NURS 287 Lecture Notes - Ventricular Assist Device, Hypovolemia, Thrombolysis
28 Apr 2013
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Document Summary
Overall goal is to restore blood flow to the myocardium by restoring the balance between oxygen supply and demand. Definitive measures include thrombolytic therapy, angioplasty with stenting, emergency revascularization, and valve replacement. Care involves hemodynamic monitoring, drug therapy (e. g. , diuretics to reduce preload), and use of circulatory assist devices (e. g. , intraaortic balloon pump, ventricular assist device). The underlying principles of managing patients with hypovolemic shock focus on stopping the loss of fluid and restoring the circulating volume: fluid replacement is calculated using a 3:1 rule (3 ml of isotonic crystalloid for every. Patients in septic shock require large amounts of fluid replacement, sometimes as much as 6 to 10 l of isotonic crystalloids and 2 to 4 l of colloids, to restore perfusion. Hemodynamic monitoring and arterial pressure monitoring are often necessary. Vasopressor drug therapy may be added and vasopressin may be given to patients refractory to vasopressor therapy.
