Preload - ✔✔ the amount of blood returning to the right side of the heart and the muscle stretch that the volume causes. ANP is released when we
... [Show More] have this stretch
Afterload - ✔✔ the pressure in the aorta and peripheral arteries that the left ventricle has to pump against to get the blood out
The pressure during afterload is referred to as - ✔✔ resistance
With hypertension there's even more _______________ for the ________________________ to pump against - ✔✔ resistance; left ventricle
Hypertension can eventually lead to _______________ and _________________, because ___________________. Plus, _________________ - ✔✔ HF; pulmonary edema; high afterload decreases CO and decreases forward flow; it wears your heart out
Stroke volume - ✔✔ the amount of blood pumped out of the ventricles with each beat
CO = ______ X _______ - ✔✔ HR; SV
Tissue perfusion is dependent on - ✔✔ an adequate CO
Cardiac output changes according to the - ✔✔ body's demands (needs)
Factors that affect CO - ✔✔ 1. HR and certain arrhythmias
2. Blood volume
3. Decreased contractility
Less volume = - ✔✔ less CO
More volume = - ✔✔ more CO
What can cause decreased contractility? - ✔✔ -MI
-medication
-cardiac muscle disease
Medications that affect preload - ✔✔ 1. diuretics (furosemide)
2. nitrates (nitroglycerin)
Medications that affect afterload - ✔✔ 1. ACE inhibitors (enalapril, fosinopril, captopril)
2. ARBS (losartan, irbesartan)
3. Hydralazine
4. Nitrates
Medications that improve contractility - ✔✔ inotropes (dopamine, dobutamine, milrinone)
Medications that affect rate control - ✔✔ 1. Beta blockers (propanolol, metoprolol, atenolol,
carvedilol)
2. Calcium channel blockers (diltiazem, verapamil,
amlodipine)
3. Digoxin
How do diuretics (furosemide) and nitrates (nitroglycerin) affect cardiac output? - ✔✔ vasodilate to diurese to reduce (decrease) preload
How do ACE inhibitors (enalapril, fosinopril, captopril), ARBS (losartan, irbesartan), Hydralazine, and Nitrates affect afterload? - ✔✔ vasodilate to reduce (decrease) afterload
If CO is decreased, - ✔✔ you cannot perfuse properly
If CO is decreased, what will happen to the brain? - ✔✔ LOC will go down
If CO is decreased, what will happen to the heart? - ✔✔ clients will report chest pain
If CO is decreased, what will happen to the lungs? - ✔✔ lungs are wet and patients have SOB
If CO is decreased, what will happen to the skin? - ✔✔ it will be cold and clammy
If CO is decreased, what will happen to the kidneys? - ✔✔ UO goes down
If CO is decreased, what will happen to peripheral pulses? - ✔✔ weak and thready
Arrhythmias are no big deal UNTIL, - ✔✔ they affect your CO
3 arrhythmias that are always a big deal - ✔✔ 1. pulseless ventricular tachycardia
2. ventricular fibrillation
3. asystole
CAD is the most common type of - ✔✔ cardiovascular disease
CAD is a broad term that includes - ✔✔ -chronic stable angina
-acute coronary syndrome
Chronic stable angina is - ✔✔ intermittent decreased blood flow to the myocardium that leads to ischemia
The ischemia brought on by chronic stable angina can lead to - ✔✔ temporary pain/pressure in chest
Chronic Stable Angina: The pain associated is brought on by - ✔✔ low O2 usually d/t exertion
Chronic Stable Angina: What relieves the pain? - ✔✔ rest and/or nitroglycerin SL
Medications for Chronic Stable Angina - ✔✔ 1. nitroglycerin (Nitrostat) SL
2. beta blockers
3. calcium channel blockers
4. acetylsalicylic acid (Aspirin)
Nitroclycerin causes ___________________ that will cause - ✔✔ venous and arterial dilation; decreased preload and afterload
Nitroclycerin also causes - ✔✔ dilation of the coronary arteries which will increase blood flow to the actual heart muscle (myocardium)
Nitroclycerin: Take 1 every - ✔✔ 5 mins x 3 doses [Show Less]