FCCN 2 QUESTIONS AND ANSWERS SURE A+
✔✔sugammadex - ✔✔NMB reversal agent of roc and vec
✔✔preload - ✔✔amount of fluid filling the heart, how wet or dry the pt is
since veins hold venous blood returning to heart, dilation and constriction affect preload
✔✔CVP - ✔✔preload of right heart
✔✔PAWP - ✔✔preload of the left heart
6-12 is normal
snapshot in time, not a continuous measurement. swan ganz is advanced and balloon is
inflated and pressure is recorded. risk of rupturing vessels, minimize how often we
measure this
✔✔Frank-Starling Law - ✔✔the greater the stretch, the stronger is the heart's
contraction
giving fluid increases preload, and therefore increases cardiac output
however if you give too much fluid, you will stretch the heart too much and it won't be
able to contract, which will decrease cardiac output
✔✔how to fix preload - ✔✔if preload is low, give crystalloids, colloids, or blood to
increase volume
if preload is high, give diuretics, vasodilators, or dialysis
✔✔how to help right heart deliver to left - ✔✔decrease right heart afterload - dilate
pulmonary arteries
, ✔✔afterload - ✔✔the amount of resistance to ejection of blood from the ventricle, how
dilated or clamped down the pt is
✔✔high afterload treatment - ✔✔treat cause
decrease SVR with ACE inhibitors, ARBs, hydralazine
decrease PVR with milrinone, isuprel, nitric oxide, sildenafil
✔✔milrinone - ✔✔pulmonary vasodilator, decreases PVR while increasing CO and
contractility
good for R side HF
✔✔low afterload treatment - ✔✔constrict arteries with dopamine, norepinephrine,
phenylephrine
✔✔PVR - ✔✔afterload to right heart
✔✔SVR - ✔✔afterload to left heart
✔✔contractility - ✔✔heart's ability to squeeze
✔✔oxygen delivery/consumption - ✔✔goal: deliver enough oxygen to tissues to meet
tissue demand
major determinants of o2 delivery are Hgb and CO
✔✔ScvO2 - ✔✔central venous oxygen saturation
✔✔SvO2 - ✔✔reflects balance between oxygen delivery and demand
normal is 60-80%
✔✔SaO2 - ✔✔oxygen saturation of hemoglobin in arterial blood, obtained through an
ABG
✔✔hypovolemic shock - ✔✔shock resulting from blood or fluid loss. dehydrated, veins
dilated, arteries clamped down. decreased CO because dry. preload will be low. SNS
and RAAS are good because they help maintain perfusion of vital organs
✔✔hypovolemic shock s/s - ✔✔cool and clamped down, tachycardic, low UOP, thirsty,
dry mucous membranes
✔✔sugammadex - ✔✔NMB reversal agent of roc and vec
✔✔preload - ✔✔amount of fluid filling the heart, how wet or dry the pt is
since veins hold venous blood returning to heart, dilation and constriction affect preload
✔✔CVP - ✔✔preload of right heart
✔✔PAWP - ✔✔preload of the left heart
6-12 is normal
snapshot in time, not a continuous measurement. swan ganz is advanced and balloon is
inflated and pressure is recorded. risk of rupturing vessels, minimize how often we
measure this
✔✔Frank-Starling Law - ✔✔the greater the stretch, the stronger is the heart's
contraction
giving fluid increases preload, and therefore increases cardiac output
however if you give too much fluid, you will stretch the heart too much and it won't be
able to contract, which will decrease cardiac output
✔✔how to fix preload - ✔✔if preload is low, give crystalloids, colloids, or blood to
increase volume
if preload is high, give diuretics, vasodilators, or dialysis
✔✔how to help right heart deliver to left - ✔✔decrease right heart afterload - dilate
pulmonary arteries
, ✔✔afterload - ✔✔the amount of resistance to ejection of blood from the ventricle, how
dilated or clamped down the pt is
✔✔high afterload treatment - ✔✔treat cause
decrease SVR with ACE inhibitors, ARBs, hydralazine
decrease PVR with milrinone, isuprel, nitric oxide, sildenafil
✔✔milrinone - ✔✔pulmonary vasodilator, decreases PVR while increasing CO and
contractility
good for R side HF
✔✔low afterload treatment - ✔✔constrict arteries with dopamine, norepinephrine,
phenylephrine
✔✔PVR - ✔✔afterload to right heart
✔✔SVR - ✔✔afterload to left heart
✔✔contractility - ✔✔heart's ability to squeeze
✔✔oxygen delivery/consumption - ✔✔goal: deliver enough oxygen to tissues to meet
tissue demand
major determinants of o2 delivery are Hgb and CO
✔✔ScvO2 - ✔✔central venous oxygen saturation
✔✔SvO2 - ✔✔reflects balance between oxygen delivery and demand
normal is 60-80%
✔✔SaO2 - ✔✔oxygen saturation of hemoglobin in arterial blood, obtained through an
ABG
✔✔hypovolemic shock - ✔✔shock resulting from blood or fluid loss. dehydrated, veins
dilated, arteries clamped down. decreased CO because dry. preload will be low. SNS
and RAAS are good because they help maintain perfusion of vital organs
✔✔hypovolemic shock s/s - ✔✔cool and clamped down, tachycardic, low UOP, thirsty,
dry mucous membranes
