5 Written questions
5 Matching questions
- symptoms of shock
- Medical management of septic shock
- S/s of hypodynamic/cold phase of septic shock?
- Medical management of anaphylactic shock
- Sequence of events for hypovolemic shock
- a Remove causitive agent.
Order of TX:
Epi IV to provide vasoconsrictive action and bronchodilation
Diphenhydramine (Benadryl) IV to reverse histamine effectsa
Nebulized albuterol (Proventil) to reverse histamine-induced bronchospasm.
Oral steroid such as methylprednisolone (Solumedrol) for longer lasting antiinflammatory effects.
- b Id and treat infection (usually Gram neg); eliminate potential sources of infection (remove and culture all lines and tubes, restart lines at different sites); Start broad spectrum abx-usually 3rd generation cephalosporin and an aminoglycoside, until C&S reports are received. Change abx according to organisms to a more specific/less toxic abx.; fluid replacement; aggressive nutritional support
- c mental confusion, depression, apathy, oliguria, heart failure (low CO), tachycardia (report HR >100/min), thready pulse, thirst, restlessness, anxiety, lethargy, cool extremities, pale skin, frequently hypotension (report BP <90), fainting, syncope rapid, shallow breathing (body trying to get more O2), metabolic acidosis, coma.
- d 1. Decreased circulating volume 2. decreased venous return 3. decreased stroke volume, 4. decreased CO, 5. decreased cellular oxygen supply, 6. impaired tissue perfusion,
7. impaired cellular metabolism.
- e Further increased HR; Further decreased BP; Increased pulse; decreased CO; cool, mottled skin; further increased respirations;
decreased urine output; Decreased temperature/subnormal, low WBC count with many immature cells.
5 Multiple choice questions
- Drug of choice for cardiogenic shock because does not cause vasoconstriction but increases strength of contractions, improves stroke volume and CO. Minimal increase in HR. has a half-life of 2 minutes, given as an IV infusion drip, dosed in mcg/kg/min. only give in the ICU
- also called 'colloid osmotic pressure', is the 'pulling force', pulling fluids from the surrounding tissue into the capillaries. It's the result of a difference in the concentration of solutes in the fluid inside the capillaries as opposed to outside them
- Severe allergic reaction in a patient who has previously been exposed to an allergen. Ie. contrast dyes, drugs, insect bites, foods such as peanuts.
- monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
- brain, heart, kidneys (cells with high metabolic rates
5 True/False questions
what is the universal blood type → MASSIVE VASODILATION resulting in relative hypovolemia (3 divisions: anaphylactic, neurogenic, septic)
Nursing concerns for neurogenic shock → VS, elastic compression stockings, HOB elevated 30 degrees.
Use of isoproterenol (Isuprel) in cardiogenic shok → Limited to shock associated with slow HR and myocardial depression. Not a first line drug, used when pt not responsive to other meds.
Nursing considerations during cardiogenic shock → vital signs, electrolyte imbalance, I&O, correct acidosis
mechanical support during cardiogenic shock → intra-aortic ballon pump (IABP)