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16 Cards in this Set
- Front
- Back
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Dobutrex - Action
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Inotrope. > myocardial contractility. < ventricular filling pressures. Used in cardiogenic shock c/ severe systolic dysfunction & in septic shock c/ normal CO that is not meeting > metabolic demands.
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Dobutrex - Nursing Implications
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Correct hypovolemia. Do not administer in same line c/ NaHCO3. Admin via central line (infiltration leads to tissue sloughing). Monitor HR, BP (hypotension may worsen) & for tachydysrhythmias.
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Dopamine - Action
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Vasoconstrictor. Precursor to epinephrine & norepinephrine. > myocardial contractility. Improves HR, CO & BP
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Dopamine - Nursing Implications
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Used to improve hypovolemia in cardiogenic shock pts. Admin via central line & not in same line as NaHCO3. Monitor: tachydysrhythmias, peripheral vasoconstriction (paresthesias, coldness in extremities)
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Xigris - Action
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Anticoagulant effect. Inhibits factors Va/VIIIa. Profibrinolytic & antiinflammatory.
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Xigris - Nursing Implications
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Used for septic shock. Monitor for s/s of bleeding, Hg, platelets, PT & PTT
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Epinephrine - Action
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Low doses; B-adrenergic agonist. Cardiac stimulation, bronchial dilation, peripheral vasodilation. High doses: a-adrenergic agonist; peripheral vasoconstrictor.
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epinephrine - Nursing Implications
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Used for cardiogenic shock combined c/ afterload reduction & anaphylactic shock. Monitor HR, dyspnea, pulmonary edema, chest pain, dysrhythmias 2nd to > MVO2. Monitor for renal failure 2nd to ischemia.
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Norepinephrine - Action
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Vasoconstrictor. B1-Adrenergic agonist, a-adrenergic agonist, renal/splanchnic
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Norepinephrine - Nursing Implications
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Used in pts for cardiogenic shock p/ MI & septic shock. > vascular tone. Used for hypotension unresponsive to adequate fluid resuscitation. Admin via central line. Monitor for dysrhythmias.
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Neo-Synephrine - Action
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a-Adrenergic agonist Vasoconstriction; renal, mesenteric, splanchnic, cutaneous & pulmonary. > HR, BP/ SVR.
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Neo-Synephrine - Nursing Implications
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For neurogenic shock. Monitor for reflex bradycardia, HA, restlessness, renal failure 2nd to < renal blood flow. Admin via central line.
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Pitressin (Vasopressin) - Action
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ADH. nonadrenergic vasoconstrictor. > MAP, > urine output.
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Pitressin (vasopressin) - Nursing Implications
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Shock states (most commonly septic shock) refractory to other vasopressors. Usually administered low dose. Monitor hemodynamic pressures, urine output.
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Crystalloids; Normal Saline, Lactated Ringers
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> intravascular volume. Initial volume replacement in most types of shock. Monitor for fluid overload. LR should NOT be used in pts c/ liver failure.
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Colloids; Albumin, Hetastarch, Dextran
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Volume Expanders. Albumin & Hetastarch; do not use in cardiogenic or neurogenic shock.Hetastarch & Dextran; risk for bleeding.
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