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medication NOt to give decompensating bradydysrythmias with 2nd degree
HB type II or CHB or heart transplant
atropine
S/S decompensating tachydysrythmias
SBP <90 AMS
treatment for decompensating tachydysrythmias
consider sedation / synchronized cardioversion (100 J)
becks triad indicates
cardiac tamponade
becks triad for cardiac tamponade
hypotension, muffled/distant heart sounds, jugular venous distention (JVD)
,elevated lab values in rhabdomyolysis (crush injury)
CK, K+, Bun/creatinine, AST/ALT
markers of cardiac reperfusion after fibrinolytic therapy include relief of chest
pain, normalization of ST segment changes
reperfusion dysrythmias such AIVR
normal CVP range
2-6 mmHg
normal cardiac index
2.5-4.3
normal PAWP (pulmonary artery wedge pressure)
6-12 mmHg
normal SVR (systemic vascular resistance)
800-1200
normal coronary perfusion formula
aortic diastolic pressure (ADP), LCeft ventricular end-diastolic pressure
(LVEDP)
,hemodynamic readings: hypovolemic
CVP: low , cardiac index: low, PAWP: low, SVR: high
shock index formula
SI=HR/SBP (systolic BP)
normal shock index
0.5-0.7
steps to determine shock/condition the PT is presenting
1. SVR, 2a.SVR <800 think distributive, 2b. cardiac index: high= septic,
low=neurogenic (brady or normal HR)/ anaphylactic (tachycardia) OR SVR >
1200 (hypovolemic), CVP: low= hypovolemic, high= cardiogenic shock or
RVMI, PCWP: low= RVMI, high= cardiogenic
hemodynamic readings: cardiogenic
CVP: high, Cardiac index: low, PAWP: high, SVR: high
hemodynamic readings: RVI
CVP: high, Cardiac index: low, PAWP: low, CVP: high
, hemodynamic readings: septic
cardiac index: high, SVR: low, CVP: low
hemodynamic readings: neruogenic
cardiac index: low w/ normal HR or bradycardia, SVR: low
hemodynamic readings: anaphylactic
cardiac index: low w/ tachycardia, SVR: low
hemodynamic finding is expected in a PT with RIGHT ventricular MI
elevated CVP
S/S pericarditis
classic sign: friction rub, CP radiating to back, CP relieved by sitting
up/forward, CP worsening when laying flat
treatment of pericarditis & what not to give
O2 administration, NSAIDS (toradol), corticosteroids. do NOT give:
nitroglycerin
S/S of endocarditis
olsers nodes (red painful pads of digits), janeway lesions fat, purpuric, non
painful hands and feet, subconjuctivital hemorrhages (eye roth spots), flu
like symptoms/fever, fatigue/night sweats, CP/SOB