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Hypovolemic shock treatment
1. fluids fluids fluids! (crystalloid/colloid replacement, RBC for hemorrhage) 2. support
oxygenation 3. vasopressors started after fluid replacement.
Cardiogenic shock signs and symptoms
Decreased blood pressure, increased heart rate, increased filling pressures (CVP,
wedge), increased systemic vascular resistance, decreased cardiac output, cardiac index.
Cardiogenic shock treatment
1. support myocardial perfusion by decreasing filling pressures and systemic vascular
resistance (vasodilators like nitroglycerin) 2. use inotropes to support increase in
cardiac output (dobutamine, milrinone) 3. control rhythm disturbances 4. reduce
myocardial workload and improve coronary flow (stent, bypass surgery) 5. remove
obstruction (cardiac tamponade-- drain, aspirate or PE- give antithrombotic).
Anaphylactic shock hemodynamic changes
Decreased blood pressure, increased heart rate, decreased cardiac output/cardiac index,
decreased central venous pressure/pulmonary artery wedge pressure, decreased
systemic vascular resistance.
Anaphylactic shock treatment
1. REMOVE the causative factor 2. maintain patent airway 3. give epinephrine 4.
medications: vasopressors, bronchodilators, Benadryl, steroids, histamine blockers 5.
educate to prevent in future.
Sepsis treatment
,1. draw lactate within 3 hours 2. blood cultures and antibiotics within 1 hour 3.
FLUIDS!!! 30 mL/kg of crystalloid fluids 4. start pressors to keep MAP > 65 (Levophed
is first choice) 5. inotrope like dobutamine added if they have evidence of myocardial
dysfunction.
Blood glucose range goal for sepsis
Less than 180.
Antidote to heparin
Protamine sulfate.
Digoxin toxicity signs and symptoms
Nausea/vomiting, diarrhea, blurred vision (green/yellow halos), palpitations, syncope,
dyspnea, paroxysmal atrial tachycardia, confusion/dizziness/delirium.
Medical power of attorney
Someone that you permit to speak on your behalf in regard to medical decisions, in the
case that you cannot speak for yourself.
Living will
A living will (sometimes called an advance directive, health care directive, or advanced
medical directive) expresses your wishes regarding medical treatment in very specific
situations.
Respiratory complication from long bone fracture
Fat embolism-- dyspnea, shortness of breath.
Initial treatment for burn patients
FLUIDS, FLUIDS, FLUIDS.
Complications of chest trauma
PE, pneumothorax, pleural effusion, ARDS.
Effects of rewarming in hypothermia
Closely monitor for mass vasodilation and subsequent hypotension, gently handle,
prevent afterdrop (continued cooling of temperature even after rewarming).
mass vasodilation
closely monitor for mass vasodilation and subsequent hypotension
initial treatment for chest pain
,REST
most prominent EKG change in acute MI
ST segment elevation in two or more contiguous leads
elevated cardiac enzymes conditions
MI, pericarditis, myocarditis
not elevated cardiac enzymes conditions
not so much elevated in congestive heart failure
normal chest tube drainage per hour
no more than 100 mL/hr
conditions causing heart murmurs
Aortic dissection, Aortic regurgitation (both acute and chronic), Mitral valve
regurgitation (both acute and chronic), Mitral valve stenosis
drugs that INCREASE preload
Colloids, Crystalloids, Blood Hetastarch
drugs that DECREASE preload
Dilators: Nitroglycerin, Nitroprusside, Amrinone, Alpha and Calcium Channel blockers
drugs that increase contractility
INOTROPES: dobutamine, dopamine, milrinone, digoxin
drugs that decrease contractility
beta-blockers, calcium channel blockers
drugs that increase afterload
vasopressors: epinephrine, norepinephrine, dopamine, neosynephrine
drugs that DECREASE afterload
dilators: nitroprusside, nitroglycerin, amrinone, alpha and calcium channel blockers
complications of thrombolytics
Bleeding/Hemorrhage, Allergic rxns, Hypotension, Hemorrhagic stroke, Reperfusion
arrhythmias
indications for external pacing
, symptomatic bradycardia, tachydysrhythmias, prophylaxis following a surgery, code,
etc.
s/sx of cardiac tamponade
Rise in filling pressure with decreased CO and hypotension, JVD, Elevated CVP, severe
hypotension, and tachycardia, Pulsus paradoxus, Narrowing pulse pressure,
Tachycardia, Dysrhythmias, Decreased ECG voltage, Decreased UOP,
Anxiety/restlessness, Chest pain radiating to neck, shoulders, back, Tachypnea, Muffled
heart tones are a late sign, Chest x-ray may show enlarged cardiac silhouette,
Discomfort that's relieved by sitting or leaning forward
energy settings for biphasic defibrillators
150
med for asystole
epi (1mg)
med for V tach with pulse
150 mg Amiodarone
med for atrial fib/atrial flutter
calcium channel blockers like Cardizem
med for bradycardia
atropine
drugs to decrease afterload/SVR/PVR
Arterial Dilators: Nitroprusside, nitroglycerin, amrinone, alpha (Regitine) & Ca channel
blockers
drugs to increase afterload/SVR/PVR
Pressors: epinephrine, norepinephrine, neosynephrine/phenylephrine
drugs to decrease contractility/SVI
Beta blockers (atenolol, metoprolol, propranolol, labetalol, esmolol) and Ca channel
blockers
drugs to increase contractility/SVI
Positive inotropes: dobutamine, dopamine, milrinone, and digoxin
drugs to decrease preload/CVP/PAWP
Preparation/ BKAT Exam Practice Exam
With 800 Complete Questions And Correct
Detailed Answers (Verified Answers)
|Already Graded A+|Brand New Version!!
Hypovolemic shock treatment
1. fluids fluids fluids! (crystalloid/colloid replacement, RBC for hemorrhage) 2. support
oxygenation 3. vasopressors started after fluid replacement.
Cardiogenic shock signs and symptoms
Decreased blood pressure, increased heart rate, increased filling pressures (CVP,
wedge), increased systemic vascular resistance, decreased cardiac output, cardiac index.
Cardiogenic shock treatment
1. support myocardial perfusion by decreasing filling pressures and systemic vascular
resistance (vasodilators like nitroglycerin) 2. use inotropes to support increase in
cardiac output (dobutamine, milrinone) 3. control rhythm disturbances 4. reduce
myocardial workload and improve coronary flow (stent, bypass surgery) 5. remove
obstruction (cardiac tamponade-- drain, aspirate or PE- give antithrombotic).
Anaphylactic shock hemodynamic changes
Decreased blood pressure, increased heart rate, decreased cardiac output/cardiac index,
decreased central venous pressure/pulmonary artery wedge pressure, decreased
systemic vascular resistance.
Anaphylactic shock treatment
1. REMOVE the causative factor 2. maintain patent airway 3. give epinephrine 4.
medications: vasopressors, bronchodilators, Benadryl, steroids, histamine blockers 5.
educate to prevent in future.
Sepsis treatment
,1. draw lactate within 3 hours 2. blood cultures and antibiotics within 1 hour 3.
FLUIDS!!! 30 mL/kg of crystalloid fluids 4. start pressors to keep MAP > 65 (Levophed
is first choice) 5. inotrope like dobutamine added if they have evidence of myocardial
dysfunction.
Blood glucose range goal for sepsis
Less than 180.
Antidote to heparin
Protamine sulfate.
Digoxin toxicity signs and symptoms
Nausea/vomiting, diarrhea, blurred vision (green/yellow halos), palpitations, syncope,
dyspnea, paroxysmal atrial tachycardia, confusion/dizziness/delirium.
Medical power of attorney
Someone that you permit to speak on your behalf in regard to medical decisions, in the
case that you cannot speak for yourself.
Living will
A living will (sometimes called an advance directive, health care directive, or advanced
medical directive) expresses your wishes regarding medical treatment in very specific
situations.
Respiratory complication from long bone fracture
Fat embolism-- dyspnea, shortness of breath.
Initial treatment for burn patients
FLUIDS, FLUIDS, FLUIDS.
Complications of chest trauma
PE, pneumothorax, pleural effusion, ARDS.
Effects of rewarming in hypothermia
Closely monitor for mass vasodilation and subsequent hypotension, gently handle,
prevent afterdrop (continued cooling of temperature even after rewarming).
mass vasodilation
closely monitor for mass vasodilation and subsequent hypotension
initial treatment for chest pain
,REST
most prominent EKG change in acute MI
ST segment elevation in two or more contiguous leads
elevated cardiac enzymes conditions
MI, pericarditis, myocarditis
not elevated cardiac enzymes conditions
not so much elevated in congestive heart failure
normal chest tube drainage per hour
no more than 100 mL/hr
conditions causing heart murmurs
Aortic dissection, Aortic regurgitation (both acute and chronic), Mitral valve
regurgitation (both acute and chronic), Mitral valve stenosis
drugs that INCREASE preload
Colloids, Crystalloids, Blood Hetastarch
drugs that DECREASE preload
Dilators: Nitroglycerin, Nitroprusside, Amrinone, Alpha and Calcium Channel blockers
drugs that increase contractility
INOTROPES: dobutamine, dopamine, milrinone, digoxin
drugs that decrease contractility
beta-blockers, calcium channel blockers
drugs that increase afterload
vasopressors: epinephrine, norepinephrine, dopamine, neosynephrine
drugs that DECREASE afterload
dilators: nitroprusside, nitroglycerin, amrinone, alpha and calcium channel blockers
complications of thrombolytics
Bleeding/Hemorrhage, Allergic rxns, Hypotension, Hemorrhagic stroke, Reperfusion
arrhythmias
indications for external pacing
, symptomatic bradycardia, tachydysrhythmias, prophylaxis following a surgery, code,
etc.
s/sx of cardiac tamponade
Rise in filling pressure with decreased CO and hypotension, JVD, Elevated CVP, severe
hypotension, and tachycardia, Pulsus paradoxus, Narrowing pulse pressure,
Tachycardia, Dysrhythmias, Decreased ECG voltage, Decreased UOP,
Anxiety/restlessness, Chest pain radiating to neck, shoulders, back, Tachypnea, Muffled
heart tones are a late sign, Chest x-ray may show enlarged cardiac silhouette,
Discomfort that's relieved by sitting or leaning forward
energy settings for biphasic defibrillators
150
med for asystole
epi (1mg)
med for V tach with pulse
150 mg Amiodarone
med for atrial fib/atrial flutter
calcium channel blockers like Cardizem
med for bradycardia
atropine
drugs to decrease afterload/SVR/PVR
Arterial Dilators: Nitroprusside, nitroglycerin, amrinone, alpha (Regitine) & Ca channel
blockers
drugs to increase afterload/SVR/PVR
Pressors: epinephrine, norepinephrine, neosynephrine/phenylephrine
drugs to decrease contractility/SVI
Beta blockers (atenolol, metoprolol, propranolol, labetalol, esmolol) and Ca channel
blockers
drugs to increase contractility/SVI
Positive inotropes: dobutamine, dopamine, milrinone, and digoxin
drugs to decrease preload/CVP/PAWP
