Changes in CK-MB
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Released after myocardial necrosis. Specific for myocardial damage.
Rise: 3-12 hours
Peak: 24 hours
Normal: 2-3 days
SE of dobutamine
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, Less effect on HR than dopamine. Use central line. Check compatibilities.
Can be used peripherally during an emergency. SE: ectopic beats,
tachycardia, arrhythmias, tissue necrosis with extravasation.
If PAWP is elevated?
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Hypervolemia and indicative of left ventricular failure.
Troubleshooting over damped arterial line waveforms
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No dicrotic notch, waveform is smooth and curved (abnormal). Check
patient first. Check for blood clots, hypotension, correct leveling, insertion
sight, straighten insertion site, air bubbles, pressure bag.
Drugs to treat increased ICP
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Osmotic diuresis (mannitol, 3%, 23%). Sedation/analgesia. Reduce fever.
Antihypertensives. Vasodilators. (Strict management of SBP.)
Troponin I
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Protein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 24 hours
Normal: 5-10 days
Describe digoxin toxicity
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Confusion, Irregular pulse, Loss of appetite, Nausea, vomiting, diarrhea,
Palpitations, Vision changes (blind spots, blurred vision, changes in how
colors look, or seeing spots), Decreased consciousness, Decreased urine
output, Difficulty breathing when lying down, Excessive nighttime urination
Goals when responding to ventilator alarm
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Always check patient first.
Stroke patient care
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Ischemic: IV thrombolytic if within 3 hours, frequent neuro checks, manage
HTN, ASA, avoid hypotonic solution, manage BG, no steroids or
anticonvulsants
Hemorrhagic: Cause/location of bleed, keep euvolemic, avoid
, hyperthermia, anticonvulsants, quiet/dim room, HOB 30-45%, treat pain,
avoid valsalva, prevent vasospams, HHH therapy, Mg replace, statins
CLABSI prevention
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Hand hygiene, chlorhexidine skin prep, full-barrier precautions (mask,
patient head turned away), avoid femoral vein, take out catheters as soon
as possible, daily assessment of catheters
Purpose of Swan (PA) catheter
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Measure vascular capacity, blood volume, pump effectiveness, and tissue
perfusion.
Doses of dopamine
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Low: 0.5-2 mcg/kg/min (dopaminergic)
Intermediate: 2-10 mcg/kg/min (beta receptors, increases CO)
High: over 10 mcg/kg/min (alpha receptors, vasoconstrict)
Situations when PAWP < LVEDP
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Released after myocardial necrosis. Specific for myocardial damage.
Rise: 3-12 hours
Peak: 24 hours
Normal: 2-3 days
SE of dobutamine
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, Less effect on HR than dopamine. Use central line. Check compatibilities.
Can be used peripherally during an emergency. SE: ectopic beats,
tachycardia, arrhythmias, tissue necrosis with extravasation.
If PAWP is elevated?
Give this one a try later!
Hypervolemia and indicative of left ventricular failure.
Troubleshooting over damped arterial line waveforms
Give this one a try later!
No dicrotic notch, waveform is smooth and curved (abnormal). Check
patient first. Check for blood clots, hypotension, correct leveling, insertion
sight, straighten insertion site, air bubbles, pressure bag.
Drugs to treat increased ICP
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Osmotic diuresis (mannitol, 3%, 23%). Sedation/analgesia. Reduce fever.
Antihypertensives. Vasodilators. (Strict management of SBP.)
Troponin I
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Protein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 24 hours
Normal: 5-10 days
Describe digoxin toxicity
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Confusion, Irregular pulse, Loss of appetite, Nausea, vomiting, diarrhea,
Palpitations, Vision changes (blind spots, blurred vision, changes in how
colors look, or seeing spots), Decreased consciousness, Decreased urine
output, Difficulty breathing when lying down, Excessive nighttime urination
Goals when responding to ventilator alarm
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Always check patient first.
Stroke patient care
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Ischemic: IV thrombolytic if within 3 hours, frequent neuro checks, manage
HTN, ASA, avoid hypotonic solution, manage BG, no steroids or
anticonvulsants
Hemorrhagic: Cause/location of bleed, keep euvolemic, avoid
, hyperthermia, anticonvulsants, quiet/dim room, HOB 30-45%, treat pain,
avoid valsalva, prevent vasospams, HHH therapy, Mg replace, statins
CLABSI prevention
Give this one a try later!
Hand hygiene, chlorhexidine skin prep, full-barrier precautions (mask,
patient head turned away), avoid femoral vein, take out catheters as soon
as possible, daily assessment of catheters
Purpose of Swan (PA) catheter
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Measure vascular capacity, blood volume, pump effectiveness, and tissue
perfusion.
Doses of dopamine
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Low: 0.5-2 mcg/kg/min (dopaminergic)
Intermediate: 2-10 mcg/kg/min (beta receptors, increases CO)
High: over 10 mcg/kg/min (alpha receptors, vasoconstrict)
Situations when PAWP < LVEDP
