SlideShare ist ein Scribd-Unternehmen logo
1 von 20
Downloaden Sie, um offline zu lesen
VIVEKANANDA COLLEGE OF NURSING
MICRO-TEACHING PRACTICE
PRESENTED BY- APURVA DWIVEDI [M.Sc. NSG. 1ST YR.]
Central venous pressure
Overview
Introduction
Measurement of CVP
Factors affecting CVP
Low central venous pressure
Elevated central venous
pressure
Why do we measure CVP?
Methods to measure CVP
CVP-transducer set-up
Set up of equipment
Position of CVP patient
Access of CVP
Nurses role
Introduction
Central venous pressure, which is a measure of pressure in the vena cava, can be
used as an estimation of preload and right atrial pressure.
Central venous pressure is often used as an assessment of hemodynamic status,
particularly in the intensive care unit.
The central venous pressure can be measured using a central venous catheter
advanced via the internal jugular vein and placed in the superior vena cava near the
right atrium.
A normal central venous pressure reading is between 8 to 12 mmHg. This value is
altered by volume status and/or venous compliance.
Measurement
Normal CVP in patients can be measured from two points of reference:
•Sternum: 0–14 cm H2O
•Midaxillary line: 8–15 cm H2O
CVP can be measured by connecting the patient's central venous catheter to
a special infusion set which is connected to a small diameter water column.
If the water column is calibrated properly the height of the column indicates
the CVP.
In most intensive care units, facilities are available to measure CVP
continuously.
Normal values vary between 4 and 12 cmH2O.
Site
Normal
pressure range
(in mmHg)[5]
Central venous pressure 3–8
Right ventricular pressure
systolic 15–30
diastolic 3–8
Pulmonary artery pressure
systolic 15–30
diastolic 4–12
Pulmonary vein/
Pulmonary capillary wedge pressure
2–15
Left ventricular pressure
systolic 100–140
diastolic 3–12
Factors affecting CVP
Factors that increase CVP include:
•Cardiac tamponade
•Decreased cardiac output
•Forced exhalation
•Heart failure
•Hypervolemia
•Mechanical ventilation and the application of positive end-expiratory pressure (PEEP)
•Pleural effusion
•Pulmonary embolism
•Pulmonary hypertension
•Tension pneumothorax
Conti..
Factors that decrease CVP include:
•Deep inhalation
•Distributive shock
•Hypovolemia
Low central venous pressure
Some factors that can decrease central venous pressure are hypovolemia or
vasodilation.
Either of these would decrease venous return and thus decrease the central venous
pressure.
A decrease in central venous pressure is noted when there is more than 10% of blood
loss or shift of blood volume.
A decrease in intrathoracic pressure caused by forced inspiration causes the vena cave
to collapse which decreases the venous return and, in turn, decreases the central
venous pressure.
Elevated central venous pressure
Elevated Central Venous Pressure can occur in heart failure due to decreased
contractility, valve abnormalities, and dysrhythmias.
Any patients on ventilator assistance that have excessive positive end-expiratory
pressure would have an increase in pulmonary arterial resistance which causes an
increase in central venous pressure.
However, an increased central venous pressure caused by increased pulmonary
arterial resistance can also be affected by a decrease in the fraction of inspired
oxygen, an increase in ventilation/perfusion abnormalities in the lung, an increase
in pericardial pressure, or an increase in intra-abdominal pressure which would
increase thoracic pressure.
Increased juxta-cardiac pressure - tension pneumothorax, pericardial tamponade,
right ventricular infarct, right ventricular outflow obstruction - can also
decrease venous return.
Why do we measure CVP?
To serve as a guide of fluid balance in
critically ill patients
To estimate the circulating blood volume
To determine the function of the right side of
the heart
To assist in monitoring circulatory failure
None of these variables are measured
directly; they must be interpreted.
Methods to measure CVP
CVP Measurement
Method
Direct
Using manometer
Using transducer
Indirect
Inspection of Juglar
venous pulsations
in the neck
CVP-transducer set-up
✓500ml NS
✓ Pressure bag
✓ Transducer KIT
✓ Transducer holder
✓ Transducer pressure cable
Set up of equipment
Maintain aseptic technique
Open the transducer set and tighten all the connections
Hang the 500 ml saline in the pressure bag, and spike it.
Inflate the pressure bag to 300 mm hg and turn stopcock to upwards position.
Clamp iv tubing
Place the transducer holder on IV pole
Place transducer in transducer holder attach the IV tubing and the PM line in the
transducer kit
Unclamp the tubing and remove air from the tubing by activating the flush device.
Point stopcock of the transducer horizontal and do the tubing's
Position of CVP
patient
Access of CVP
Nurses role
Monitor for the signs of complications.
Assess for patency of the CVP line.
Sterile dressing should be done to prevent infection( CVP care
per the hospital protocol)
The length of the indwelling catheter should be recorded and
regularly monitored.
Summary
We have learned about Introduction, Measurement of CVP,
Factors affecting CVP, Low central venous pressure, Elevated
central venous pressure, Why do we measure CVP?, Methods to
measure CVP, CVP-transducer set-up, Set up of equipment,
Position of CVP patient, Access of CVP and Nurses role.
Conclusion
Central venous pressure estimates the right atrial pressure
pulmonary capillary wedge pressure estimates the left atrial
pressure. The values reflect end-diastolic volume, or pre load, of
the right and left ventricles, respectively. Central venous pressure
and pulmonary capillary wedge pressure both would have been
decreased because of the loss of blood volume from the venous
side.
Bibliography
Book reference
‘‘SUDDARTH’S AND BRUNNER’’, Text book of medical surgical
nursing,volume-1,edition-13,wolters Kluwer publisher, Page no
‘‘CHINTAMANI, MRINALINI, HARINDARJEET GOYAL;’’ Lewis’s medical
surgical nursing ,volume2,1st edition-2011, Elsevier publisher, page no.
Net reference
https://www.ncbi.nlm.nih.gov/books/NBK519493/#:~:text=Central%20venous
%20pressure%2C%20which%20is,in%20the%20intensive%20care%20unit.

Weitere ähnliche Inhalte

Was ist angesagt? (20)

Respiratory Assessment
Respiratory AssessmentRespiratory Assessment
Respiratory Assessment
 
Intercostal drainage tube insertion
Intercostal drainage tube insertionIntercostal drainage tube insertion
Intercostal drainage tube insertion
 
Defibrilation
DefibrilationDefibrilation
Defibrilation
 
Cardiac monitoring
Cardiac monitoringCardiac monitoring
Cardiac monitoring
 
Cardiac monitor ppt
Cardiac monitor pptCardiac monitor ppt
Cardiac monitor ppt
 
Chest tube drainage
Chest tube drainageChest tube drainage
Chest tube drainage
 
Bag and mask Ventilation
Bag and mask VentilationBag and mask Ventilation
Bag and mask Ventilation
 
1 Monitoring of Central Venous Pressure & Its Techniques
1 Monitoring of Central Venous Pressure & Its Techniques1 Monitoring of Central Venous Pressure & Its Techniques
1 Monitoring of Central Venous Pressure & Its Techniques
 
Thoracentesis
ThoracentesisThoracentesis
Thoracentesis
 
Thoracentesis
ThoracentesisThoracentesis
Thoracentesis
 
Ppt on CARDIO PULMONARY RESUSCITATION
Ppt on CARDIO PULMONARY RESUSCITATIONPpt on CARDIO PULMONARY RESUSCITATION
Ppt on CARDIO PULMONARY RESUSCITATION
 
Care of patient with chest drainage system
Care of patient with chest drainage systemCare of patient with chest drainage system
Care of patient with chest drainage system
 
Hemodynamic monitoring
Hemodynamic monitoringHemodynamic monitoring
Hemodynamic monitoring
 
Ppt on cpr
Ppt on cprPpt on cpr
Ppt on cpr
 
Hemodynamic monitoring ppt
Hemodynamic monitoring pptHemodynamic monitoring ppt
Hemodynamic monitoring ppt
 
Cvp line
Cvp lineCvp line
Cvp line
 
Procedure checklist
Procedure checklistProcedure checklist
Procedure checklist
 
10. ventilator care
10.  ventilator care10.  ventilator care
10. ventilator care
 
Thoracentesis
Thoracentesis Thoracentesis
Thoracentesis
 
Suctioning -neonates-
Suctioning -neonates-Suctioning -neonates-
Suctioning -neonates-
 

Ähnlich wie CVP micro teaching.pptx

arterial and CVP monitoring in perioperative period.pptx
arterial and CVP monitoring in perioperative period.pptxarterial and CVP monitoring in perioperative period.pptx
arterial and CVP monitoring in perioperative period.pptxkhelifakolea
 
Central venous catheterization
Central venous catheterizationCentral venous catheterization
Central venous catheterizationsuji kalai
 
HAEMODYNAMIC MONITORING PART 1&2.pptx
HAEMODYNAMIC MONITORING PART 1&2.pptxHAEMODYNAMIC MONITORING PART 1&2.pptx
HAEMODYNAMIC MONITORING PART 1&2.pptxashishnair22
 
central venous pressure and intra-arterial blood pressure monitoring. invasiv...
central venous pressure and intra-arterial blood pressure monitoring. invasiv...central venous pressure and intra-arterial blood pressure monitoring. invasiv...
central venous pressure and intra-arterial blood pressure monitoring. invasiv...prateek gupta
 
Clinicalteaching [autosaved]
Clinicalteaching [autosaved]Clinicalteaching [autosaved]
Clinicalteaching [autosaved]Anvin Thomas
 
Clinical monitoring in ICU
Clinical monitoring in ICUClinical monitoring in ICU
Clinical monitoring in ICUabrahahailu
 
Lec # 6 hemodynamic monitoring
Lec # 6 hemodynamic monitoringLec # 6 hemodynamic monitoring
Lec # 6 hemodynamic monitoringAli Sheikh
 
Hemodynamic Monitoring
Hemodynamic MonitoringHemodynamic Monitoring
Hemodynamic MonitoringMaggie Roman
 
Arterial_and_CVP_monitoring.ppt
Arterial_and_CVP_monitoring.pptArterial_and_CVP_monitoring.ppt
Arterial_and_CVP_monitoring.pptssuser35745f
 
MONITORING HEMODYNAMIC STATUS-1.pptx
MONITORING HEMODYNAMIC STATUS-1.pptxMONITORING HEMODYNAMIC STATUS-1.pptx
MONITORING HEMODYNAMIC STATUS-1.pptxRizwanUllah151255
 
Hemodynamic Pressure Monitoring
Hemodynamic Pressure MonitoringHemodynamic Pressure Monitoring
Hemodynamic Pressure MonitoringKhalid
 
Hemodynamic monitoring of critically ill patients
Hemodynamic monitoring of critically ill patientsHemodynamic monitoring of critically ill patients
Hemodynamic monitoring of critically ill patientsV4Veeru25
 
CVP Pulmonary artery wedge pressure monitoring: Physiology
CVP Pulmonary artery wedge pressure monitoring: PhysiologyCVP Pulmonary artery wedge pressure monitoring: Physiology
CVP Pulmonary artery wedge pressure monitoring: PhysiologySaneesh P J
 
fluid optimization concept based on dynamic parameters of hemodynamic monitoring
fluid optimization concept based on dynamic parameters of hemodynamic monitoringfluid optimization concept based on dynamic parameters of hemodynamic monitoring
fluid optimization concept based on dynamic parameters of hemodynamic monitoringSurendra Patel
 
Mechanical Ventilation for Nursing.ppt
Mechanical Ventilation for Nursing.pptMechanical Ventilation for Nursing.ppt
Mechanical Ventilation for Nursing.ppthuhu736156
 
Basic haemodynamic monitoring
Basic haemodynamic monitoringBasic haemodynamic monitoring
Basic haemodynamic monitoringDeepankar Mishra
 

Ähnlich wie CVP micro teaching.pptx (20)

arterial and CVP monitoring in perioperative period.pptx
arterial and CVP monitoring in perioperative period.pptxarterial and CVP monitoring in perioperative period.pptx
arterial and CVP monitoring in perioperative period.pptx
 
Central venous catheterization
Central venous catheterizationCentral venous catheterization
Central venous catheterization
 
HAEMODYNAMIC MONITORING PART 1&2.pptx
HAEMODYNAMIC MONITORING PART 1&2.pptxHAEMODYNAMIC MONITORING PART 1&2.pptx
HAEMODYNAMIC MONITORING PART 1&2.pptx
 
central venous pressure and intra-arterial blood pressure monitoring. invasiv...
central venous pressure and intra-arterial blood pressure monitoring. invasiv...central venous pressure and intra-arterial blood pressure monitoring. invasiv...
central venous pressure and intra-arterial blood pressure monitoring. invasiv...
 
Clinicalteaching [autosaved]
Clinicalteaching [autosaved]Clinicalteaching [autosaved]
Clinicalteaching [autosaved]
 
Cvp
CvpCvp
Cvp
 
Clinical monitoring in ICU
Clinical monitoring in ICUClinical monitoring in ICU
Clinical monitoring in ICU
 
Lec # 6 hemodynamic monitoring
Lec # 6 hemodynamic monitoringLec # 6 hemodynamic monitoring
Lec # 6 hemodynamic monitoring
 
Hemodynamic Monitoring
Hemodynamic MonitoringHemodynamic Monitoring
Hemodynamic Monitoring
 
Arterial_and_CVP_monitoring.ppt
Arterial_and_CVP_monitoring.pptArterial_and_CVP_monitoring.ppt
Arterial_and_CVP_monitoring.ppt
 
Hemodynamic monitoring
Hemodynamic monitoringHemodynamic monitoring
Hemodynamic monitoring
 
MONITORING HEMODYNAMIC STATUS-1.pptx
MONITORING HEMODYNAMIC STATUS-1.pptxMONITORING HEMODYNAMIC STATUS-1.pptx
MONITORING HEMODYNAMIC STATUS-1.pptx
 
Hemodynamic Pressure Monitoring
Hemodynamic Pressure MonitoringHemodynamic Pressure Monitoring
Hemodynamic Pressure Monitoring
 
Hemodynamic monitoring of critically ill patients
Hemodynamic monitoring of critically ill patientsHemodynamic monitoring of critically ill patients
Hemodynamic monitoring of critically ill patients
 
Icu monitoring
Icu monitoringIcu monitoring
Icu monitoring
 
CVP Pulmonary artery wedge pressure monitoring: Physiology
CVP Pulmonary artery wedge pressure monitoring: PhysiologyCVP Pulmonary artery wedge pressure monitoring: Physiology
CVP Pulmonary artery wedge pressure monitoring: Physiology
 
fluid optimization concept based on dynamic parameters of hemodynamic monitoring
fluid optimization concept based on dynamic parameters of hemodynamic monitoringfluid optimization concept based on dynamic parameters of hemodynamic monitoring
fluid optimization concept based on dynamic parameters of hemodynamic monitoring
 
Mechanical Ventilation for Nursing.ppt
Mechanical Ventilation for Nursing.pptMechanical Ventilation for Nursing.ppt
Mechanical Ventilation for Nursing.ppt
 
Ahmadalishah3
Ahmadalishah3Ahmadalishah3
Ahmadalishah3
 
Basic haemodynamic monitoring
Basic haemodynamic monitoringBasic haemodynamic monitoring
Basic haemodynamic monitoring
 

Mehr von Apurva Dwivedi

hemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptx
hemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptxhemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptx
hemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptxApurva Dwivedi
 
legal issues of nursing profession.docx.pptx
legal issues of nursing profession.docx.pptxlegal issues of nursing profession.docx.pptx
legal issues of nursing profession.docx.pptxApurva Dwivedi
 
seminar on directng for future nurse.pptx
seminar on directng for future nurse.pptxseminar on directng for future nurse.pptx
seminar on directng for future nurse.pptxApurva Dwivedi
 
seminar on deligation for management.pptx
seminar on deligation for management.pptxseminar on deligation for management.pptx
seminar on deligation for management.pptxApurva Dwivedi
 
Chemical Spill And Chemical Burn Management.pptx
Chemical Spill And Chemical Burn Management.pptxChemical Spill And Chemical Burn Management.pptx
Chemical Spill And Chemical Burn Management.pptxApurva Dwivedi
 
inventory control seminar FOR MANAGEMENT STUDENT.pptx
inventory control seminar FOR MANAGEMENT STUDENT.pptxinventory control seminar FOR MANAGEMENT STUDENT.pptx
inventory control seminar FOR MANAGEMENT STUDENT.pptxApurva Dwivedi
 
seminar on COMMUNICATION, process, .pptx
seminar on COMMUNICATION, process, .pptxseminar on COMMUNICATION, process, .pptx
seminar on COMMUNICATION, process, .pptxApurva Dwivedi
 
SEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptx
SEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptxSEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptx
SEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptxApurva Dwivedi
 
seminar ON cardiomegaly FOR NURSING STUDENTS.pptx
seminar ON cardiomegaly FOR NURSING STUDENTS.pptxseminar ON cardiomegaly FOR NURSING STUDENTS.pptx
seminar ON cardiomegaly FOR NURSING STUDENTS.pptxApurva Dwivedi
 
HYPERTENSION TOPIC OF SEMINAR FOR NURSING STUDENTS.pptx
HYPERTENSION TOPIC OF SEMINAR  FOR NURSING STUDENTS.pptxHYPERTENSION TOPIC OF SEMINAR  FOR NURSING STUDENTS.pptx
HYPERTENSION TOPIC OF SEMINAR FOR NURSING STUDENTS.pptxApurva Dwivedi
 
LUNG CANCER MICRO TEACHING.pptx
LUNG CANCER MICRO TEACHING.pptxLUNG CANCER MICRO TEACHING.pptx
LUNG CANCER MICRO TEACHING.pptxApurva Dwivedi
 
Age related body system changes.pdf
Age related body system changes.pdfAge related body system changes.pdf
Age related body system changes.pdfApurva Dwivedi
 
(NE)Continuing nursing education in nursing sminar.pptx
(NE)Continuing nursing education in nursing sminar.pptx(NE)Continuing nursing education in nursing sminar.pptx
(NE)Continuing nursing education in nursing sminar.pptxApurva Dwivedi
 
Pulse Oximetry micro teaching.pptx
Pulse Oximetry micro teaching.pptxPulse Oximetry micro teaching.pptx
Pulse Oximetry micro teaching.pptxApurva Dwivedi
 
prosthesis micro teaching.pptx
prosthesis micro teaching.pptxprosthesis micro teaching.pptx
prosthesis micro teaching.pptxApurva Dwivedi
 

Mehr von Apurva Dwivedi (20)

hemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptx
hemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptxhemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptx
hemmrrhoid NURSING MANAGEMENT, SURGICAL MANAGEMENT.pptx
 
legal issues of nursing profession.docx.pptx
legal issues of nursing profession.docx.pptxlegal issues of nursing profession.docx.pptx
legal issues of nursing profession.docx.pptx
 
seminar on directng for future nurse.pptx
seminar on directng for future nurse.pptxseminar on directng for future nurse.pptx
seminar on directng for future nurse.pptx
 
seminar on deligation for management.pptx
seminar on deligation for management.pptxseminar on deligation for management.pptx
seminar on deligation for management.pptx
 
Chemical Spill And Chemical Burn Management.pptx
Chemical Spill And Chemical Burn Management.pptxChemical Spill And Chemical Burn Management.pptx
Chemical Spill And Chemical Burn Management.pptx
 
inventory control seminar FOR MANAGEMENT STUDENT.pptx
inventory control seminar FOR MANAGEMENT STUDENT.pptxinventory control seminar FOR MANAGEMENT STUDENT.pptx
inventory control seminar FOR MANAGEMENT STUDENT.pptx
 
seminar on COMMUNICATION, process, .pptx
seminar on COMMUNICATION, process, .pptxseminar on COMMUNICATION, process, .pptx
seminar on COMMUNICATION, process, .pptx
 
SEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptx
SEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptxSEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptx
SEMINAR ON Myocardial infarction FOR NURSING STUDENT.pptx
 
seminar ON cardiomegaly FOR NURSING STUDENTS.pptx
seminar ON cardiomegaly FOR NURSING STUDENTS.pptxseminar ON cardiomegaly FOR NURSING STUDENTS.pptx
seminar ON cardiomegaly FOR NURSING STUDENTS.pptx
 
HYPERTENSION TOPIC OF SEMINAR FOR NURSING STUDENTS.pptx
HYPERTENSION TOPIC OF SEMINAR  FOR NURSING STUDENTS.pptxHYPERTENSION TOPIC OF SEMINAR  FOR NURSING STUDENTS.pptx
HYPERTENSION TOPIC OF SEMINAR FOR NURSING STUDENTS.pptx
 
angina pectoris.pptx
angina pectoris.pptxangina pectoris.pptx
angina pectoris.pptx
 
angina pectoris.pptx
angina pectoris.pptxangina pectoris.pptx
angina pectoris.pptx
 
CAD seminar.pptx
CAD seminar.pptxCAD seminar.pptx
CAD seminar.pptx
 
UNCONSCIOUSNESS.pptx
UNCONSCIOUSNESS.pptxUNCONSCIOUSNESS.pptx
UNCONSCIOUSNESS.pptx
 
LUNG CANCER MICRO TEACHING.pptx
LUNG CANCER MICRO TEACHING.pptxLUNG CANCER MICRO TEACHING.pptx
LUNG CANCER MICRO TEACHING.pptx
 
MENINGITIS.pdf
MENINGITIS.pdfMENINGITIS.pdf
MENINGITIS.pdf
 
Age related body system changes.pdf
Age related body system changes.pdfAge related body system changes.pdf
Age related body system changes.pdf
 
(NE)Continuing nursing education in nursing sminar.pptx
(NE)Continuing nursing education in nursing sminar.pptx(NE)Continuing nursing education in nursing sminar.pptx
(NE)Continuing nursing education in nursing sminar.pptx
 
Pulse Oximetry micro teaching.pptx
Pulse Oximetry micro teaching.pptxPulse Oximetry micro teaching.pptx
Pulse Oximetry micro teaching.pptx
 
prosthesis micro teaching.pptx
prosthesis micro teaching.pptxprosthesis micro teaching.pptx
prosthesis micro teaching.pptx
 

Kürzlich hochgeladen

Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...
Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...
Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...Dr. Suhyun An
 
Presentation on COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSING
Presentation on  COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSINGPresentation on  COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSING
Presentation on COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSINGKREDASONBANGALORE
 
Health literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptxHealth literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptxPamela McKinney
 
Unit I - Statistical parameter estimation.pptx
Unit I - Statistical parameter estimation.pptxUnit I - Statistical parameter estimation.pptx
Unit I - Statistical parameter estimation.pptxsneha_pharmacist
 
Disability & Inclusion Training for health professionals.pptx
Disability & Inclusion Training for health professionals.pptxDisability & Inclusion Training for health professionals.pptx
Disability & Inclusion Training for health professionals.pptxtilahun36
 
World Autism Awareness day describin.ppt
World Autism Awareness day describin.pptWorld Autism Awareness day describin.ppt
World Autism Awareness day describin.pptShifaSikri3
 
Sensitive analysis - Unit I (Computer aided drug development.pptx
Sensitive analysis - Unit I (Computer aided drug development.pptxSensitive analysis - Unit I (Computer aided drug development.pptx
Sensitive analysis - Unit I (Computer aided drug development.pptxsneha_pharmacist
 
Pediatric Language: What is Language (Free Speech-Language Resource)
Pediatric Language: What is Language (Free Speech-Language Resource)Pediatric Language: What is Language (Free Speech-Language Resource)
Pediatric Language: What is Language (Free Speech-Language Resource)Open Lines Speech and Communication
 
Ayurvedic Principles in Nutritional Counseling_.pptx
Ayurvedic Principles in Nutritional Counseling_.pptxAyurvedic Principles in Nutritional Counseling_.pptx
Ayurvedic Principles in Nutritional Counseling_.pptxLiam P
 
Diseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptxDiseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptxEMADABATHINI PRABHU TEJA
 
Determining Prognosis in Cancer and Non-Cancer Diagnoses
Determining Prognosis in Cancer and Non-Cancer DiagnosesDetermining Prognosis in Cancer and Non-Cancer Diagnoses
Determining Prognosis in Cancer and Non-Cancer DiagnosesVITASAuthor
 
Best Cancer Hospital in Varanasi Pinak Cancer Hospital
Best Cancer Hospital in Varanasi Pinak Cancer HospitalBest Cancer Hospital in Varanasi Pinak Cancer Hospital
Best Cancer Hospital in Varanasi Pinak Cancer Hospitaldrpankajsinghonco
 
Experience the Power of Chiropractic in Maui
Experience the Power of Chiropractic in MauiExperience the Power of Chiropractic in Maui
Experience the Power of Chiropractic in MauiCentral Maui Chiropractic
 
NABH Onsite assessment Questions for all department pptx
NABH Onsite assessment Questions for all department pptxNABH Onsite assessment Questions for all department pptx
NABH Onsite assessment Questions for all department pptxGODWIN SUJIN
 
Dr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem Cells
Dr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem CellsDr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem Cells
Dr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem CellsDr. David Greene Arizona
 

Kürzlich hochgeladen (20)

Pediatric General: Different Kinds of Language
Pediatric General: Different Kinds of LanguagePediatric General: Different Kinds of Language
Pediatric General: Different Kinds of Language
 
Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...
Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...
Suhyun An's Insights on Chiropractic Care for Stress Management and Mental We...
 
Pediatric Social Language: Instead of "I Don't Know"
Pediatric Social Language: Instead of "I Don't Know"Pediatric Social Language: Instead of "I Don't Know"
Pediatric Social Language: Instead of "I Don't Know"
 
Presentation on COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSING
Presentation on  COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSINGPresentation on  COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSING
Presentation on COUNSELING. 1ST YEAR GNM ,COMMUNITY HEALTH NURSING
 
The Power of Active listening - Tool in effective communication.pdf
The Power of Active listening - Tool in effective communication.pdfThe Power of Active listening - Tool in effective communication.pdf
The Power of Active listening - Tool in effective communication.pdf
 
Health literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptxHealth literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptx
 
Unit I - Statistical parameter estimation.pptx
Unit I - Statistical parameter estimation.pptxUnit I - Statistical parameter estimation.pptx
Unit I - Statistical parameter estimation.pptx
 
Disability & Inclusion Training for health professionals.pptx
Disability & Inclusion Training for health professionals.pptxDisability & Inclusion Training for health professionals.pptx
Disability & Inclusion Training for health professionals.pptx
 
World Autism Awareness day describin.ppt
World Autism Awareness day describin.pptWorld Autism Awareness day describin.ppt
World Autism Awareness day describin.ppt
 
Sensitive analysis - Unit I (Computer aided drug development.pptx
Sensitive analysis - Unit I (Computer aided drug development.pptxSensitive analysis - Unit I (Computer aided drug development.pptx
Sensitive analysis - Unit I (Computer aided drug development.pptx
 
Pediatric Language: Fast Facts of Bilingualism
Pediatric Language: Fast Facts of BilingualismPediatric Language: Fast Facts of Bilingualism
Pediatric Language: Fast Facts of Bilingualism
 
SCOPE OF CRITICAL CARE ORGANIZATION
SCOPE OF CRITICAL CARE ORGANIZATIONSCOPE OF CRITICAL CARE ORGANIZATION
SCOPE OF CRITICAL CARE ORGANIZATION
 
Pediatric Language: What is Language (Free Speech-Language Resource)
Pediatric Language: What is Language (Free Speech-Language Resource)Pediatric Language: What is Language (Free Speech-Language Resource)
Pediatric Language: What is Language (Free Speech-Language Resource)
 
Ayurvedic Principles in Nutritional Counseling_.pptx
Ayurvedic Principles in Nutritional Counseling_.pptxAyurvedic Principles in Nutritional Counseling_.pptx
Ayurvedic Principles in Nutritional Counseling_.pptx
 
Diseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptxDiseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptx
 
Determining Prognosis in Cancer and Non-Cancer Diagnoses
Determining Prognosis in Cancer and Non-Cancer DiagnosesDetermining Prognosis in Cancer and Non-Cancer Diagnoses
Determining Prognosis in Cancer and Non-Cancer Diagnoses
 
Best Cancer Hospital in Varanasi Pinak Cancer Hospital
Best Cancer Hospital in Varanasi Pinak Cancer HospitalBest Cancer Hospital in Varanasi Pinak Cancer Hospital
Best Cancer Hospital in Varanasi Pinak Cancer Hospital
 
Experience the Power of Chiropractic in Maui
Experience the Power of Chiropractic in MauiExperience the Power of Chiropractic in Maui
Experience the Power of Chiropractic in Maui
 
NABH Onsite assessment Questions for all department pptx
NABH Onsite assessment Questions for all department pptxNABH Onsite assessment Questions for all department pptx
NABH Onsite assessment Questions for all department pptx
 
Dr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem Cells
Dr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem CellsDr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem Cells
Dr. David Greene's Guide to Healing: Unleashing PRP's Power on Blood Stem Cells
 

CVP micro teaching.pptx

  • 1. VIVEKANANDA COLLEGE OF NURSING MICRO-TEACHING PRACTICE PRESENTED BY- APURVA DWIVEDI [M.Sc. NSG. 1ST YR.]
  • 3. Overview Introduction Measurement of CVP Factors affecting CVP Low central venous pressure Elevated central venous pressure Why do we measure CVP? Methods to measure CVP CVP-transducer set-up Set up of equipment Position of CVP patient Access of CVP Nurses role
  • 4. Introduction Central venous pressure, which is a measure of pressure in the vena cava, can be used as an estimation of preload and right atrial pressure. Central venous pressure is often used as an assessment of hemodynamic status, particularly in the intensive care unit. The central venous pressure can be measured using a central venous catheter advanced via the internal jugular vein and placed in the superior vena cava near the right atrium. A normal central venous pressure reading is between 8 to 12 mmHg. This value is altered by volume status and/or venous compliance.
  • 5. Measurement Normal CVP in patients can be measured from two points of reference: •Sternum: 0–14 cm H2O •Midaxillary line: 8–15 cm H2O CVP can be measured by connecting the patient's central venous catheter to a special infusion set which is connected to a small diameter water column. If the water column is calibrated properly the height of the column indicates the CVP. In most intensive care units, facilities are available to measure CVP continuously. Normal values vary between 4 and 12 cmH2O.
  • 6. Site Normal pressure range (in mmHg)[5] Central venous pressure 3–8 Right ventricular pressure systolic 15–30 diastolic 3–8 Pulmonary artery pressure systolic 15–30 diastolic 4–12 Pulmonary vein/ Pulmonary capillary wedge pressure 2–15 Left ventricular pressure systolic 100–140 diastolic 3–12
  • 7. Factors affecting CVP Factors that increase CVP include: •Cardiac tamponade •Decreased cardiac output •Forced exhalation •Heart failure •Hypervolemia •Mechanical ventilation and the application of positive end-expiratory pressure (PEEP) •Pleural effusion •Pulmonary embolism •Pulmonary hypertension •Tension pneumothorax
  • 8. Conti.. Factors that decrease CVP include: •Deep inhalation •Distributive shock •Hypovolemia
  • 9. Low central venous pressure Some factors that can decrease central venous pressure are hypovolemia or vasodilation. Either of these would decrease venous return and thus decrease the central venous pressure. A decrease in central venous pressure is noted when there is more than 10% of blood loss or shift of blood volume. A decrease in intrathoracic pressure caused by forced inspiration causes the vena cave to collapse which decreases the venous return and, in turn, decreases the central venous pressure.
  • 10. Elevated central venous pressure Elevated Central Venous Pressure can occur in heart failure due to decreased contractility, valve abnormalities, and dysrhythmias. Any patients on ventilator assistance that have excessive positive end-expiratory pressure would have an increase in pulmonary arterial resistance which causes an increase in central venous pressure. However, an increased central venous pressure caused by increased pulmonary arterial resistance can also be affected by a decrease in the fraction of inspired oxygen, an increase in ventilation/perfusion abnormalities in the lung, an increase in pericardial pressure, or an increase in intra-abdominal pressure which would increase thoracic pressure. Increased juxta-cardiac pressure - tension pneumothorax, pericardial tamponade, right ventricular infarct, right ventricular outflow obstruction - can also decrease venous return.
  • 11. Why do we measure CVP? To serve as a guide of fluid balance in critically ill patients To estimate the circulating blood volume To determine the function of the right side of the heart To assist in monitoring circulatory failure None of these variables are measured directly; they must be interpreted.
  • 12. Methods to measure CVP CVP Measurement Method Direct Using manometer Using transducer Indirect Inspection of Juglar venous pulsations in the neck
  • 13. CVP-transducer set-up ✓500ml NS ✓ Pressure bag ✓ Transducer KIT ✓ Transducer holder ✓ Transducer pressure cable
  • 14. Set up of equipment Maintain aseptic technique Open the transducer set and tighten all the connections Hang the 500 ml saline in the pressure bag, and spike it. Inflate the pressure bag to 300 mm hg and turn stopcock to upwards position. Clamp iv tubing Place the transducer holder on IV pole Place transducer in transducer holder attach the IV tubing and the PM line in the transducer kit Unclamp the tubing and remove air from the tubing by activating the flush device. Point stopcock of the transducer horizontal and do the tubing's
  • 17. Nurses role Monitor for the signs of complications. Assess for patency of the CVP line. Sterile dressing should be done to prevent infection( CVP care per the hospital protocol) The length of the indwelling catheter should be recorded and regularly monitored.
  • 18. Summary We have learned about Introduction, Measurement of CVP, Factors affecting CVP, Low central venous pressure, Elevated central venous pressure, Why do we measure CVP?, Methods to measure CVP, CVP-transducer set-up, Set up of equipment, Position of CVP patient, Access of CVP and Nurses role.
  • 19. Conclusion Central venous pressure estimates the right atrial pressure pulmonary capillary wedge pressure estimates the left atrial pressure. The values reflect end-diastolic volume, or pre load, of the right and left ventricles, respectively. Central venous pressure and pulmonary capillary wedge pressure both would have been decreased because of the loss of blood volume from the venous side.
  • 20. Bibliography Book reference ‘‘SUDDARTH’S AND BRUNNER’’, Text book of medical surgical nursing,volume-1,edition-13,wolters Kluwer publisher, Page no ‘‘CHINTAMANI, MRINALINI, HARINDARJEET GOYAL;’’ Lewis’s medical surgical nursing ,volume2,1st edition-2011, Elsevier publisher, page no. Net reference https://www.ncbi.nlm.nih.gov/books/NBK519493/#:~:text=Central%20venous %20pressure%2C%20which%20is,in%20the%20intensive%20care%20unit.