Pam Bartley CEN Study Guide-Cardiology Verified A+

Pam Bartley CEN Study Guide-Cardiology Verified A+ Cardiac output ️️stroke volume x heart rate (amount of blood ejected per contraction) Primary compensatory mechanism for low cardiac output in peds ️️Tachycardia Late sign of low CO ️️Hypotension, bradycardia is ominous sign in peds What is stroke volume influenced by ️️afterload, preload, contractility Preload ️️volume evaluated by CVP How to increase preload ️️volume (blood/fluids), pressprs How to decrease preload ️️diuretics What is afterload ️️resistance to ventricular emptying, measured by systemic vascular resistance When is afterload decreased and how would you treat ️️distributive shocks (neurogenic, septic, anaphylactic) and by vasodilators- give them vasopressors How would you decrease afterload ️️vasodilators when is afterload increased ️️HTN, shock compensation SNS stimulation releases what ️️epinephrine, catecholamines, norepi-increases HR, vasoconstriction, pupil dilation, catecholamines increase BSG through glycogenesis Parasympathetic system does what ️️Decreases HR MAP equation ️️(SBP + 2DBP)/3 Pulse pressure ️️difference between systolic and diastolic pressure Widened PP seen in... ️️increased ICP Narrowed PP seen in.... ️️early stages of shock Cushing's triad indicates what and what are the signs ️️Increased ICP, widened PP (or HTN), irregular breathing pattern, and bradycardia What do chronotropes do and what is an example ️️Control HR- cardizem is a negative chronotrope, atropine positive What do inotropes do and what is an example ️️Affect contractility- dobutamine and dopamine are positive inotropes What do dromotropes do and what is an example ️️Control automaticity- positive dromotrope is epi, negative dromotrope is beta blockers Beta blockers end in and do what ️️-olols, slow HR and lower BP, may mask signs of early shock and hypoglycemia Calcium channel blockers end in and do what ️️-dipine (and cardizem), control ventricular rate in a fib and HTN ACE inhibitors ️️"PRIL" Captopril, Enalapril, Afosiopril Antihypertensive. Blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss. Check BP before giving (hypotension) *Orthostatic Hypotension Adverse effects of ACE inhibitors ️️cough is most common, angioedema most serious ARBs ending ️️-sartans Nitroglycerin-drug class, what it does, contraindications ️️vasodilator, decreases preload and afterload, BP, and oxygen consumption, don't take within 24 hrs of phosphodiesterase use Nitroprusside-drug class, what it does, what to watch for ️️vasodilator, decreases preload and afterload, watch for hypotension because it can come on quickly d/t rapid onset Vasopressors ️️Norepinephrine, epinephrine, phenylephrine, vasopressin (second line) What to watch for with vasopressors and treatment for it ️️Watch for infiltration and extravasation-treat with phentolamine (regitine) for extravasation, may use NTG ointment Types of acute coronary syndromes ️️Stable angina, unstable angina, prinzmetal's aangina, NSTEMI, STEMI Stable angina-characteristics, treatment, labs ️️pain relieved by rest and NTG, (-) trop Unstable angina-characteristics, labs ️️pain NOT relieved by rest and NTG, (-) trop NSTEMI- cause, labs ️️plaque rupture, +trop, no ST elevation on E