Basic Assessment and Evaluation of the Complex Patient Flashcards

Vocabulary flashcards covering indicators of perfusion, hemodynamic formulas, monitoring equipment (PA, CVP, and Arterial lines), and oxygen evaluation based on lecture notes.

Physical Assessment Indicators of Perfusion

Key markers including level of consciousness, pulses, skin color, skin temperature, capillary refill time, and urine output.

CNS Indicators of Poor Perfusion

Clinical manifestations such as restlessness, confusion, and irritability caused by decreased $O_2$ delivery and alkalosis.

Cardiac Output

$$\text{Cardiac output} = \text{Heart rate} \times \text{Stroke volume}$$

Stroke Volume Determinants

The three factors that determine stroke volume: Preload, Afterload, and Contractility.

Preload

Filling pressures or volume at end diastolic volume; measured as CVP for the right heart and PAOP/PAWP for the left heart.

Afterload

Resistance to ejection of blood from the ventricles, represented by SVR and PVR.

Contractility

The pumping action of the heart.

Ejection Fraction

The percentage of blood ejected from the ventricle with each contraction.

Central Venous Pressure (CVP)

A measurement of right heart preload obtained via a Central Venous Line or the proximal port of a Pulmonary Artery (PA) line.

PAOP/PAWP

Pulmonary Artery Occlusion Pressure or Pulmonary Artery Wedge Pressure; used to measure left heart preload via the distal port of a PA line.

Pulmonary Artery Catheter (PA line)

A 4-lumen catheter (proximal, distal/balloon, thermistor, and balloon inflation) used for measuring CO, $SvO_2$, pulmonary artery pressures, and left heart preload.

Pulse Contour Analysis

A method of measuring Cardiac Output (e.g., PiCCO and FloTrac) via arterial line analysis where SV is estimated through the systolic portion of the arterial wave form.

Arterial Line

A monitoring device that allows for continuous BP monitoring, easy blood sampling, and ABG sampling; requires regular monitoring for patency and bleeding.

Oxygen Delivery Components

Factors including Cardiac Output and arterial oxygen content (Hemoglobin, $SaO_2$, and $PaO_2$).

SvO2 (Mixed Venous Oxygen Saturation)

Oxygen saturation of blood returning from both the lower and upper body, sampled from the distal port of a PA line (Normal: 60\text{--}75\text{%}).

ScvO2 (Central Venous Oxygen Saturation)

Oxygen saturation of blood returning from the upper body, sampled from a CVP line or the proximal port of a PA line.

Low SvO2

An indicator that oxygen supply is insufficient or oxygen demand has increased.

High SvO2

An indicator that oxygen demand has declined (decreased extraction) or oxygen supply has increased.

Thermodilution Method

A technique used to measure cardiac output via a pulmonary artery (PA) line.

Lactate

A laboratory assessment value used to evaluate metabolic status and perfusion in complex patients.