This pressor is usually added in conjunction with another pressor when the first failed to improve Bp. It works through stimulation of smooth muscle and an action in the kidneys. Must monitor BP, HR, UO, BUN & CR during admin. (also known as ADH)
Your patient has a radial graft post CABG. This drip is run for 6 hours post admin of the first PO dose then discontinued. It is a calcium channel blocker which prevents the new graft from spasming.
Your patient has a low BP and cardiac output which both need to be increased. His heart rate is 58 bpm. His SVR is low >800. Which Adrenergic can be given to increase contractility and heart rate, but may cause decreased peripheral circulation?
This vasopressor increased cardiac output by acting on alpha and beta receptors. It causes vasoconstriction and has inotropic effects that increase cardiac output. It must be administered in a central line because infiltration will cause necrosis.
Your patient has an increased SVR, >1200, but still has a low C.O. and C.I. <1.5. Which vasopressor would give the appropriate positive inotropic affect while at the same time lowering the SVR?
This is often used as a first line pressor in the CVICU. It is a beta 1 & 2 agonist causing cardiac and CNS stimulation. It may cause metabolic acidosis and tachyaryrhithmias. BG must be monitored while administering this medication.
Verticales
Your patient returns to the CVICU from surgery and has an ACT of 138. What medication will you prepare to administer to your patient?
Your patient's blood pressure is 170/90 post CABG. You are worried about the high pressure blowing the new graft sites. What medication will you request from the surgeon? This medication can be started at 5 mg/hr and titrated based on ordered patient BP.
Patients return from surgery with this drip running. It is continued for 24 hours. It begins at 1 mg/min for 6 hrs then at 0.5 mg/min. The PO dose is started POD 1. It is given as a prophylactic to prevent A-fib.
This is typically a first line vasopressor, but not always in the CVICU. It increases contractility, heart rate, and coronary blood flow. It will increase AV not conduction and may cause A-fib to become more rapid.
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