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5 Written questions

5 Matching questions

  1. symptoms of shock
  2. Medical management of septic shock
  3. S/s of hypodynamic/cold phase of septic shock?
  4. Medical management of anaphylactic shock
  5. Sequence of events for hypovolemic shock
  1. 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.
  2. 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
  3. 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.
  4. 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.
  5. 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

  1. 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
  2. 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
  3. Severe allergic reaction in a patient who has previously been exposed to an allergen. Ie. contrast dyes, drugs, insect bites, foods such as peanuts.
  4. monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
  5. brain, heart, kidneys (cells with high metabolic rates

5 True/False questions

  1. what is the universal blood typeMASSIVE VASODILATION resulting in relative hypovolemia (3 divisions: anaphylactic, neurogenic, septic)

          

  2. Nursing concerns for neurogenic shockVS, elastic compression stockings, HOB elevated 30 degrees.

          

  3. Use of isoproterenol (Isuprel) in cardiogenic shokLimited to shock associated with slow HR and myocardial depression. Not a first line drug, used when pt not responsive to other meds.

          

  4. Nursing considerations during cardiogenic shockvital signs, electrolyte imbalance, I&O, correct acidosis

          

  5. mechanical support during cardiogenic shockintra-aortic ballon pump (IABP)

          

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