Multisystem PCCN Test Questions with
Correct Solutions, Graded to Pass
What are vasopressors used for? - cORRECT sOLUTION Drugs used to elevate arterial BP with the goal of reestablishing blood floor to vital organs.
-used in multiple forms of shock to maintain vascular tone
-goal: keep MAP above 60
- constricts the vessels and can decrease blood flow to organs even though the map is higher
when are vasopressors contraindicated - cORRECT sOLUTION pt in cariogenic shock
**because they increase after load and myocardial oxygen consumption
what is an intra aortic balloon pump used for - cORRECT sOLUTION decrease after load and increase coronary perfusion pressure
-good for pt who are too hypotensive to use arterial vasodilators to reduce afterload
(in conjunction with VADS can be a bridge to transplant)
dobutamine - cORRECT sOLUTION beta 1 agonist
-inotropic agent, inc. contractility and CO, does NOT inc HR. -used in acute management of heart failure.
-short 1/2 life due to COMT
Nitroglycerin - cORRECT sOLUTION venous vasodilator
-decrease after load
S/S of mesenteric ischemia - cORRECT sOLUTION abdominal pain/ bloddy diarrhea
difference between hemorrhagic shock and volume loss - cORRECT sOLUTION loss of blood decreases cardiac index and hemoglobin
--- negative impact on oxygen delivery to tissues and accentuating tissue hypoxia
loss of volume just decreases cardiac index
reasons for hematocrit to be elevated in shock - cORRECT sOLUTION if shock is due to dehydration
reasons for hematocrit to be decreased during shock - cORRECT sOLUTION if due to blood loss
purpose of peritoneal lavage - cORRECT sOLUTION diagnose intraabdominal bleeding
affect of coronary artery perfusion pressure on cariogenic shock - cORRECT sOLUTION CAPP is affected by the decrease in cardiac index and increase in PAOP (both occur with pump failure that occurs in cariogenic shock) -decrease in CAPP causes worsening myocardial ischemia, decrease contractility and cardiac index decrease
CAPP= diastolic bp- PAOP
Cardiac Index - cORRECT sOLUTION amount of blood pumped out of heart per minute per sq meter of body mass. normal ranges btwn 2.5 to 4.2 L/min/meter2
PAOP - cORRECT sOLUTION pulmonary artery occluded pressure
8-12
what is anaphylactic shock - cORRECT sOLUTION immunoglobulin E mediated response
-massive vasodilation caused by release of histamine in response to severe allergic reaction
-usually within an hour of exposure
*symptoms occur within 5 to 20 minutes
difference in epinephrine dosage for anaphylaxis vs pulseless VT - cORRECT sOLUTION anaphylaxis 0.1 mg
pulseless VT (1 mg)
Correct Solutions, Graded to Pass
What are vasopressors used for? - cORRECT sOLUTION Drugs used to elevate arterial BP with the goal of reestablishing blood floor to vital organs.
-used in multiple forms of shock to maintain vascular tone
-goal: keep MAP above 60
- constricts the vessels and can decrease blood flow to organs even though the map is higher
when are vasopressors contraindicated - cORRECT sOLUTION pt in cariogenic shock
**because they increase after load and myocardial oxygen consumption
what is an intra aortic balloon pump used for - cORRECT sOLUTION decrease after load and increase coronary perfusion pressure
-good for pt who are too hypotensive to use arterial vasodilators to reduce afterload
(in conjunction with VADS can be a bridge to transplant)
dobutamine - cORRECT sOLUTION beta 1 agonist
-inotropic agent, inc. contractility and CO, does NOT inc HR. -used in acute management of heart failure.
-short 1/2 life due to COMT
Nitroglycerin - cORRECT sOLUTION venous vasodilator
-decrease after load
S/S of mesenteric ischemia - cORRECT sOLUTION abdominal pain/ bloddy diarrhea
difference between hemorrhagic shock and volume loss - cORRECT sOLUTION loss of blood decreases cardiac index and hemoglobin
--- negative impact on oxygen delivery to tissues and accentuating tissue hypoxia
loss of volume just decreases cardiac index
reasons for hematocrit to be elevated in shock - cORRECT sOLUTION if shock is due to dehydration
reasons for hematocrit to be decreased during shock - cORRECT sOLUTION if due to blood loss
purpose of peritoneal lavage - cORRECT sOLUTION diagnose intraabdominal bleeding
affect of coronary artery perfusion pressure on cariogenic shock - cORRECT sOLUTION CAPP is affected by the decrease in cardiac index and increase in PAOP (both occur with pump failure that occurs in cariogenic shock) -decrease in CAPP causes worsening myocardial ischemia, decrease contractility and cardiac index decrease
CAPP= diastolic bp- PAOP
Cardiac Index - cORRECT sOLUTION amount of blood pumped out of heart per minute per sq meter of body mass. normal ranges btwn 2.5 to 4.2 L/min/meter2
PAOP - cORRECT sOLUTION pulmonary artery occluded pressure
8-12
what is anaphylactic shock - cORRECT sOLUTION immunoglobulin E mediated response
-massive vasodilation caused by release of histamine in response to severe allergic reaction
-usually within an hour of exposure
*symptoms occur within 5 to 20 minutes
difference in epinephrine dosage for anaphylaxis vs pulseless VT - cORRECT sOLUTION anaphylaxis 0.1 mg
pulseless VT (1 mg)
