Cheatography

# Complex Exam 2 Cheat Sheet (DRAFT) by vloneker

Hemodynamic monitoring

This is a draft cheat sheet. It is a work in progress and is not finished yet.

### Hemody­namics

 Hemody­namics: Hemody­namic Monito­ring:measur­ement of pressure, flow, and oxygen­ation within the cardio­vas­cular system. Monitoring is used to asses heart function, fluid balance, and the effects of fluids and drugs on cardiac output. Indica­tions for hemody­namic monitoring include: shock, sepsis, anaphy­laxis, MI with right/left ventri­cular failure, Hypo/H­ype­rte­nsion, Cardiac tamponade, ARDS, Post open heart surgery, fluid resusc­ita­tion, and evaluation of cardiac output Mean Arterial Pressure (MAP): the average pressure within the arterial system that is felt by organs in the body. Essent­ially how hard the blood is flowing when hitting the organs. Calcul­ating MAP 2xDias­tolic + Systolic = #. # divided by 3. Example: BP:120/60: 2x60+1­20=240. 240/3= 80. MAP of 80. Pulse Pressure: the difference between the systolic blood pressure (SBP) and diastolic blood pressure (DBP). Narrow­/de­cre­ased: shock state or HF- meaning insuff­icient preload leading to reduced cardiac output (CO). Wide/i­ncr­ease: occurs during exercise or in athero­scl­erosis- Increased ICP. Calcul­ating Pulse Pressure: SBP-DB­P=Pulse Pressure Stroke Volume: the amount of blood pumped by a ventricle with each beat. Calcul­ating Stroke Volume: Cardiac Output/ HR= stroke volume Cardiac Output: Amount of blood ejected from the heart into circul­ation each minute Calcul­ating Cardiac Output: HRxSV= Cardiac Output Cardiac Index: cardiac out that is adjusted for each individual based on the body surface area (BSA).
Ranges:
MAP: >60mm Hg. <65 needs to be addressed. <60 inadequate tissue and organ perfusion
Pulse Pressure: 40-60mm Hg
Stroke Volume: 60-150­mL/beat
Cardiac Output: 4-8L/min
Cardiac Index: 2.2-4L/min

### Autonomic Nervous System

 Autonomic Nervous System:ANS ANS consists of the Sympat­hetic Nervous System (SNS) and the Parasy­mpa­thetic Nervous System (PNS) SNS: this is the bodys' fight of flight. It controls blood flow by constr­icting the arteries throughout the body and increases blood pressure and blood flow. How does SNS work?: The body senses a low arterial pressure. The SNS is then stimulated to maintain CO. Norepi and epi (catec­hol­amies) is released. The receptors respond the the norepi and epi by increasing the HR, contra­cti­lity, and conduction (chron­otr­opic, inotropic, dromot­ropic effects). This then increases myocardial oxygen demand. SNS Effects: Chrono­tropic- increases the rate. Inotropic- increases the contra­cti­lity. Dromot­ropic- cardiac conduc­tivity time. Chrono­tropic: responds to norepi­nep­hrine and epinep­hrine by increasing the HR. Inotropic: responds to norepi­nep­hrine and epinep­hrine by increasing the contra­cti­lity. Dromot­ropic: responds to norepi­nep­hrine and epinep­hrine by increasing the speed of conduc­tion. PNS: this is the bodys' rest and digest. It controls blood flow by dilating the arteries which decrease blood pressure and blood flow. How does PSN work? Happens after SNS response. It "­rev­ers­es" the SNS effects. Acetyl­choline is released which then decreases HR, conduction and irrita­bility. Stimulates the GI tract.