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Complex Midterm > Shock 3 > Flashcards

Shock 3 Flashcards

1
Q

post op care of OHS

A

1) monitor fluid volume by foley
2) may need to replace electrolytes
3) IV meds to maintain BP (ie/ epi)
4) warm the pt with bear hugger
5) give lasix before coming to unit to decrease BP

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2
Q

what is pt on after OHS

A
  • pt on mechanical ventilation until awake

- epicardial wires, medistinal tubes, central line, foley, swan ganz catheter, IV fluids, vasopressor drip

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3
Q

normal MAP

A

70-100

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4
Q

CVP

A

2-6

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5
Q

PAP

A

25

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6
Q

PCWP

A

4-12

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7
Q

SV

A

50-100

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8
Q

what is an arterial line

A

in the wrist

shows continuous BP reading

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9
Q

what is a swan line

A

nurse in charge of flushing line w/ NSS
monitors C.O. and SVO2 (systemic venous O2)
don’t lead balloon wedged

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10
Q

describe swan ganz cath

A

-monitors hemodynamic monitoring (moving blood)
-many different lines and catheters
-line is put through subclavian, R atrium, R ventricle, pulmonary artery
(does NOT go to left side)

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11
Q

what is important to remember when using an invasive catheter

A
  • zero the line to atmospheric air
  • use pressure bag (prevent blood from backing into line)
  • level at phlebostatic axis
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12
Q

why can you not leave the catheter wedged

A

will act like a PE

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13
Q

what to know after OHS

A
  • return to work/exercise after 6 wks
  • may be on nitro, BB (decrease workload), ACE inhibitor (prevent scar tissue)
  • if chest pain, nitro
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14
Q

complications post CABG

A
  • bleeding
  • no blood from chest tube
  • fluid and electrolyte imbalance
  • dysrhythmias
  • hypo/hypertension
  • hypothermia
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15
Q

describe excessive bleeding post CABG

A
  • from medial stinal chest tubes

- call dr if > 200, may need to return to surgery (unless pt has just turned/gotten up and is positional/relative)

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16
Q

describe no blood post CABG

A
  • *tamponade, filling up pericardial wall
  • prevents heart from pumping
  • call dr immediately (cardiothoracic surgeon)
  • will have decrease in BP
  • jugular vein distension
  • pulse pressure represents SV (vasoconstriction goes overboard, decrease in BP)
17
Q

cardiac tamponade is an ______

A

emergency

18
Q

s/s of cardiac tamponade

A
  • narrow pulse pressure
  • decrease in BP and C.O.
  • decrease in CT drainage
19
Q

what other complications post cabg should you look for

A
  • *infection (medianstinits)

- pericardiotomy (pain in pericardial area)

20
Q

describe intraaortic balloon pump

A
  • acts to divert blood back to coronary artery in diastole
  • maintain better perfusion so better LV filling and push
  • should increase BP and C.O.
  • do not let balloon move, timed to pts rhythm

Complex Midterm (8 decks)

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