| Question |
Answer |
| What are risk factors for developing ventricular tachycardia during a Swan-Ganz insertion? |
|
Decreased potassium, decreased magnesium, hypoxia, acidosis. You must inform the doctor if these conditions exist prior to insertion.
|
| What do changes in PAWP potentially indicate? |
|
Left ventricular dysfunction, mitral stenosis (a higher pressure in the left atrium than the left ventricle), or valvular stenosis.
|
| How is cardiac output measured using a Swan-Ganz? |
|
Inject cold water at the end of expiration. The catheter measures the amount of blood pumped in a minute through the thermistor lumen.
|
| What is a normal pulmonary artery pressure (PAP)? |
|
Systolic of 20-30, Diastolic of 5-10
|
| The systolic pressure of the pulmonary artery pressure represents the pressure in the ______ ventricle. |
|
Right ventricle
|
| The diastolic pressure of the pulmonary artery pressure represents the pressure in the ______ ventricle. |
|
Left ventricle
|
| An increase central venous pressure (CVP) is indicative of?. |
|
Fluid overload
|
| Where in the body is the proximal lumen of the Swan-Ganz catheter located? |
|
The right atrium or the superior vena cava
|
| What type of medication is used when a patient's blood pressure is good, but they have an increased Pulmonary Capillary Wedge Pressure (PCWP)? |
|
Nipride/nitroprusside. It decreases afterload (the pressure the left ventricle must overcome to pump out blood systemically), and increases preload.
|
| What medications are commonly infused for a patient with a Swan-Ganz catheter to improve the heart's contractility and pumping? |
|
Dopamine and Dobutamine.
|
|
|
| How frequently are dopamine and Dobutamine titrated to maintain a patient's blood pressure while on a Swan-Ganz catheter? |
|
Every 2 to 5 minutes under the blood pressure is stable
|
| How frequently should a patient's blood pressure be assessed once their goal heart rate and blood pressure should be reached while they are on monitored via a Swan-Ganz catheter? |
|
Assess them every 15 minutes
|
| An increased pulmonary artery pressure (PAP) is indicative of? |
|
Pulmonary hypertension, ARDS-essentially it's indicative of an increased pulmonary resistance
|
| What is an indication via the Swan-Ganz catheter that a patient has pulmonary edema? |
|
A PCWP over 20
|
| _______ measures right and left ventricle squeeze. It can be used to assess for lung problems like pulmonary hypertension. |
|
Pulmonary artery pressure (PAP)
|
| Once a Swan-Ganz is inserted what should be done post-procedurally? |
|
Clean the insertion site and cover with a Tegaderm, keep the head of the bed under 60 degrees, balance the catheter, X-ray it for placement, document to insertion site, note the exit mark on the catheter.
|
| When should readings of a Swan-Ganz catheter be done? |
|
Readings should be taken during therapeutic changes (titrating medications, infusing fluids), and at standard 15 minute intervals.
|
| What is the underlying goal for a patient with a Swan-Ganz catheter? |
|
Improve their cardiac output, not their blood pressure by maximizing preload and decreasing afterload.
|
| What PCWP level signals a need to call the physician? |
|
Any time it is over 20
|
| ________ is a measure of pressures in the left atrium and is equal to the end diastolic pressure. |
|
The Pulmonary Artery Wedge Pressure (PAWP), the same thing as a PCWP.
|
|
|