the shocker

Which functions does the nurse associate with the epidermis? Select all that apply. Serves as an energy reserve Provides cells for wound healing Serves as a mechanical shock absorber Inhibits proliferation of microorganisms Allows the photoconversion of 7-dehydrocholesterol to vitamin D

-Inhibits proliferation of microorganisms -Allows the photoconversion of 7-dehydrocholesterol to vitamin D The epidermis inhibits the proliferation of microorganisms because of its dry external surface. It also allows the photoconversion of 7-dehydrocholesterol to vitamin D. The subcutaneous tissue serves as an energy reserve. The dermis helps in providing cells for wound healing. Subcutaneous tissue acts as a mechanical shock absorber.

Dopamine cardiovascular effects

-increase CO & BP (beta1 - increase HR & contractility) -increase TPR & BP (alpha1 - vasoconstriction) -increase systolic BP, diastolic BP & mean BP

Normal INR level

0.75-1.5 When you are in IN war you need to shoot fast unless you want to wait 2-3 sec until target in range (therapeutic values)

A client diagnosed with angina pectoris complains of chest pain while ambulating in the hallway. Which action should the nurse implement first? A. Support the client to a sitting position. B. Ask the client to walk slowly back to the room. C. Administer a sublingual nitroglycerin tablet. D. Provide oxygen via nasal cannula.

A. Rationale:The nurse should safely assist the client to a resting position and then perform options C and D. The client must cease all activity immediately, which will decrease the oxygen requirement of the myocardial muscle. After these interventions are implemented, the client can be escorted back to the room via wheelchair or stretcher.

A client is experiencing hypovolemic shock with decreased tissue perfusion. Which information should the nurse consider when planning care? A. The body initially attempts to compensate by releasing more red blood cells. B. The body initially attempts to compensate by maintaining peripheral vasoconstriction. C. The body initially attempts to compensate by decreasing mineralocorticoid production. D. The body initially attempts to compensate by producing less antidiuretic hormone (ADH).

A. With shock, arteriolar vasoconstriction occurs, raising the total peripheral vascular resistance and shifting blood to the major organs. Although producing more red blood cells is a response to hypoxia, peripheral vasoconstriction is a more effective compensatory mechanism. With shock the mineralocorticoids increase to promote fluid retention, which elevates the blood pressure. With shock, more ADH is produced to promote fluid retention, which will elevate the blood pressure.

A client is brought to the emergency department with chest pain. The client asks why an electrocardiogram (ECG) has been prescribed. What does the nurse explain that the ECG will do? A.Indicates acutely impaired blood flow to the heart muscle B.Detect altered heart sounds C.Determine the flow of blood to the heart muscle D.Evaluate the spatial relationship of structures within the heart

A.Indicates acutely impaired blood flow to the heart muscle The ECG waveform can indicate myocardial ischemia or injury as evidenced by ST waveform depression or elevation, respectively. Ischemia or injury is caused by an acute lack of blood flow through the coronary arteries that supply oxygenated blood to the heart muscle. Auscultation can detect various heart sounds. Blood flow to the heart muscle is assessed during a cardiac catheterization. Spatial relationships of structures within the heart are assessed via an echocardiogram.

When assessing a patient for shock, the nurse knows that which symptom is the earliest manifestation of shock? Anuria Increased heart rate A decrease in respiratory rate and depth A change in both systolic and diastolic blood pressure

ANS: B The earliest clinical signs of hypovolemic shock are cardiovascular: increased heart rate and respiratory rate are the earliest manifestations of shock. Changes in systolic blood pressure are not always present in the initial stage of shock because of compensatory mechanisms and should not be used as the main indicator of shock presence or progression.

A woman has been experiencing atypical angina. What symptoms would the nurse anticipate? (Select all that apply.) A.Vomiting B.Indigestion C.Aching jaw pain D.Depression E.Irregular bowel movements F. Decreased patterns of activity

ANS: B, C, F Rationale: Many women experience atypical angina which manifests as indigestion, pain between the shoulders, an aching jaw, or a choking sensation that occurs with exertion. These symptoms typically manifest during stressful circumstances or during activities of daily living. Woman may curtail activity (decreased patterns of activity) as a result of the angina, and health care providers need to ask about changes in routine.

A 48-year-old female client having an annual physical asks the nurse about her risk for developing a myocardial infarction (MI). The nurse discusses risk factors with the client. Which modifiable risk factors will the nurse assess to guide the client's teaching plan? (Select all that apply.) a. Older age b. Tobacco use c. Female d. High-fat diet e. Family history f. Obesity

ANS: B, D, F Tobacco use, diet, and obesity are all considered modifiable risk factors and should be included in the plan of care.

A patient presents to the ED and is diagnosed with an acute MI. The patient's spouse asks what type of damage has been caused by the "heart attack." What is the appropriate nursing response? A."The pain is controlled, so there is no damage." B."It will take years to know the extent of the damage to the heart muscle." C."The medication will dilate the blood vessels and any damage will be corrected." D."A heart attack evolves over several hours. We won't know the extent of the damage immediately."

ANS: D Infarction is a dynamic process that does not occur instantly. The MI evolves over a period of several hours. Controlled pain does not indicate that there is no cardiac muscle damage. The medications do vasodilate to prevent further damage. They do not correct damage that has already been incurred.

Which clinical manifestations does the nurse recognize that indicates worsening in the condition of a patient in the refractory phase of shock? Warm, flushed skin Urine output of 20 mL/hr Increasing respiratory rate Bleeding, oozing from IV sites

ANS: D The onset of disseminated intravascular coagulation (DIC) as evidenced by bleeding to include oozing from IV sites indicates a consumption of clotting factors that occurs in the refractory stage of shock. The refractory stage or irreversible stage of shock occurs when too much cell death and tissue damage result from too little oxygen reaching the tissues. Vital organs have overwhelming damage. The body can no longer respond effectively to interventions and shock continues. The patient usually requires full system support (for example, mechanical ventilation, vasopressor agents, renal support [dialysis]), rapid loss of consciousness; nonpalpable pulse; cold, dusky extremities; slow, shallow respirations; and unmeasurable oxygen saturation.

The nurse is caring for a client who is one day post-acute myocardial infarction. The client is receiving oxygen at 2 L/min via nasal cannula and has a peripheral saline lock. The nurse notes that the client is having eight premature ventricular contractions (PVCs) per minute. Which intervention should the nurse implement first? A. Obtain an IV pump for antiarrhythmic infusion. B. Increase the client's oxygen flow rate. C. Prepare for immediate countershock. D. Gather equipment for endotracheal intubation.

B Rationale:Increasing the oxygen flow rate provides more oxygen to the client's myocardium and may decrease myocardial irritability as manifested by the frequent PVCs. Option A can be delegated and is a lower priority action than option B. Defibrillation may eventually be necessary, but option C is not the immediate treatment for frequent PVCs. Option D may become necessary if the client stops breathing but is not indicated at this time.

The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock is in place. Which intervention should the nurse implement first? A. Measure the urine specific gravity. B. Obtain IV fluids for infusion per protocol. C. Prepare for insertion of a central venous catheter. D. Auscultate the client's breath sounds.

B Rationale:The client is at risk for hypovolemic shock because of the postoperative status and is exhibiting early signs of shock. A priority intervention is the initiation of IV fluids to restore tissue perfusion. Options A, C, and D are all important interventions but are of lower priority than option B.

A medical/surgical nurse is completing the admission assessment on a client diagnosed with a urinary tract infection. The client's admitting weight is 165 lb (74.8 kg). The vital signs are as follows: temperature 96° F (35.6° C), pulse 110, respirations 20, and blood pressure 88/56 mm Hg. The client received 3 L of normal saline in the emergency department. The total urine output for the past 2 hours is 20 mL via Foley catheter. Which intervention should the nurse recommend to the primary healthcare provider? Transfer the client to a critical care unit Discontinue the urinary catheter Give another 1 L of sodium chloride bolus Begin a dopamine hydrochloride drip at renal perfusion

Bye bitch ! To ICU you go Rationale The client has a known infection, is exhibiting signs of sepsis, and is unresponsive to fluid therapy as evidenced by the low blood pressure. The client is showing signs of kidney failure. The client is manifesting probable signs of septic shock requiring a higher level of care. This question requires the medical/surgical nurse to synthesize the client's manifestations and make an evaluation of the need for more invasive care than is available on the admitting unit. Giving another fluid is plausible, but this client weighs 75 kg, requiring a maximum of 3 L of fluid to be given before a diagnosis of severe sepsis. The client requires more invasive monitoring than can be done on a medical/surgical unit to determine if more fluid or vasopressors are required. The urinary catheter is necessary to continue monitoring the urine output in this acute client.

With which client should the nurse remain alert for the possibility of sepsis and septic shock? A. 41-year-old man who sustained closed depression fractures of the face when hit with a baseball. B. 53-year-old woman who had an open abdominal hysterectomy 3 days ago to remove several large fibroid tumors. C. 67-year-old woman on chronic corticoid steroid therapy who had several teeth extracted 2 days ago. D. 72-year-old man with severe allergies who is undergoing radiation therapy for early-stage prostate cancer.

C

The nurse assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which electrocardiographic change would be a concern for a client taking a diuretic? A. Tall, spiked T waves B. A prolonged QT interval C. A widening QRS complex D. Presence of a U wave

D. Rationale:A U wave is a positive deflection following the T wave and is often present with hypokalemia (low potassium level). Options A, B, and C are all signs of hyperkalemia.

A client with an inferior myocardial infarction has a heart rate of 120 beats per minute. Which goal achievements are priority? Increase left ventricular filling and improve cardiac output Decrease oxygen needs of the vital organs and prevent cardiac dysrhythmias Decrease the workload on the heart and promote maximum coronary artery filling Increase venous return to the right atrium and increase pulmonary arterial blood flow

Decrease the workload on the heart and promote maximum coronary artery filling With a myocardial infarction, circulation of blood to cardiac muscle is reduced, depriving it of oxygen; therefore the oxygen demands of the body need to be decreased to reduce stress on the heart and reduce cardiac output. Increased coronary artery filling allows more blood and therefore oxygen to reach cardiac muscle; this increases myocardial efficiency. Increasing left ventricular filling increases the workload of the heart. Oxygenation of vital organs must be maintained. Decreasing oxygen to vital organs of the body may interfere with their ability to function. Increasing venous return to the right atrium increases the workload of the heart.

A 37-year-old male is admitted with a severely abscessed tooth, BP 90/42, HR 136, RR 28, Spo2 90% on room air, temperature 38.7º C. The nurse suspects that the patient has developed sepsis. What is the priority nursing intervention? Insert an indwelling urinary catheter. Initiate intravenous fluid resuscitation. Obtain a complete chemistry for laboratory analysis. Administer prescribed antibiotics prior to blood cultures.

Initiate intravenous fluid resuscitation ANS: B Initiating IV fluids is the primary intervention, followed by obtaining laboratory values, blood cultures, and providing oxygen. Antibiotics should be started ASAP, however, after blood cultures are obtained. An indwelling urinary catheter is lower in the list of necessary priority interventions. The Surviving Sepsis Campaign and IHI Sepsis Bundle provide guidelines for interventions for early resuscitation and treatment of patients with sepsis. Once a patient is suspected of sepsis, the following items (initiated within 6 hours and completed within the first 24 hours) have been found to enhance survival: (1) Obtain, monitor, and treat serum lactate. (2) Obtain blood cultures prior to antibiotics. (3) Administer broad spectrum antibiotics as soon as possible. (4) Aggressively treat hypotension with IV fluids. (5) Apply vasopressor agents for hypotension that does not respond to fluids. (6) Assess and maximize tissue oxygenation

When developing a discharge teaching plan for a client after the insertion of a permanent pacemaker, the nurse writes a goal of "The client will verbalize symptoms of pacemaker failure." Which behavior indicates that the goal has been met? A. The client demonstrates the procedures to change the rate of the pacemaker using a magnet. B. The client carries a card in his wallet stating the type and serial number of the pacemaker. C. The client tells the nurse that it is important to report redness and tenderness at the insertion site. D. The client states that changes in the pulse and feelings of dizziness are significant changes.

Rationale:Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings of dizziness may be caused by a decreased heart rate, leading to decreased cardiac output. The rate of a pacemaker is not changed by a client, although the client may be familiar with this procedure as explained by his health care provider. Option B is an important step in preparing the client for discharge but does not demonstrate knowledge of the symptoms of pacer failure. Option C indicates symptoms of possible incisional infection or irritation but does not indicate pacer failure.

A 25-year-old client was admitted yesterday after a motor vehicle collision. Neurodiagnostic studies have shown a basal skull fracture in the middle fossa. Assessment on admission revealed both halo and Battle signs. Which new symptom indicates that the client is likely to be experiencing a common life-threatening complication associated with a basal skull fracture? .A. Bilateral jugular venous distention B. Oral temperature of 102° F C. Intermittent focal motor seizures D. Intractable pain in the cervical region

Rationale:Clients with basilar skull fractures are at high risk for infection of the brain, as indicated by an increased oral temperature, because the fracture leaves the meninges open to bacterial invasion. Clients may experience options C and D, but these findings do not pose as great a life-threatening risk as infection. Jugular distention is not a typical complication of basal skull fractures

A 77-year-old female client is admitted to the hospital with confusion and anorexia of several days' duration. She has symptoms of nausea and vomiting and is currently complaining of a headache. The client's pulse rate is 43 beats/min. The nurse is most concerned about the client's history related to which medication? A. Warfarin B. Ibuprofen C. Nitroglycerin D. Digoxin

Rationale:Older persons are particularly susceptible to the buildup of cardiac glycosides, such as digoxin or digitoxin (medications derived from digitalis), to a toxic level in their systems. Toxicity can cause anorexia, nausea, vomiting, diarrhea, headache, and fatigue. Options A, B, and C are unlikely to result in the symptoms described.

Which statement reflects the highest priority nursing diagnosis for an older client recently admitted to the hospital for a new-onset cardiac dysrhythmia? A. Diarrhea related to medication side effects B. Anxiety related to fear of recurrent anginal episodes C. Altered nutrition related to high serum lipid levels D. Risk for injury related to syncope and confusion

Rationale:The loss of cardiac function in aging decreases cardiac output, so dysrhythmias, particularly tachycardias, are poorly tolerated. With onset of a tachycardic or bradycardic dysrhythmia, cardiac output is compromised further, placing the client at risk of syncope and falling, as well as confusion. Option A is of high priority but less so than maintaining client safety. Clients may experience option B as a result of a newly diagnosed cardiac condition, but this nursing diagnosis does not have the priority of option D. Option C also does not have the priority of option D.

Preload/Afterload

pre:degree of stretch of the cardiac muscle fibers at the end of diastole/ when heart is filled and "resting" afterload:force heart has to work against to pump blood into arteries

Warfarin (Coumadin)

think liver Vit K inhibition George took after HA to keep blood moving over stints Used in Afib due to blood clot risk /blood pooling in heart

Nitroglycerin treats angina how

viso-dilates, decrease preload = work load for heart

ARB and ACE

watch potassium We are Sartans and prills

ACE inhibitors

"PRIL" Captopril, Enalapril, Afosiopril Antihypertensive. Blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss. Check BP before giving (hypotension) *Orthostatic Hypotension Angiodedema annoying cause cough or your face to swell and you die... watch for both

A client is scheduled to have a coronary artery bypass graft (CABG). The client's spouse asks what the benefit of the surgery is. How should the nurse respond? "This surgery significantly decreases symptoms in most clients." "This procedure will enable your spouse to return to work after healing occurs." "Studies have consistently shown that this surgery increases an individual's life span." "Evidence substantiates that surgery can prevent progression of coronary artery disease."

"This surgery significantly decreases symptoms in most clients." The majority of those who have this surgery have marked relief from their symptoms because the flow of blood to myocardial cells is increased. Whether the procedure will enable the client to return to work depends on the client's presurgical condition and occupation, not the surgery itself. So far, studies have failed to show that coronary artery bypass surgery affects life span. The surgery itself does not affect the disease process; clients must reduce risk factors (obesity, smoking, and high-fat/high-cholesterol diet) as well.

Calcium Channel Blockers

"mean the pine blocks the cal" ... weak I know Calcium Channel Blockers The "-pine"s amlodipine, nifedipine, verapamil

The nurse is educating a client who is being discharged after insertion of a coronary artery stent. For what signs and symptoms should the nurse instruct the client to seek immediate medical attention? Select all that apply. Dyspnea on exertion Unexplainable profuse diaphoresis Indigestion not relieved by antacids Fatigue the day after a rigorous walk Acute chest pain after rigorous exercise Nonremitting chest pain after three sublingual nitroglycerine tablets

-Unexplainable profuse diaphoresis -Indigestion not relieved by antacids -Acute chest pain after rigorous exercise -Nonremitting chest pain after three sublingual nitroglycerine tablets Unexplainable profuse diaphoresis, indigestion not relieved by antacids, acute chest pain after rigorous exercise, and nonremitting chest pain after three sublingual nitroglycerine tablets are clinical indicators of inadequate oxygen to the heart. The client should be instructed to seek immediate medical intervention. Dyspnea on exertion and fatigue the day after a rigorous walk are expected.

Normal platelet range

150,000-400,000

Bicarbonate (HCO3):

22-26 mEq/L The kidneys excrete excess

Partial pressure of carbon dioxide 🌬

35-45 amount of carbon dioxide in blood

Map of 102/70

80.6 = normal (70-100)

Oxygen saturation (O2 Sat):

94-109

Partial pressure of oxygen (PaO2)☀️

A measurement of the amount of oxygen in the blood. 75-100

A client who is in the progressive stage of hypovolemic shock has all of the following signs, symptoms, or changes. Which ones does the nurse attribute to ongoing compensatory mechanisms? (select all that apply) A. increasing pallor B. increasing thirst C. increasing confusion D. increasing heart rate E. increasing respiratory rate F. decreasing systolic BP G. decreasing blood pH H. decreasing urinary output

A, B, D, E, H

A client with severe bleeding due to a motor vehicle accident was admitted to the emergency department. The nurse assessed that the client was unconscious and the healthcare provider diagnosed the client with a hand fracture. The client is receiving oxygen therapy as well as intravenous fluids through the antecubital fossa. Which sites should be used to obtain the client's pulse rate? Select all that apply. Apical Carotid Brachial Femoral Popliteal

Apical Carotid Brachial Femoral Popliteal

A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular response. Based on this finding, the nurse anticipates assisting the physician with which treatment? Select an option, then click Submit. A. Administer lidocaine, 75 mg intravenous push. B. Perform synchronized cardioversion. C. Defibrillate the client as soon as possible. D. Administer atropine, 0.4 mg intravenous push.

B

ARBs MOA

Block angiotensin-2 type 1 receptors (AT1 receptor) Decrease BP via arteriolar and venous dilation Block aldosterone secretion (decreased Na2+ and H2O retention) Does NOT increase Bradykinin levels Decrease diabetic nephrotoxicity

Why Dopamine is preferred over norepinephrine in some shocks?

Both drugs can increase blood pressure in shock states, although norepinephrine is more powerful. Dopamine can increase cardiac output more than norepinephrine, and in addition to the increase in global blood flow, has the potential advantage of increasing renal and hepatosplanchnic blood flow.

The nurse observes ventricular fibrillation on telemetry and, on entering the client's bathroom, finds the client unconscious on the floor. Which intervention should the nurse implement first? A. Administer an antidysrhythmic medication. B. Start cardiopulmonary resuscitation. C. Prepare for mechanical ventilation. D. Assess the client's pulse oximetry.

C. Start CPR

The nurse is assessing a client with chest pain. Which symptoms assessed by the nurse would be most indicative of myocardial infarction? (Select all that apply.) a. Chest pain brought on by exertion or stress b. Substernal chest discomfort occurring at rest c. Substernal chest discomfort relieved by nitroglycerin or rest d. Substernal chest pressure relieved only by opioids

Chest pain associated with ECG changes Chest pain relieved only by opioids Chest pain associated with shortness of breath

Which systemic assessment finding in a client being treated for hypovolemic shock indicates to the nurse that interventions are currently effective? A. Oxygen saturation remains unchanged B. Core body temperature has increased to 99 degrees F (37.2 degrees C) C. The client correctly states the month and year D. Serum lactate and serum potassium levels are declining.

D

A client who is receiving an angiotensin-converting enzyme (ACE) inhibitor for hypertension calls the clinic and reports the recent onset of a cough to the nurse. Which action should the nurse implement? A. Advise the client to come to the clinic immediately for further assessment. B. Instruct the client to discontinue use of the drug and to make an appointment at the clinic. C. Suggest that the client learn to accept the cough as a side effect to a necessary prescription. D. Encourage the client to keep taking the drug until seen by the health care provider.

D Rationale:Coughing is a common side effect of ACE inhibitors and is not an indication to discontinue the medication. Immediate evaluation is not needed. Antihypertensive medications should not be stopped abruptly because rebound hypertension may occur. Option C is demeaning because the cough may be very disruptive to the client, and other antihypertensive medications may produce the desired effect without the adverse effect.

Inotropic medications

Dig Calcium medications that increase strength of the contractions in the heart

The nurse in the intensive care unit is monitoring a client who had an aortic valve replacement. What can a slowing pulse rate during the early postoperative period after open heart surgery indicate? Shock Hypoxia Heart block Cardiac failure

Heart Block During open heart surgery, the conductive system of the heart can be damaged because of trauma. Shock results in a weak, rapid pulse. Hypoxia causes tachycardia. Heart failure causes a rapid pulse rate.

What are the clinical manifestations of myocardial infarction in women? Select all that apply. Anoxia Indigestion Unusual fatigue Sleep disturbances Tightness of the chest

Indigestion Unusual fatigue Sleep disturbances Rationale Indigestion, unusual fatigue, and sleep disturbances are clinical manifestations of myocardial infarction in women. Anoxia and tightness of the chest are clinical manifestations of angina pectoris, not myocardial infarction.

A client is in profound (late) hypovolemic shock. The nurse assesses the client's laboratory values. What does the nurse know that clients in late shock develop? Hypokalemia Metabolic acidosis Respiratory alkalosis Decreased Pco 2 levels

Metabolic acidosis Decreased oxygen increases the conversion of pyruvic acid to lactic acid, resulting in metabolic acidosis. Hyperkalemia will occur because of renal shutdown; hypokalemia can occur in early shock. Respiratory alkalosis can occur in early shock because of rapid, shallow breathing, but in late shock metabolic or respiratory acidosis occurs. The Pco 2 level will increase in profound shock.

A client has a colon resection with an anastomosis. What assessments by the nurse support a suspicion of impending shock? Select all that apply. Select all that apply Some correct answers were not selected Oliguria Lethargy Irritability Hypotension Slurred speech

Oliguria Irritablity Hypotension Decreased blood flow to the kidneys leads to oliguria or anuria. Irritability, along with restlessness and anxiety, occurs because of a decrease in oxygen to the brain. Hypotension and a narrowing of the pulse pressure occur because of declining blood volume. Restlessness, not lethargy, usually occurs because of decreased cerebral blood flow. There are various changes in sensorium, but slurred speech is not a manifestation of shock.

A nurse is caring for a client with severe burns. The nurse determines that this client is at risk for hypovolemic shock. Which physiologic finding supports the nurse's conclusion? Decreased rate of glomerular filtration Excessive blood loss through the burned tissues Plasma proteins moving out of the intravascular compartment Sodium retention occurring as a result of the aldosterone mechanism

Plasma proteins moving out of the intravascular compartment The shift of plasma proteins into the burned area increases the shift of fluid from the intravascular to the interstitial compartment; the result is decreased blood volume and hypovolemic shock. Decreased glomerular filtration may occur because of hypovolemia; it does not cause hypovolemia. Extracellular fluid, not blood, is lost through burned tissue. Sodium is not retained; it passes to interstitial spaces and surrounding tissue.

Apizaban (Eliquis) differences

Prevention of DVT, PE AFib/flutter, MI, stroke, prosthetic heart valves Inhibit activity of clotting factor Xa, prevent clot formation No serum/lab monitoring less shit to check, thats cool

Lactic Acid and Shock(septic shock) hypothesis

Sepsis a septic shock are associated with a stress response that includes increased release of epinephrine. This hormone simulates the membrane- bound enzyme Na+/K+-ATPase stimulation increases aerobic glycolysis and therby lactate production.

skin in early stages of septic shock

The early stage of septic shock precedes sepsis.In the early stage of septic shock, the client is usually warm and febrile.

Identify the laboratory test that is most specific for myocardial infarction and cardiac necrosis. Troponin HDL CK-MB CK

Troponin

A client thought to be at risk for distributive shock is given a drug that constricts blood vessels. What effect does the nurse expect the drug to have on the client's MAP ? A. Increased MAP without a change in vascular volume.B. Increased MAP by increasing vascular volume.C. Decreased MAP from widespread capillary leak.D. Decreased MAP by decreasing vascular volume.

a

Calcium Channel Blockers

anti angina and anti-ischemic properties

Nipride (nitroprusside)

arterial and venous vasodilator get it in brown bag

ARB and ACE

both my boys... hitting those kidneys hard. These MF be spitting on that angiotension system and flushed water out to bring down the beats ( just pressure)

beta blockers

decrease heart rate and dilate arteries by blocking beta receptors

negative intropic

decreasing heart contractility Beta Blockers

postive intrope

epi, Ca, Dig, Caffiene get the heart going

Vassopressors treat shock

increase stroke volume/ output with venous return

Intermediate claudication

is related to peripheral arterial occlusive disease numbness or burning pain in lower extremities with excercise, may stop with rest

Beta Blockers

lol all you do is block adrenaline and noradrenaline but you lower HR and BP

The nurse assesses a client who had a coronary artery bypass graft yesterday. Which assessment finding will cause the nurse to suspect cardiac tamponade?

muffled heart sounds and presence of jugular distension

HYPOVELMIC SHOCK skin

pale cold extremities

Calcium Channel Blockers

pines don't eat grapefruit Blood pressure Heart rate: afib, SVT

If you give a beta blocker you "beta" ck their

pulse is <55 and Systolic <100

Lovenox (enoxaparin) Heparin

short term prevents clots PTT protamine MI, PE

grel and lor (Clopidogrel /Plavix, Ticagrelor/Brilinta)

the trolls that fight you platelets

Dopamine

vasopressor, used to initiate an increase in blood pressure and cardiac output, with the goal of increased perfusion.