Release of catecholamines --- (epinephrine& Congestion of the blood into the R side of the heart
norepinephrine)
Backflow to the systemic circulation ---- Manifestation:
Vasoconstriction --- (especially in the kidneys) Increase preload and afterload Edema
Increase ICP Ascites
Renal perfusion Increase stress on the ventricular wall Anorexia and nausea
Pump failure Jugular distention
Increase GFR “counterregulatory mechanism” dizziness
Decrease contractility
Oliguria Release of natriuretic peptide
Decrease CO Manifestation:
1) HYPOtension
Release of renin Vasodilation 2) TACHYcardia
Pump failure 3)
4)
TACHYpnea
Altered hemodynamics
“angiotensinogen” Diuresis and natriuresis * NPA: systolic = 20-30mmHg
Diastolic: = 8-12mmHG
“cardiogenic shock”
Angiotensin I Increase workload ---- *NPWCP: 8-12 mmHg ( L ventricular appears @ a
wedge between 14-18mmHg
*NCI= 2.5-4L/min/m2
ACE Decrease contractility
5) cold clammy skin
Dilation of ventricles
2) VASODILATOR THEREAPHY:
Nitroglycerin ( Tridil)
! adverse effe3ct may include worsening of
hypotension
3) DIURETIC THERAPHY:
! may cause hyponatremia, hypokalemia
and hypovolemia
NURSING INTERVENTION: