Cardiac output = - CO + HR x stroke volume (amount of blood ejected per contraction)
Primary compensatory mechanism of low Cardiac output in peds? Other signs? - Tachycardia -- Peds are unable to increase stroke volume. Hypotension is a late sign, and bradycardia is an ominous sign in peds.
S...
, Cardiac output = - CO + HR x stroke
volume (amount of blood ejected per Sympathetic nervous system (SNS)
contraction) stimulation causes... - causes release
of catecholamine, which increase HR
Primary compensatory mechanism of in response to shock.
low Cardiac output in peds? Other
signs? - Tachycardia -- Peds are Parasympathetic nervous system
unable to increase stroke volume. (effect on heart, example; seen in
Hypotension is a late sign, and what type of shock and why?) -
bradycardia is an ominous sign in decreased HR, like vagal response;
peds. and as seen in neurogenic shock (no
SNS, unopposed parasympathetic)
Stroke Volume is influenced by... -
Contractility, preload, and afterload. MAP - Mean arterial pressure =
(2DBP+SBP)/3
Frank-Starling's Law -- Stretch heart
with volume to increase contractility Pulse pressure (PP) (different types
(rubber band snapping shut) and why) - PP = difference between
SBP and DBP
Preload is evaluated by... - Central Narrowing - seen in shock; widening -
venous pressure (CVP) on the Right increased ICP
(invasive). Jugular vein distention
(non-invasive measure) Cushing triad - is indicative of
Decreased when hypovolemic and increased ICP. Widened PP or
from vasodilators, increased by increased SBP, bradycardia, irregular
volume and vasoconstrictors. TX: breathing pattern.
Increase preload w/ fluids/blood,
decrease w/ diuretics. Chronotropes - Affect HR at SA node
-- Cardizem (neg chronotrope)
Afterload... - Afterload (resistance to
ventricular emptying) is evaluated by Inotropes - affect contractility (force
systemic vascular resistance. of contraction) -- Dopamine (positive
Decreased in distributive shocks inotrope)
(neurogenic, septic, and
anaphylactic), and by vasodilators. Dromotropes - affect automaticity
Tx: vasopressors (norepinephrine). (electrical impulse) of the heart at the
Increased n hypertension, aortic AV note
stenosis, and thru other shock
compensation. Tx Vasodilators like Beta-blockers (effects, what organs,
NTG. examples, mask what?) - (olols) -
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