STUDY GUIDE NR 340 EXAM TWO
*Remember: The exam questions will test more of the higher level thinking skills (analyzing, application, and evaluating) and fewer lower level (remembering, understanding), with the nursing process and QSEN application. There may be medication calculation and multiple answers.
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Get Help Now!Pharmacodynamics of medications – i.e. action/therapeutic effects, uses, and nursing implications for the following: crystalloid solutions
colloid solutions
hypotonic/hypertonic solutions
ACEs
ARBs
beta-blockers
calcium channel blockers
arterior and venous vasodilators
dobutamine
dopamine
norepinephrine
vasopressin
Primacor
Aspirin
nitroglycerin
morphine sulfate
tPA
Plavix
LMWH
methylprednisolone.
Causes and treatment for elevated/decreased preload & afterload, contractility. Interpretation of lab data:
Lactate
SvO²
CK
CK-MB
Troponin T & I
Myoglobin
C-reactive protein
PTT.
Hemodynamic calculations and normal values:
pulse pressure
MAP
CO
CI
stroke volume
CVP (RAP) 2-6 mmHg
Pressure created by volume of blood on right side of heart; assess fluid balance/responsiveness Obtained through central line in vena cava, preferably through subclavian/internal jugular vein Measure at end expiration & end of ventricular diastole
Fluid overload, right ventricular dysfunction, superior vena cava obstruction, right heart failure, pulmonary hypertension, severe vasocontriction, mechanical ventilation Causes jugular vein distension: To assess have pt supine w/HOB 30-45 degrees. Stand on pt’s right side, turn head to the left. Observe highest point of pulsation of internal jugular vein, measure distance between pulsation and angle of louis. Add 5cm to number. Normal 7-9cm Treatment: Diuretics, vasodilators
Hypovolemia from dehydration or blood loss
Treatment: IV fluids, vasopressin
RAP / SI = RV dysfunction
RAP / SI = Hypovolemia
RA
PVR
PAWP
SVR.
Afterload/preload findings with applications to…
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