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AHN 568 EXAM 5 ( 5/ ) 85 QUESTIONS AND
ANSWERS
CVP Central venous pressure
CVP = 2-8
Preload (R side of heart) Volume
PCWP pulmonary capillary wedge pressure
PCWP = 6-12
Preload (L side of Heart) volume PCWP = PA diastolic
Indications for Lumbar Puncture diagnostic = infectious disease (meningitis or encephalitis), inflammatory process (MS & GB), oncologic procedures, metabolic processes
Therapeutic = spinal & epidural anesthesia, antibiotic administration, chemo for leukemia and lymphomas
position for lumbar puncture --Lateral recumbent position or the sitting position = Lateral recumbent position = is preferred to obtain accurate opening pressures and reduce post LP headache occurrence. (can be lying on the right or left side) 1 / 3
where is the needle inserted for a Lumbar Puncture The needle will be inserted between L3/L4 or L4/L5
Contraindications for a Lumbar Puncture
- increased ICP ***
- cardioresp. compromise
-S&S of Cerebral herniation -focal neurologic signs coagulopathy - hematoma -infection at site -previous lumbar surgery
needle size for Lumbar puncture 22-gauge needle
3.5 in (8.9 cm) for adults
Complications of Lumbar Puncture -Headache (Most common) -Herniation (most serious) -Cardiorespiratory compromise -local or referred pain 2 / 3
-bleeding -infection -subarachnoid epidermal cyst
- leakage of CSF
· Be careful with blood dyscrasia as a hematoma (subdural) may form post procedure and compress the cord (MONITOR!)
contraindication for ART lines
- Allens >15 secs
- infection at site
- traumatic injury proximal to site
-Raynauds -thromboangiitis Obliterans
proper ART line placement --The radial pulse is palpated 1 to 2 cm from the wrist, between the bony head of the distal radius and the flexor carpi radialis tendon.
can be placed via over-the-wire technique OR over-the-needle technique
Arterial spasm when inserting an ART line inability to pass wire or catheter through the artery due to spasm of the artery.
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