FCCN LEVEL 2 QUESTIONS WITH
CORRECT OPTIONS
preload ANSW✅✅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 ANSW✅✅preload of right heart
PAWP ANSW✅✅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 ANSW✅✅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 ANSW✅✅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 ANSW✅✅decrease right heart afterload - dilate pulmonary
arteries
,afterload ANSW✅✅the amount of resistance to ejection of blood from the ventricle, how dilated
or clamped down the pt is
high afterload treatment ANSW✅✅treat cause
decrease SVR with ACE inhibitors, ARBs, hydralazine
decrease PVR with milrinone, isuprel, nitric oxide, sildenafil
milrinone ANSW✅✅pulmonary vasodilator, decreases PVR while increasing CO and contractility
good for R side HF
low afterload treatment ANSW✅✅constrict arteries with dopamine, norepinephrine,
phenylephrine
PVR ANSW✅✅afterload to right heart
SVR ANSW✅✅afterload to left heart
contractility ANSW✅✅heart's ability to squeeze
oxygen delivery/consumption ANSW✅✅goal: deliver enough oxygen to tissues to meet tissue
demand
major determinants of o2 delivery are Hgb and CO
ScvO2 ANSW✅✅central venous oxygen saturation
SvO2 ANSW✅✅reflects balance between oxygen delivery and demand
, normal is 60-80%
SaO2 ANSW✅✅oxygen saturation of hemoglobin in arterial blood, obtained through an ABG
hypovolemic shock ANSW✅✅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 ANSW✅✅cool and clamped down, tachycardic, low UOP, thirsty, dry
mucous membranes
hypovolemic shock treatment ANSW✅✅give fluid or blood, control any bleeding
cardiogenic shock ANSW✅✅shock caused by inadequate function of the heart, or pump failure.
poor contractility. SNS and RAAS are bad because they will cause an increase in resistance and fluid
retention, making the situation worse.
distributive shock s/s ANSW✅✅flushed, peripherally dilated, tachycardic, concentrated urine,
hypotensive, high temp
distributive shock treatment ANSW✅✅fill tank first by giving fluid, then clamp down with
vasopressors, add inotrope if needed, treat infection if there is one
distributive shock ANSW✅✅A condition that occurs when there is widespread dilation. low BP,
low afterload, low preload. SNS and RAAS are good but cannot vasoconstrict
this includes septic shock
cardiogenic shock s/s ANSW✅✅cool and clamped down, mottled, crackles, peripheral edema
cardiogenic shock treatment ANSW✅✅block SNS and RAAS, decrease preload in L failure,
decrease afterload by dilating arteries, increase contractility with inotropes
CORRECT OPTIONS
preload ANSW✅✅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 ANSW✅✅preload of right heart
PAWP ANSW✅✅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 ANSW✅✅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 ANSW✅✅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 ANSW✅✅decrease right heart afterload - dilate pulmonary
arteries
,afterload ANSW✅✅the amount of resistance to ejection of blood from the ventricle, how dilated
or clamped down the pt is
high afterload treatment ANSW✅✅treat cause
decrease SVR with ACE inhibitors, ARBs, hydralazine
decrease PVR with milrinone, isuprel, nitric oxide, sildenafil
milrinone ANSW✅✅pulmonary vasodilator, decreases PVR while increasing CO and contractility
good for R side HF
low afterload treatment ANSW✅✅constrict arteries with dopamine, norepinephrine,
phenylephrine
PVR ANSW✅✅afterload to right heart
SVR ANSW✅✅afterload to left heart
contractility ANSW✅✅heart's ability to squeeze
oxygen delivery/consumption ANSW✅✅goal: deliver enough oxygen to tissues to meet tissue
demand
major determinants of o2 delivery are Hgb and CO
ScvO2 ANSW✅✅central venous oxygen saturation
SvO2 ANSW✅✅reflects balance between oxygen delivery and demand
, normal is 60-80%
SaO2 ANSW✅✅oxygen saturation of hemoglobin in arterial blood, obtained through an ABG
hypovolemic shock ANSW✅✅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 ANSW✅✅cool and clamped down, tachycardic, low UOP, thirsty, dry
mucous membranes
hypovolemic shock treatment ANSW✅✅give fluid or blood, control any bleeding
cardiogenic shock ANSW✅✅shock caused by inadequate function of the heart, or pump failure.
poor contractility. SNS and RAAS are bad because they will cause an increase in resistance and fluid
retention, making the situation worse.
distributive shock s/s ANSW✅✅flushed, peripherally dilated, tachycardic, concentrated urine,
hypotensive, high temp
distributive shock treatment ANSW✅✅fill tank first by giving fluid, then clamp down with
vasopressors, add inotrope if needed, treat infection if there is one
distributive shock ANSW✅✅A condition that occurs when there is widespread dilation. low BP,
low afterload, low preload. SNS and RAAS are good but cannot vasoconstrict
this includes septic shock
cardiogenic shock s/s ANSW✅✅cool and clamped down, mottled, crackles, peripheral edema
cardiogenic shock treatment ANSW✅✅block SNS and RAAS, decrease preload in L failure,
decrease afterload by dilating arteries, increase contractility with inotropes
