A client awaiting a heart transplant is experiencing decompensation of her left ventricle that will not respond to medications. The physicians suggest placing the client on a ventricular assist device (VAD)

Question

The client asks what this equipment will do. The health care providers respond:
A) "Pull your blood from the right side of the heart and run it through a machine to oxygenate it better, and then return it to your body."
B) "Measure the pressures inside your heart continuously to asses pumping ability of your left ventricle."
C) "Have a probe at the end of a catheter to obtain thermodilution measures, so cardiac output can be calculated."
D) "This device will decrease the workload of the myocardium while maintaining cardiac output and systemic arterial pressure."

Answer 1

Ans: D
Feedback:
Refractory heart failure reflects deterioration in cardiac function that is unresponsive to medical or surgical interventions. Ventricular assist devices (VADs) are mechanical pumps used to support ventricular function. VADs are used to decrease the workload of the myocardium while maintaining cardiac output and systemic arterial pressure. This decreases the workload on the ventricle and allows it to rest and recover. The rest of the distractors relate to the monitoring in an ICU of cardiac functioning. Invasive hemodynamic monitoring may be used for assessment in acute, life-threatening episodes of heart failure. With the balloon inflated, the catheter monitors pulmonary capillary pressures (i.e., pulmonary capillary wedge pressure or pulmonary artery occlusion pressure), which reflect pressures from the left ventricle. The pulmonary capillary pressures provide a means of assessing the pumping ability of the left ventricle. One type of pulmonary artery catheter is equipped with a thermistor probe to obtain thermodilution measurements of cardiac output.