Term
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Definition
Naturally occurring catecholamine: functions as a neuro transmitter.
-stimulates alpha,beta, or dopaminergic receptors depending on the dosage amount.
-Low dose-renal perfusion
-Moderate dose-increase in heart rate, contractilly and BP.
High dose-vasoconstriction |
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Term
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Definition
Synthetic catecholamines
-*Acts mainly on beta 1 receptors to increase myocardial contractions with minimal increase in heart rate.
*May increase BP with large doses
*Used for Shock for short term (cardiogenic)
*Continuous IV
*May be used with dopamine to augment the beta 1 overridden by alpha effects. |
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Term
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Definition
-stimulates beta receptors increasing cardiac output by increasing HR and force of myocardial contractility.
-increase BP
-produces bronchodilation
-*sub Q for therapeutic/continuous IV, for shock bolus dose in ER.
Drug of Choice for Anaphylactic shock (prevents histamine) Reversing vasodilation and bronchoconstriction. May produce excessive cardial stimulation, ventricular dysrhythmias, and reduced renal blood flow. |
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Term
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Definition
-Inability of myocardium to maintain adequate cardiac output.
Myocardium lost ability to contract, high peripheral vascular resistance
*May be complicated my pulmonary congestion+ need for diuretic drugs |
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Term
Distributive Shock
or
Vasogenic |
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Definition
Massive vasodilation
*norepinephrin is the 1st drug of choice |
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Term
| What drug is usually the cardiotonic agent of choice in critically ill patients? |
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Definition
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Term
| What are the 3 types of distributive or vasogenic shock? |
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Definition
anaphylactic
neurogenic
septic |
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Term
| For all drugs used to manage shock, what should be monitored frequently during infusion? |
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Definition
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Term
| A patient receiving norephinephrine (Levophed) for shock has an aterial line in place. The patients blood pressure has been near 90/42 mmHg all morning. The blood pressure reading on the continuous monitor suddenly shows a bp of 130/80, the nurse should? |
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Definition
| confirm the bp with a manual reading |
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Term
| What drugs are widely used in patients with a low cardiac output that persist despite adequate fluid replacement and correction of electrolyte imbalance? |
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Definition
| adrenergic catecholamines: dobutamine, dopamine, epinephrine, norepenephrine |
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Term
| In hypotension and shock, what type of drugs would be used to increase peripheral vascular resistance and raise blood pressure? |
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Definition
| Drugs with alpha-adrenergic activity (e'g' norephynephrine) |
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Term
| A patient who is in anaphylactic shock presents to the emergency room. The nurse should anticipate the drug of choice for this type of shock would be |
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Definition
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Term
| What is the overall goal in treatment of hypotensioin and shock? |
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Definition
-Restore & maintain adequate tissue perfusion, especially to vital organs.
to maximize oxygen delivery to the tissues by maintaining vascular volume and optimal hemoglobin levels. |
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Term
| A patient in cardiogenic shock is started on dobutamine (doubutere. Doubutamine 10mcg/kg/min IV. What effect should the nurse expect after beginning drug therapy? |
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Definition
| Increased cardiac output through stimulation of beta 1 receptors |
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Term
| Vasopression drugs are less effective in what conditions? |
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Definition
| inadequate blood volume, electrolyte abnormalities, and acidosis |
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Term
| What is usually the cardiotonic agent of choice in critically ill patients? |
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Definition
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Term
| During administration of dopamines, a patient complains of pain at the infusion site. The nurse should recognize that the... |
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Definition
| medication should be stopped, phentolamine should be infused, and the infusion site should be changed. |
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Term
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Definition
-Overwhelming infection
massive vasodilation release of mediators of the inflammatory process in response to overwhelming infection due to bacterial infection. Requires antibiotic therapy in addition. |
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Term
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Definition
-Spinal Cord injury
Massive vasodilation caused by suppression of the sympathetic nervous system.
*Treated with crystalloids and colloids. |
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Term
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Definition
-Allergic reaction
massive vasodilation caused by release of histamine in response to allergic reaction.
*1st drug of choice is EPINEPHRINE |
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Term
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Definition
Loss of intravascular fluid due to
*blood loss or fluid shift (burns) |
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Term
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Definition
-clinical condition of insufficient perfusion of cells and vital organs causing tissue hypoxia.
-symptoms depend on degree of impaired perfusion |
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Term
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Definition
-Oliguria, HF, mental confusion
-Cool extremities, coma, tachycardia than bradycardia |
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Term
| Most people in shock are hypotensive when the BP is? |
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Definition
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Term
| What classifications of drugs are used to treat antishock? |
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Definition
Primarily adrenergic drugs
Alpha adrenergic
Beta adrenergic |
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Term
| Guideline of management of antishock drugs are |
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Definition
-Max 02 delivery to tissues
-Administer volume replacement based on type of shock involved
-blood producs
-crystalloids & colloids
-meds used after initial fluid resuscitation |
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Term
| Norepinephrine (Levophed) |
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Definition
-Stimulates alpha adrenergic receptors
-increase BP by vasoconstriction
-Stimulates beta 1
-increases HR, force of myocardial contractility
-Caution reduce renal blood flow |
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