Credits: 3Presents the theory and application of skills required to provide adult hemodynamic and ECG monitoring and interpretation.
Prerequisite(s):RT 132, RT 135, RT 146, & RT 149 each with a minimum grade of “C” Corequisite(s): None Lecture Hours: 41 Lab Hours: 8 Meets MTA Requirement: None Pass/NoCredit: No
Outcomes and Objectives
Demonstrate, through successful completion of written examination and/or return demonstration, the ability to:
Explain the limitations of monitoring or lab values.
Describe the “feelings” of the patient facing a life threatening situation.
Define:
Ventilation
Diffusion
Perfusion
Explain those factors that effect:
Ventilation
Diffusion
Pul. Vas. Resistance (PVR)
Calculate:
O2 content
O2 consumption
Cardiac output
O2 delivery
A-aD02
a-vDO2
Qs/Qt
Describe and explain the significance of those factors involved in the physical assessment of the pulmonary system.
Define:
Pericardium
Epicardium
Myocardium
Endocardium
Describe the anatomy of the heart.
Describe the blood flow and intrachamber pressures through the heart.
Describe the phases of the cardiac cycle.
Explain those factors affecting CO.
Describe the coronary circulation.
Explain the primary determinants of myocardial O2 consumption.
Describe those factors that contribute to PVR.
Describe and explain the function of:
Arteries
Capillaries
Veins
Calculate mean arterial pressure. (MAP)
Compare and contrast the pulmonary and systemic circulations in terms of:
Structure
Function
Pressures
Pressure drop
Define and explain the effect on fluid-filled monitoring systems of:
Dynamic pressure element
Static pressure head
Explain the function of the following components of a pressure monitoring system:
Transducer
Transducer dome
Amplifier/Monitor
Flush system and tubing
Explain the clinical application of CVP monitoring:
Assessment of cardiac function
Assessment of fluid volume
Administration of fluids/drugs
Describe the complications of CVP monitoring.
State the normal pressures and identify the pressure waveforms as the PA catheter passes through the heart.
Calculate and give the normal values for:
PVR
SVR
Describe the indications for PAP monitoring.
Describe the general design of the PA catheter.
Explain the function of each of the following ports of the catheter and where the terminal opening would lie when the catheter is properly placed:
Proximal
Distal
Inflation
Thermistor
Describe the two approaches for gaining vascular access.
Identify the common site used for pulmonary artery catheterization.
Describe the steps involved in the insertion and floatation of the catheter.
Describe techniques to document a true wedge position.
Explain the significance of the PADP to PCWP gradient.
Explain postinsertion and rewedging protocol.
Describe the use of the PA catheter in assessing:
Preload
Afterload
Explain the complications associated with PA catheters:
Arrhythmias
Balloon rupture
Knotting
Trauma
Infection
Thromboemboli
Pneumothorax
Pul. Ischemia or infarction
Describe methods of determining cardiac output.
List the equipment required for the thermaldilution method of determining C.O.
Describe those factors that affect C.O.
Explain the significance of the cardiac index.
Explain the significance of SvO2 monitoring.
Describe the types of myocardial cells.
Define:
Contractility
Automaticity
Excitability
Conductivity
Identify the components of the electrical conduction system of the heart.
Describe the phases of the action potential of the myocardial cells.
Relate the phases of the action potential to depolarization and repolarization of the cells.
Explain the significance of Phase 4 in pacemaker cells.
Identify the various segments of the normal ECG.
Identify those arrhythmias covered in class.
Identify those individuals involved in the in-hospital resuscitation and the responsibilities of each.