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62 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the most common type of shock?
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Bleeding
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18.4
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Shock
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An abnormal state associated with inadequate oxygen and nutrient delivery to the metabolic apparatus of the cells.
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18.31
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What is the crucial job of the cardiovascular system?
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Keep blood flow between the lungs and the peripheral tissue.
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18.4
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What is the chief waste product of metabolism?
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Carbon dioxide
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18.4
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What are the three parts require to keep the circulatory system intact?
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1) Function pump: The heart
2) Adequate fluid volume: The blood and body fluid 3) An intact system of tubing capable of reflex adjustments (constriction and dilation) in response to changes in pump output and fluid volume: The blood vessels |
18.4
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Heart size
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~ the size of closed fist- roughly 5" long 3" wide, and 2 and half" thick. Weighing ~10-12 oz in men and ~8-10oz in women.
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18.5
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How much of the heart is located in the left side of the mediastinum?
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~2/3
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18.5
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afterload
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The pressure in the aorta against which the left ventricle must pump blood. The greater the afterload the harder it is for the ventricle to eject blood into the aorta, reducing stroke volume.
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18.5
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stroke volume
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The amount of blood ejected per contraction.
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18.5
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cardiac output (CO)
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The amount of blood pumped throught the circulatory system in 1 minute, expressed in liters per minute L/min. CO=Pulse rate x stroke volume
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18.5
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starling law of the heart
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Discovered by Ernest Henery Starling, If a muscle stretched slightly before it is stimulated to contract, it would contract with greater force. Thus, if the heart is stretched, the muscle contracts with more force.
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18.5
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ejection fraction
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The portion of the blood ejected from the ventricle during systole.
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18.31
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Blood consist of...
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Plasma, and formed elements or cells suspended in plasma-RBCs, WBCs, and platelets.
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18.6
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Plasma
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A watery, straw-colored fluid that accounts for more than half the total blood volume. 92% water 8% dissolved substances such as chemicals, minerals, and nutrients.
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18.6
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RBCs
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Red blood cells also know as erythrocytes flow through plasma passively containing hemoglobin, a protein that contains the reddish color and binds oxygen from the lungs and transports it to tissues that need oxygen.
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18.6
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WBCs
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White blood cells, also known as leukocytes fight infection.
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18.6-7
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Platelets
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Small cells in blood essential for clot formation. During clotting platelets aggregate in a clump and form much of the foundation of a blood clot.
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18.7
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perfusion
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The circulation of blood within an organ or tissue in adequate amounts to meet the cells' current need for oxygen, and nutrients, and waste removal.
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18.7
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The brain and spinal cord cannot go for more than _____________ without perfusion or the nerve cells will be permanently damaged.
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4 to 6 minutes
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18.7
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How long before inadequate perfusion causes damage to the kidneys, skeletal muscle, and GI tract?
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Kidneys 45 mins
skeletal muscle 2 hrs GI several hrs |
18.7
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Why are colder organs able to resist damage from hypoperfusion?
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Slower metabolism
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18.7
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Hemorrhage
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Bleeding
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18.8
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S/S of internal bleeding
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MOI, discoloration and hemotoma (sometimes a late sign), pain or tenderness, development of tachycardia, decrease BP, guarding, swelling, and pallor.
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18.8
18.10 |
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~ Blood volume
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Accounts for 6 to 8% of total body weight and one pint of body weights ~1lb. ~70mL of blood per Kg in adult males. ~65mL of blood per Kg in adult females.
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18.9
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The body can easily compensate for a blood loss of?
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20% or less after that vital signs can be drastically effected.
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18.9
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Melena
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Dark, tardy, stools, indicating lower GI Bleed.
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18.10
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Hematochezia
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Stool contains bright red blood may indicate bleeding near the external opening of the colon.
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18/10
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SVR
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18.15
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Hypoperfusion
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When the level of tissue perfusion decreases below normal.
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18.15
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Baroreceptors monitor
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fluid volume and BP
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18.16
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initial compensatory mechanism
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Aim to increase preload, stroke volume, pulse rate, all usually resulting in an increase cardiac output.
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18.16
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Epinephrine improve CO by...
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increasing the pulse rate and strength.
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18.17
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Cardiogenic shock
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When the heart is unable to circulates sufficient blood to maintain adequate peripheral oxygen delivery. Expect fluid back up and possible arrthymias (especially too slow or too fast).
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18.17
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Obstructive shock
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When blood flow in the heart or great vessels becomes blocked.
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18.17
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Hypovolemic shock
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When the circulating blood volume does not deliver adequate oxygen and nutrients to the body. Two types exogenous being external, and endogenous being internal.
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18.17
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Burns can cause what type of hypovolemic shock?
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Endogenic
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18.18
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S/s of dehydration include
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Loss of appetite (anorexia), nausea, vomiting, fainting from standing position, poor skin tugor, weak and rapid pulse. Pulse rate may increase by 15 BPM when they stand.
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18.18
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Distributive shock
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When there is widespread dilation of the resistance vessels (small arterioles), the capacitance vessels (small venules), or both. Three types septic shock, neurogenic shock, and anaphylactic shock.
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18.18
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Septic shock
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A type of distributive shock with the presence of sepsis (infection) syndrome plus a systolic below 90mm Hg or a decrease from the baseline systolic of more than 40mm Hg.
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18.18
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Neurogenic shock
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A type of distributive shock usually from spinal cord injury, but is also cause by conditions that put pressure of the brain or spinal cord. Effects include loss of normal sympathetic nervous system tone and vasodilation, as vessels are cut from normal nerve supply.
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18.18
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spinal shock
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Local neurological condition that occurs immediately after a spinal injury producing motor and sensory loss which may or may not be permanent.
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18.18
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anaphylactic shock
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A type of distributive shock where the body reacts violently to a allergy causing widespread vascular dilation, resulting in relative hypovolemia, due to larger container.
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18.19
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angioedema
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Recurrent large areas of subcutaneous edema of sudden onset, usually disappearing within 24 hrs, which is seen mainly in young women, frequently as a result of allergy to food or drugs.
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18.30
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aerobic metabolism
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Metabolism that can proceed only in the presence of oxygen.
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18.30
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anaerobic metabolism
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Metabolism that takes place in the absence of oxygen.
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18.30
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Multiple-organ dysfunction syndrome (MODS)
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A progressive condition characterized by combined failure of several organs, such as the lungs, liver, and kidney, along with some clotting mechanisms, which occurs after severe illness or injury.
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18.20
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Primary vs secondary MODS
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Primary MODS is a direct result of an insult, such as pulmonary contusion from striking the chest on the steering wheel.
Secondary MODS encompasses the organ dysfunction that occurs as integral component to the host's response, such as renal failure following trauma. |
18.20
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MODS triggers...
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a massive systemic immune, inflammatory, and coagulation response, resulting in the release of numerous inflammatory mediators and activation of complement system, coagulation system, and kallikrein-kinin system.
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18.20
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S/S of MODS
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Hypotension, insufficient tissue perfusion, uncontrolled bleeding, and multisystem organ failure caused mainly by hypoxia, tissue acidosis, and severe local alterations of metabolism. May also have low-grade fever from inflammartory respones and are tachycardia, and dyspneic.
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18.21
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List the three phases of shock
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Compensated
Decompensated Irreversible |
18.21
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Compensated phase of shock
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-BP remain normal or slightly elevated
-Increase in rate and depth or respirations to bring more oxygen in and carbon dioxide out. -Narrowing pulse pressure -Positive orthostatic tilt test |
18.21
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Positive orthostatic
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When move from sitting to standing:
Increase in BPM by 20 beats/min or BP decrease of at lease 20mm Hg |
18.22
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Decompensated phase of shock
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Also known as uncompensated or progressive shock
-Can result from 30% or more blood loss -BP is falling -Blood shunts to the brain, heart and kidneys |
18.22
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In infants and children BP may maintian until they have lost than ______ of their blood volume.
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half
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18.22
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Irreversible phase of shock
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Also known as terminal stage.
-Can result in 40% or more blood loss -Low BP -Blood is shunt away from the liver, kidneys, and lungs to keep the heart and brain perfused. -Cells begin to die. -Even with recovery there will be permanent damage. |
18.22
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List some s/s of shock
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-The pt just does not feel right.
-Nausea and vomiting -Thirst -skin is pale cool and clammy -tachycardia -weak pulse -tachypnea -Decrease BP -Decrease state of consciousness -Decrease cap refill |
18.22
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Only elevate legs for shock when...
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not on a back board and no fractures are suspected. Elevate to 1 foot.
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18.24
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The presence of a radial pulse equates to systolic BP of...
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80 to 90 mm Hg, which is general sufficient to perfuse the brain and other vital organs.
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18.24
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Prevent body heat loss in shock by...
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covering with blankets, however do not overheat as that can cause vasodilation.
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18.24
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If you cannot obtain a radial pulse but can obtain a femoral pulse sytolic BP is probably...
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70 to 80 mm Hg.
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18.27
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Alpha Receptors
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Main effect is vasoconstriction BP.
Drugs that we give that act on A 1 and A 2 are Epi to increase HR and vasconstriction and Dopamine for vasoconstriction. |
Notes
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Beta Receptors
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Control (relax) of smooth muscle and airway, bronchodilators.
Meds we give include A and A. |
Notes
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