Exam 2 Study Guide PDF

EXAM 2 STUDY GUIDE - MEAN ARTERIAL PRESSURE (MAP) \- The number in parenthesis \- Normal range is 70-105 \- Less than 60= inadequate organ perfusion \ [\$\$\\text{𝑀𝐴𝑃} = \\frac{2 \\cdot \\text{𝐷𝐵𝑃} + \\text{𝑆𝐵𝑃}}{3}\$\$]{.math.display}\ MAP Practice: What is the MAP if the patient has a BP...

EXAM 2 STUDY GUIDE - MEAN ARTERIAL PRESSURE (MAP) \- The number in parenthesis \- Normal range is 70-105 \- Less than 60= inadequate organ perfusion \ [\$\$\\text{𝑀𝐴𝑃} = \\frac{2 \\cdot \\text{𝐷𝐵𝑃} + \\text{𝑆𝐵𝑃}}{3}\$\$]{.math.display}\ MAP Practice: What is the MAP if the patient has a BP of 70/50mmHg? Are their organs adequately perfusing? \ [\$\$\\text{𝑀𝐴𝑃} = \\frac{2 \\cdot 50 + 70}{3} = 56\$\$]{.math.display}\ Whatis the MAP if the patient has a BP of 190/105mmHg? Are their organs adequately perfusing? \ [\$\$\\text{𝑀𝐴𝑃} = \\frac{2 \\cdot 105 + 190}{3} = 133\$\$]{.math.display}\ - CARDIAC INDEX (CI) -CI tells us if QT is adequate for the size of our patient -Bigger patients need a higher QT \ [\$\$\\text{𝐶𝐼} = \\frac{\\text{𝑄𝑇}}{\\text{𝐵𝑆𝐴}}\$\$]{.math.display}\ \- QT is in L/min \- BSA is in m2 -Normal range is 2.5-4.0 L/min/m2 CI Practice: If a patient has a QT of 6Lpm and a BSA of 3m2. What is the CI? \ [\$\$\\text{𝐶𝐼} = \\frac{6}{3} = 2\$\$]{.math.display}\ If a patient has a QT of 8.5Lpm and a BSA of 3m2. What is the CI? \ [\$\$\\text{𝐶𝐼} = \\frac{8.5}{3} = 2.8\$\$]{.math.display}\ - CARDIAC OUTPUT (QT) -The amount of blood pumped out of the L ventricle in one min -QT=SV\*HR -Stroke Volume (SV) -60-130ml/beat -Heart Rate (HR) -60-100bpm -Normal QT -4-8 Lpm at rest QT Practice: If stroke volume is 80ml and heart rate is 70 bpm. What is the cardiac output? Is it adequate? \ [→ ]{.math.display}\ If the patient has an SV of 60ml and HR of 50bpm. What is the QT? \ [→ ]{.math.display}\ - SYMPATHETIC NERVOUS SYSTEM -Releases NE -Increases electrical impulses -Increases heart rate -Effects all areas of the heart -Converts glycogen to glucose -Pupil dilation -Fight or flight - PARASYMPATHETIC NERVOUS SYSTEM -Releases ACH -Reduces electrical impulses -Decreases heart rate -Effects AV nodes -Pupil constriction -SLUDBB -Salivation, Lacrimation, Urination, Defecation, Bronchospasm, Bradycardia -Due to activation of the PNS - FACTORS THAT CAN INCREASE OR DECREASE HEART RATE -Decreases heart rate -Parasympathetic -Beta blockers -Vomiting -Bladder distension -Bearing down -Increases heart rate -Sympathetic -Nitrates -Vasodilator medication -Caffeine -Pain -Hypoxia -Anxiety -Sympathomimetics - SYSTOLE V DIASTOLE -Systole -The top number of BP -Normal range is 90-120mmHg -Semilunar valves open -AV valves close -Ventricles contract -Diastole -The bottom number of BP -Normal range is 60-90mmHg -Semilunar valves close -AV valves open -Ventricles relax - VENOUS SYSTEM -Muscles, liver, and kidneys receive the greatest amount of blood flow -Due to high metabolic demand -Acts as a reservoir of blood for the vital organs \ [∼ ]{.math.display}\ - VENOUS RETURN -The amount of blood returning to the right atrium each min -Venous return should =QT -As VR increases so does QT and vice versa - EJECTION FRACTION -EF=ESV/EDV -Normal is 65-70% -Considered to be reduced once it drops below 50% -Once less than 30%, exercise tolerance is severely limited -QT cannot be maintained - PRELOAD, AFTERLOAD, CONTRACTILITY -Preload -Ventricular stretch before contraction -Affected by: -Filling -Compliance -Venous return -End diastolic volume -Afterload -Resistance to ventricular emptying -Affected by: -PVR -Ventricular wall tension -Viscosity and volume of blood -Amount of vascular space available -Sum of all external factors opposing ventricular ejection -Contractility -Strength of ventricular contraction -When contractility increases or decreases, QT does as well -Increase is referred to as positive inotropism -Decrease is referred to as negative inotropism -Inotropism= modification of muscle contractility -Amount of force the myocardium produces during contraction - PULSE PRESSURE -The difference between systolic and diastolic -Normal range is 30-40mmHg \ [\