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himilayaneyes, MSN, APRN 8,705 Views

Joined Jul 4, '10. himilayaneyes is a ARNP. She has 'since 2008' year(s) of experience and specializes in 'Critical Care/Coronary Care Unit,'. Posts: 502 (44% Liked) Likes: 667

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  • Aug 31 '17

    Beta blockers as you know decrease the workload of the heart. They also as you say decrease afterload. This is going to be your best friend. CO = HR x SV. Cardiac output = Heart rate x Stroke Volume. Cardiac output = volume of blood pumped by heart per minute (liter/min). Stroke volume = volume of blood pumped from one ventricle per minute (usually left ventricle). Remember that stroke volume consists of preload, afterload, and contractility. If any of these three things are affected, it affects stroke volume....thus affecting heart rate and cardiac output. When one goes up, the other usually goes down. If stroke volume goes down, HR goes up. If beta blockers decrease afterload (resistance heart must work against to pump blood into periphery) and contractility, the blood pressure will decrease b/c you're vasodilating. Heart rate goes down, stroke volume (compensatory mechanism) goes up.

    However, the easiest way to think of it is that you know that beta-blockers affect the sympathetic nervous system which causes you to vasoconstrict and increase heart rate. If it's working against the SNS, it'll have the opposite effect..lower BP and lower HR. However, that formula I gave you is still good to know especially for the cardiac section of your med-surg class. Good luck.

  • Mar 15 '17

    Well that social worker sounds like she has nothing else to do. If she felt what you did was inappropriate, it would have been better for her to approach you. I don't work LTC for a reason...it's always the same stories from these LTCs. I know at the hospital, if I have a medication that isn't essential and a patient that's oriented. I'll give him the cup of meds to take and when I make my rounds to check up on him, the patient says they took their meds. If the patient is confused, well yeah I'll stand there and watch them take the meds. Even if you took a short cut...we all have at some point so I won't sit (type) here and throw stones at you. It would have been better for the social worker to approach you. Perhaps she should shadow a nurse for a bit to see what it is you actually do. However, I've noticed that some social workers will have problems with things nurses do...things they don't even really understand. There's NCLEX world and then there's the real world of nursing. Next time you see her, tell her "welcome to the real world."



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