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Nursing In a Flash 
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Question Answer
What are risk factors for developing ventricular tachycardia during a Swan-Ganz insertion?
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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?
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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?
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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)?
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Systolic of 20-30, Diastolic of 5-10
The systolic pressure of the pulmonary artery pressure represents the pressure in the ______ ventricle.
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Right ventricle
The diastolic pressure of the pulmonary artery pressure represents the pressure in the ______ ventricle.
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Left ventricle
An increase central venous pressure (CVP) is indicative of?.
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Fluid overload
Where in the body is the proximal lumen of the Swan-Ganz catheter located?
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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)?
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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?
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Dopamine and Dobutamine.
How frequently are dopamine and Dobutamine titrated to maintain a patient's blood pressure while on a Swan-Ganz catheter?
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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?
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Assess them every 15 minutes
An increased pulmonary artery pressure (PAP) is indicative of?
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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?
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A PCWP over 20
_______ measures right and left ventricle squeeze. It can be used to assess for lung problems like pulmonary hypertension.
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Pulmonary artery pressure (PAP)
Once a Swan-Ganz is inserted what should be done post-procedurally?
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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?
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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?
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Improve their cardiac output, not their blood pressure by maximizing preload and decreasing afterload.
What PCWP level signals a need to call the physician?
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Any time it is over 20
________ is a measure of pressures in the left atrium and is equal to the end diastolic pressure.
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The Pulmonary Artery Wedge Pressure (PAWP), the same thing as a PCWP.
________ is a direct measurement of pressures in the pulmonary vein.
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The Pulmonary Artery Wedge Pressure (PAWP), the same thing as a PCWP.
A _______ measures pressures in the atria and gives a picture of circulating volume, thus guiding fluid replacement.
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Central venous pressure (CVP)
Always check with the doctor if a PCWP (PAWP) goes above _______.
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20, or if it deviates dramatically from the patient norms
To maximize preload, a patient's PAWP/PCWP should be between _________.
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15-20
_________ are used to increase a pulmonary artery wedge pressure (PAWP), thereby increasing preload.
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Infusions of blood, solutions or albumin
_________ are used to decrease a pulmonary artery wedge pressure (PAWP), thereby decreasing preload (as in cases of fluid overload).
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Diuretics
What does pulmonary artery wedge pressure (PAWP) measure?
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Pressure in the left side of the heart, the pumping ability
A _______ represents pressure changes during a cycle of systole and diastole.
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Wave
What is a normal central venous pressure (CVP)?
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2 to 5
A CVP of _______ is a signal to worry about the patient. A CVP of _____ is a sign of a definite problem.
Show Answer
CVP of 6, worry. CVP of 8, there's a problem


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