week 4 - hemodynamics Flashcards
preload
amount of blood left in the ventricles right before contraction
ex: hypervolemia (too much fluid) means high preload
(R) = CVP
(L)= PAWP
CVP range
2 to 8 mmHg
*right side of heart PRELOAD
PAWP range
8 to 12 mmHg
left side of heart preload
afterload
amount of pressure the heart needs to PUSH out blood
(R) = PVR
(L) = SVR
PVR range
100 to 250 dynes
(R) of heart AFTERLOAD
SVR range
800 to 1200 dynes
(L) heart AFTER LOAD
meds to give if afterload is high
high PVR or SVR = heart is working too hard & needs more blood
*VASODILATORS = nitroprusside & nitroglycerin
meds to give if afterload is low
low PVR & SVR = too much blood at that area:
VASOPRESSORS = norepinephrine
function of vasopressors
raise blood pressure
*norepinephrine
*dopamine
low preload means
dehydration - hypovolemia, n/v
treated w fluids
first thing to do with hypovolemic shock
- fluids = o.9% NS or LR
- THEN vasopressors is bp has no change
adverse effeects of diphenhydramine
hypotension, dizziness, & tachycardia
*anaphylactic shock
vasodilators work to
reduce the workload of the heart
*reduces preload & afterload
nitroprusside
nitroglycerin
if BP does not decrease w vasopressors within 10 min at max infusion rate
DISCONTINUE
afterload reducing meds are for
cardiogenic shock
a nurse is planning care for a client who has septic shock. which of the following actions is the priority for the nurse to take?
1. maintain adequate fluid volume w IV infusions
2. admin antibiotic therapy
3. monitor hemodynamic status
4. admin vasopressor meds
admin antibiotic therapy
low preload is treated w
fluids FIRST – NS then pressors if no change in BP
high preload means
too much fluids treat w DIURETICS
HIGH CVP/ PAWP
to increase afterload
give vasopressors – raise the afterload
to decrease afterload
BB, CCB, & vasodilators
normal cardiac output range
4 to 8L
cardiac output formula
HR x SV (amt of blood pumed out by heart in 1 minute)
inotropics
increase contractility & cardiac output
*dobutamine
*dopamine
common causes of cardiogenic shock
MI, heart failure, dysrhythmias, & valvular disorders
indication that MODS is developing
high creatine (0.6 to 1.3)
first thing to do w septic shock
FLUIDSSS — NS or LR
neurogenic shock will present
BRADYCARDIA
**CANNOT REGULATE TEMP
