A patient's hemodynamic parameters include the following: right atrial pressure (RAP) of 13 mm Hg, pulmonary artery wedge pressure (PAWP) of 8 mm Hg, systemic vascular resistance (SVR) of 1,000 dynes/sec/cm2, cardiac output (CO) of 4
9 L/min, cardiac index (CI) of 3.5 L/min, and pulmonary vascular resistance (PVR) of 280 dynes/sec/cm2. Which heart function should cause the nurse concern? 1. Afterload
2. Left heart contractility
3. Right heart contractility
4. Heart rate
3
Rationale 1: The CO, CI, and SVR are within normal limits and are indicators of left ventricular function.
Rationale 2: The CO, CI, and SVR are within normal limits and are indicators of left ventricular function.
Rationale 3: The RAP reflects the amount of blood returning to the right atrium and is a measurement of preload. The elevated PVR is a reflection of the pressure within the right ventricle and is the amount of pressure needed for the right ventricle to eject blood into the PA. The elevated RAP and PVR indicate a problem with right heart contractility and is most likely related to right heart failure.
Rationale 4: No data is available about the patient's heart rate.
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