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Cardiac output
HR X stroke volume
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How do we obtain a stroke volume reading?
By a swan ganz line
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How does heart rate affect cardiac output?
If HR ↑ too much like > 150 CO will drop due to decreased filling time. If HR is too low it will decrease co
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What is the normal range for CO?
50-70%
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What is important to know about pre-load?
Think fluid, need to decrease fluid using Lasix, monitor potassium
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What to know about after-load
Think BP, decrease BP with meds
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What meds decrease BP?
Think ABCD, ACE rils/ARB artins, Beta blockers lol, Calcium channel blockers amlodipine diltiazem (Cardizem, Tiazac, others) and nifedipine Diuretics lasix
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Wheezes
r/t bronchial constriction, asthma
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crackles
fluid pulmonary edema
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stridor
airway obstruction, anaphylaxis
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contractility
- SA node 60-100 bpm
- AV node 40-60
- Perkinje 20-40 fibers
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cardiac enzyme to measure for MI
troponin, comb
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Rhythm problem
check thyroid
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Kidney function test
creatinine and bun
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Ischemia
ST elevation problems
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Thallium and radio nuclear scan
show perfusion of the heart
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TEE and TTE
show the structure of the heart
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If a patient can't do a physical stress test what meds are used for a pharmacologic stress test?
Dipyridamole, and adenosine
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increased vasovago tone, bearing down cause what to the HR?
Decreased HR
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What meds are used for bradycardia?
ATROPENE AND epinephrine
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Normal appt? an therapeutic levels?
50 -70 therapeutic 2-2.5 x so anything over 100 might be too hight appt and risk for bleeding
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PAC Premature atrial contractions
pt trying to go into Afib. premature beat, sometimes don't see a p wave, it gets buried into wave.
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Meds for a fib
IV amiodarone bolus then drip, anticoagulation, cardizem/diltizem, sotalol, propafaone, IV digoxin (narrow therapeutic range),
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