C-reactive Protein vessels behind balloon to be

measured
 Produced by liver in response to
inflammation
 Nonspecific inflammation marker – CRP
Hemodynamic Normal Values
levels increase in response to inflammation;
helps assess presence and extent of  Cardiac Index (CI)
inflammation in body o 2.5 – 4.0 L/min/m2
 May also be used as a cardiovascular risk  Cardiac Output (CO)
indicator o 4 – 8 L/min
 Effective Dynamic Compliance (EDC)
o 50 – 100 mL/cmH2O
Pulmonary Capillary Wedge Pressure  Ejection Fraction (EF)
o > 60%
 Reflects pressure in left atrium and end-
 Mean Arterial Pressure (MAP)
diastolic pressure in left ventricle
o 70 – 100 mmHg
 To assess heart function if heart is able to
pump blood effectively  Pulmonary Vascular Resistance (PVR)
 Risks: bleeding, infection, arrhythmias, or o 100 – 200 dynes/sec/m2
damage to blood vessels  Right to Left Shunt (Qs/Qt)
 ↑ PCWP – may indicate heart failure, volume o 0 – 5%
overload, valvular heart disease, or  Stroke Volume (SV)
pulmonary hypertension o 50 – 100 mL/beat
o Increased PCWP = increased  Stroke Index (SI)
pressure in the left side of the heart o 25 – 45 mL/m2
 ↓ PCWP – hypovolemia, reduced left  Systemic Vascular Resistance (SVR)
ventricular function (assc. with ↓ EF), o 800 – 1200 dynes/sec/m2
cardiomyopathy  Central Venous Pressure (CVP)
o Decreased PCWP = low blood o 2 – 5 mmHg
volume, impaired relaxation or filling  Pulmonary Artery Pressure (PAP)
of heart chambers o 25/10 mmHg
 Procedure:  Pulmonary Artery Occlusion Pressure (PAOP)
o Swan-Ganz catheter is inserted into o 8 – 12 mmHg
peripheral vein (in neck or groin  Pulmonary Artery Wedge Pressure (PAWP)
area) to pulmonary artery o 8 – 12 mmHg
o Catheter is advanced through right  Left Ventricular End-Diastolic Pressure
side of heart into pulmonary artery (LVEDP)
 Catheter has sensors that can o 5 – 12 mmHg
measure pressures in various
parts of heart
o Once catheter tip is in artery, the Cardiac Output Importance
balloon at the end will then be
Low CO – heart is unable to pump blood to meet
inflated and wedged into a smaller
body’s needs
pulmonary vessel
 Temporarily blocks blood
flow & allows pressure in
  Symptoms: fatigue, weakness, SOB,
dizziness/lightheadedness, chest pain,
peripheral edema, confusion
 Low blood flow to heart = low O2 delivery
to cardiac muscle → myocardial ischemia →
angina or myocardial infarction
 Reduced oxygen delivery to organs and
tissues → fatigue, weakness, dizziness
 Tissue hypoperfusion → damage and
dysfunction → brain cell damage or stroke
 Heart failure symptoms = SOB, peripheral
edema, and difficulty exercising
 Body will increase HR or constrict blood
vessels to compensate for the low CO,
improving BP and CO
 Low CO may cause syncope (fainting) due to
inadequate blood flow to brain = LOC
High CO – heart pumps more amount of blood
than body’s needs
 Heart works harder → hypertrophy or other
cardiac issues over time
 Symptoms = palpitations, SOB, peripheral
edema, fatigue, weakness, heart murmur,
flushed skin
 Increased risk of aneurysms or bleeding due
to increased pressure in blood vessels
Interventions
 Low CO
o Elevate head of bed to reduce heart
workload and improve oxygenation
o O2 therapy to increase O2 levels
o Monitor VS to track changes
o Administer diuretics, inotropes,
vasodilators to manage heart failure
and improve cardiac function
 High CO
o Restrict fluid intake to prevent
excessive volume overload
o Assess for signs of fluid overload
(edema) or other symptoms like SOB
or palpitations
o Administer meds for underlying
cause
o Limit excessive physical activity to
reduce strain on heart
Neurological Assessment in Cerebral Infarction
Perform complete neurological assessment; these
might be the abnormalities seen in cerebral
infarction:
 Hemiparesis or hemiplegia
 Facial droop in one side
 Numbness, tingling, or loss of sensation on
one side of body
 Dysphasia or aphasia
 Visual field deficits (loss of vision in one or
both eyes; partial or complete)
 Confusion, disorientation, or LOC
Catheter Nursing Considerations
Pre-procedure:
 Inform patient, get consent, perform
baseline assessment
 Assess coagulation status to ensure pt’s
blood clotting is w/in normal range
During:
 Maintain aseptic technique to minimize risk
of infection
 Continuously monitor pt’s VS, ECG, and O2
sat throughout the procedure
 Reassure pt to help alleviate anxiety
Post-procedure:
 Monitor VS and cardiac status; WOF signs of
complications like arrhythmias or bleeding
 Ensure proper care of catheter insertion site
 Assess for signs of infection and maintain
sterility

- catheter basta yung pangmonitor ng shits
- diagnostics sa TBI, mga need ifocus
- spinal injury, ano need imonitor pag involved ang
spine, read abt spinal surgery
- after effect ng trauma (brain edema) > nursing
interventions and meds
- SCI clinical manifestations per part, nursing
interventions, ano yung involved, basta reviewhin
mo yan
- neurogenic shock anong meron daw

- fluid and electrolytes involved in severely - pharmacology (vasopressors, inotropes, etc)

dehydrated pts or basta trauma pts (interventions
and rationale, paano naging effective)
- DIC > clotting cascade, why does it happen & wat
r its medical and nursing interventions, what to
monitor, ano yung mga pwede at bawal (food, sa
hosp, ewan basta mga ganyan daw)
- hypovolemic shock, pinakadistinct
manifestation and what to do first
cardiogenic shock effect, early (or lahat ng)
manifestation para maconclude na cardiogenic
shock
- situational: if assigned sa ICU tapos may
endorsement, what are ur priorities
indications to trauma
- nursing assessment sa MODS pt pag nakakabit sa
respirator, nursing interventions, and what to
anticipate
- hemodynamic monitoring phlebostatic area ewan
ano daw yung sa TBI, paano daw gagawin basta
na related sa ICP 'to
- sepsis medical and nursing mgmt
- head trauma classifications (acceleration,
deceleration, etc), what to do first
- MODS pt what to assess in lungs, kidney, heart
- fluid resuscitation ano gagawin (prioritization)

- spinal shock, clinical manifestations and why does - lactic acidosis why and how it happens
it happen
- ABG analysis sa conditions, manifestations and
- DIC, when does it happen, why does it happen, values ng ABG
who is at risk, what to do to avoid DIC, nursing
- indications if Hgb is low, how did it became low
interventions for DIC
(causes)
- lab results ng nadiscuss na diseases that is distinct
to that particular disease

- low Na, monitor ICP ??? if increased, what are the

dos and donts

- what are dos and donts of a nurse when

repositioning pt with mga nakakabit???

- SCI at risk pts

- trauma etiology and characteristics

- TBI mga need iassess, head to toe

- trauma nursing interventions pagkadating sa ER

- MAP manifestation if low or high and relationship

with CO and urine output