Midterm Study Guide

Arterial Line

A catheter placed in an artery for continuous blood pressure monitoring and frequent blood gas analysis.

Phlebostatic Axis

Level at the 4th intercostal space, mid-axillary line, used for leveling the transducer in arterial line monitoring.

Square Wave Test

A test that assesses the accuracy and functionality of an arterial blood pressure monitoring system.

Normal Square Wave Test Result

Square wave with 1-2 oscillations and a dicrotic notch indicates accurate reading.

Overdamped Square Wave Test Result

Falsely low BP with no notch; check for air, clots, kinks, or loose connections.

Underdamped Square Wave Test Result

Falsely high BP with extra oscillations; shorten tubing and stabilize the patient.

Central Venous Pressure (CVP)

Measures pressure in the thoracic vena cava; normal range is 2-8 mmHg.

Hypervolemia

Condition of excess blood volume, can be indicated by high CVP (>13-15 mmHg).

Hypovolemia

Condition of below-normal blood volume, indicated by low CVP (<2 mmHg).

Left Ventricular Assist Device (LVAD)

Device that pumps blood from the left atrium to the aorta to support the heart.

Signs of Myocardial Infarction (MI)

May include sudden cold, clammy, ashen/gray skin from vasoconstriction.

Stable Angina

Predictable chest pain that occurs with exertion and is relieved by rest and nitroglycerin.

Unstable Angina

New or worsening chest pain lasting more than 10 minutes, not relieved by rest; medical emergency.

STEMI

Type of myocardial infarction characterized by ST elevation on ECG and complete arterial blockage.

NSTEMI

Type of myocardial infarction characterized by no ST elevation on ECG and partial arterial blockage.

Troponins

Blood markers used to diagnose myocardial infarctions; elevated in STEMI and NSTEMI.

Nitrates

Medications that vasodilate to increase coronary blood flow, decrease afterload, and lower oxygen demand.

Common Side Effects of Nitrates

Hypotension and headache; patients should sit or lie down before taking.

Modifiable Risk Factors for CAD

Includes hypertension, smoking, hyperlipidemia, obesity, inactivity, and uncontrolled diabetes.

Congestive Heart Failure (CHF) Signs

Include chest pain, shortness of breath, dizziness, edema, sudden weight gain, fatigue.

Diuretics

Medications used to reduce fluid overload in CHF patients.

Patient Education for CHF

Advise daily weights, low sodium diet, and fluid restrictions.

Compensation Mechanisms in CHF

Include SNS activation, RAAS activation, and ventricular remodeling.

Lethal Rhythm - Ventricular Tachycardia (VT)

Wide QRS and fast rate; can be treated with amiodarone or synchronized cardioversion.

Lethal Rhythm - Ventricular Fibrillation (VF)

Chaotic heart rhythm requiring immediate defibrillation and CPR.

Signs of Increased ICP

Includes Cushing's triad - widened pulse pressure, bradycardia, irregular respirations.

Cerebral Perfusion Pressure (CPP)

Calculated by MAP - ICP; normal range is 60-100 mmHg.

Common Causes of Spinal Cord Injuries

Include violence, sports injuries, diving accidents, and falls.

Autonomic Dysreflexia (AD)

Occurs in SCI above T6; causes sudden hypertension and other symptoms; requires immediate management.

Guillain-Barré Syndrome (GBS)

An autoimmune condition causing ascending paralysis and severe respiratory muscle weakness.

Cranial Nerves - CN I (Olfactory)

Sensory nerve responsible for smell.

Cranial Nerves - CN II (Optic)

Sensory nerve responsible for vision.

Cranial Nerves - CN VII (Facial)

Both sensory and motor; responsible for facial expressions and anterior taste.

Cranial Nerves - CN X (Vagus)

Both sensory and motor; controls parasympathetic functions of heart and digestion.

Ischemic Stroke

Results from a clot causing ischemia; treated with thrombectomy and thrombolytics if within window.

Hemorrhagic Stroke

Results from bleeding; management focuses on preventing further bleeding.

Expressive Aphasia

Difficulty producing speech but can understand language.

Receptive Aphasia

Difficulty understanding language but can produce speech.

Respiratory Failure

Characterized by hypoxemia (PaO₂

Acute Respiratory Distress Syndrome (ARDS)

Involves inflammatory injury to alveoli leading to pulmonary edema and refractory hypoxemia.

VAP Bundle

Protocols to prevent ventilator-associated pneumonia, including head elevation and oral hygiene.

Sudden Respiratory Distress on Ventilator

Remove from ventilator, manually ventilate, and call for help immediately.

Glasgow Coma Scale (GCS)

Used to assess consciousness; mild (13-15), moderate (9-12), severe (<8 indicates possible intubation).