pressure is 118/62 by arterial line
and 88/64 by cuff, which one should guide clinical decisions?
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| When monitoring blood pressure by radial arterial line, should the
air-fluid interface of the pressure monitoring system be positioned at
the level of the heart or the level of the radial artery?
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Presented by:
Laura
E. Luecke,
R.N.,
B.S.N., CCRN
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