Prosedur Keperawatan - Pengukuran Central Venous Pressure (CVP)

Summary

This video provides a comprehensive tutorial on Central Venous Pressure (CVP) and Jugular Venous Pressure (JVP) assessment. The script details the procedure for measuring CVP to assess patients with hemodynamic disorders. It covers the necessary equipment, patient positioning, and steps to measure fluid status and pressure. Additionally, it explains how to interpret results and potential health implications such as heart failure or fluid imbalance. The tutorial is accompanied by a demonstration of the process, emphasizing proper technique, patient communication, and documentation.

Takeaways

• 😀 CVP (Central Venous Pressure) is the pressure in the right atrium and large veins in the thoracic cavity, reflecting the blood returning to the heart and the heart's pumping ability.
• 😀 A CVP examination is important for monitoring fluid status, oxygenation, and providing fluid therapy, nutrition, and medication.
• 😀 The CVP measurement is performed using a central venous catheter (CVC), which is inserted through large veins to the Superior Vena Cava and right atrium.
• 😀 The patient should be positioned in semi-Fowler's position (45°) for accurate CVP measurement.
• 😀 The zero point for measuring CVP is typically located at the fourth intercostal space, parallel to the right atrium.
• 😀 The fluid manometer needs to be aligned with the zero point on the patient’s body and adjusted using a waterpass for accurate measurement.
• 😀 The examination involves a two-way fluid system to ensure smooth fluid flow, starting from the fluid source and ending at the patient.
• 😀 Undulation, the rise and fall of the fluid in the manometer, occurs in response to the patient's inspiration and expiration.
• 😀 Normal CVP values range from 5-12 cm H2O. Lower values indicate poor fluid status or negative pressure ventilation, while higher values may suggest fluid overload or right heart failure.
• 😀 The procedure requires careful monitoring of the fluid level in the manometer, noting the changes during inspiration and expiration.
• 😀 After completing the examination, it is crucial to document the results and ensure proper hygiene by washing hands and removing any protective gear used during the procedure.

Q & A

What is the purpose of the Central Venous Pressure (CVP) examination?

The purpose of the CVP examination is to assess a patient's hemodynamic status by measuring the pressure in the right atrium and large veins. It helps evaluate blood return to the heart and the heart's ability to pump blood into the arterial system.

What are the key learning objectives of the practicum described in the script?

The key objectives are for students to understand the examination of patients with hemodynamic disorders through JVP or CVP examinations and to practice the procedure correctly.

What is the meaning of Central Venous Pressure (CVP)?

CVP refers to the pressure in the right atrium of the heart and large veins in the thoracic cavity. It reflects the amount of blood returning to the heart and the heart's ability to pump blood into the arterial system.

What is the purpose of using a Central Venous Catheter (CVC)?

The purpose of the CVC is to measure CVP by inserting a catheter through large veins, reaching the tip of the catheter at the Superior Vena Cava and right atrium. It also helps with fluid administration, nutrition delivery, and drug infusion.

What equipment is needed for the CVP measurement procedure?

The necessary equipment includes a liquid manometer, waterpass, extension tube, three-way valve, and other accessories needed to set up the system for measuring CVP.

How should the patient be positioned for the CVP examination?

The patient should be positioned in a semi-Fowler's position, at a 45° angle, to ensure comfort and accurate measurement of CVP.

How is the zero point for the CVP measurement determined?

The zero point is determined by locating the fourth intercostal space, just below the clavicle. This is the point parallel to the location of the right atrium, which serves as a reference for measurement.

What does the fluid undulation on the manometer indicate during the examination?

The undulation of the fluid in the manometer corresponds to the patient's respiratory cycle. When the patient inhales, the fluid rises, and when the patient exhales, the fluid falls. This fluctuation is normal and reflects the pressures in the chest.

What are the normal and abnormal ranges of CVP in a patient?

The normal CVP range is typically between 5-12 cm H2O. A lower value indicates hypovolemia or inadequate fluid status, while a higher value suggests conditions like fluid overload, right heart failure, or positive pressure ventilation.

What is the significance of the CVP result in clinical practice?

The CVP result helps healthcare providers assess a patient's fluid status and cardiac function. A normal reading indicates stable hemodynamics, while abnormal readings may suggest conditions requiring intervention, such as fluid imbalance or heart failure.