NURS 460 Exam 4 Cardiac Study Questions and Correct Answers Epinephrine (cardiac arrest meds) ✅-Vasoconstrictor; Reverse cardiac arrest -IM, IV push 1 mg every 3 -5 minutes (push fast), IV drip Norepinephrine (cardiac arrest meds) ✅-Vasopressor; increases BP not really HR -IV drip 8 -12 mcg/min? Vasopressin (cardiac arrest meds) ✅-Vasopressor; raises BP & HR -IV push, IV drip: 40 units? Dopamine (cardiac arrest meds) ✅-Inotropic agent; raises BP & HR -IV drip 2 -20 mcg/kg/min? Sodium Bicarbonate (cardiac arrest meds) ✅-Reverse acidosis -1 ampule IV push Atropine (cardiac arrest meds) ✅-Treats symptomatic bradycardia -IV push 0.5 mg Calcium Chloride/Calcium Gluconate (cardiac arrest meds) ✅-Cardiac protection -IV drip, IV push 1 mg Adenosine (cardiac arrest meds) ✅-Restart heart; treats supraventricular tachycardia -IV push 6mg, 12 mg Amiodarone (cardiac arrest meds) ✅-Antiarrhythmic drug, for A fib -IV drip, PO, IV push 300 mg & 150 mg Central Venous Pressure (CVP) ✅-Measures right heart pressure -Normal 2 -8 mmHg -High = fluid overload -Low = fluid deficit Pulmonary Artery Wedge Pressure (PAWP) ✅-The indirect measurement of pressure in the left ventricle at the end of diastole -6-12 mmHg -Elevated levels might indicate severe left ventricle failure or severe mitral stenosis -Hemorrhage, v -tach Cardiac Output (CO) ✅-Amount of blood pumped by heart in liters per minute -4-8L/min -High = high circulating volume; severe anemia, septic shock -Low = MI, HTN, valvular heart disease, congenital heart disease, cardiomyopathy, HF, pulmonary disease, arrhythmias Preload ✅-Volume within the ventricle at the end of diastole -Increased in hypervolemia, regurgitation of cardiac valves, heart failure -TX: increase fluids or give blood Afterload ✅-Resistance to ejection of blood from ventricle -Increased in hypertension, vasoconstriction -Increased afterload = increase cardiac workload -TX: diuretics, vasodilators Stroke Volume (SV) ✅-The amount of blood ejected from the left ventricle with each heartbeat (60 -100) -End-diastolic volume - end systolic volume -Patient dependent -If low = heart failure Stroke Volume Index ✅-As above accounting for body surface area (BSA) -30-60 mL/beat/m2 -Low = an independent predictor of mortality among pts with low gradient severe aortic stenosis and preserved left ventricle function Arterial Line (use) ✅-Draw blood easily -Draw blood tests -Close blood pressure monitoring Arterial Line (complications) ✅-Temporary vascular occlusion -Thrombosis -Ischemia -Hematoma formation -Local & catheter -related infection & sepsis -Hemorrhage Pulmonary Artery Catheter (PAC) ✅-Blood volume - pressure -Blood flow - how well pumping and resistance to that flow -Tissue oxygenation - how well body using oxygen Pulmonary Artery Catheter (use) ✅-When previous interventions have not yielded the expected outcome (increased urine output w/ increased IV fluid administration) -When a pt has a complicating factor such as kidney or heart failure or pulmonary hypertension, that makes clinical judgements difficult w/o additional information Pulmonary Artery Catheter (complications) ✅-Pneumothorax -Cardiac arrhythmias -Pulmonary artery rupture Endotracheal Tube (use) ✅-To establish & maintain the airway in patients with respiratory insufficiency or hypoxia -To establish an airway for a pt who cannot be adequately ventilated w/ an oropharyngeal airway -To bypass an upper airway obstruction -To prevent aspiration -To permit connection of the pt to a resuscitation bag or mechanical ventilator -To facilitate the removal of tracheobronchial secretions Endotracheal Tube (complications) ✅-Upper airway & nasal trauma -Tooth avulsion -Oral-pharyngeal laceration -Laceration or hematoma of the vocal cords -Tracheal laceration -Perforation -Hypoxemia -Intubation of the esophagus -Hemorrhage -Infection Pulmonary Artery Catheter (wavelengths upon insertion) ✅ Pulmonary Artery Catheter (insertion complications) ✅-Arrhythmias -Infection -Perforation -Clots -Hemorrhage -Ischemia to lung Dilated Cardiomyopathy ✅-Most common cardiomyopathy -Distinguished by significant irreversible dilation of the ventricles & systolic dysfunction w/o hypertrophy -Common cause of HF & the major reason for cardiac transplant -S/S: dyspnea, fatigue, weight gain, volume overload, arrhythmias & SCD, valve regurgitation, poor blood flow, & atrial thrombi Hypertrophic Cardiomyopathy ✅-Characterized by hypertrophied, nondilated left ventricle that can lead to obstruction of left ventricular outflow -Most common cause of SCD (sudden cardiac death) in young adults
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