5 Written Questions
5 Matching Questions
- What are the EXTRINSIC precipitating factors for septic shock?
- S/s of hypodynamic/cold phase of septic shock?
- hypovolemic shock
- What is cardiogenic shock characterized by?
- Medical management of septic shock
- a 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
- b Invasive procedures, Drug therapy, Fluid therapy, Surgical and traumatic wounds, Immunosuppressive therapy.
- c DECREASED: CO, stroke volume, UO, ventricular emptying, tissue perfusion, blood pressure, LOC.
- d 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.
- e absolute volume loss or relative volume loss as with ascites (3rd spacing) - 10-31% mortality rate.
5 Multiple Choice Questions
- the 'pushing force', pushing the fluid out of the capillaries. It's the result of the actual pressure of the fluid on the capillary walls.
- monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
- 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.
- vasodilation d/t mediators of inflammatory process in response to overwhelming INFECTION - 40-70% mortality rate depending on organism.
- Adequate cardiac pump
Sufficient blood volume
5 True/False Questions
Shock → a condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to support vital organs and cellular function- hypoxia
Use of dobutamine (Dobutrex) in cardiogenic shock → 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
3 organs most concerned about with shock → brain, heart, kidneys (cells with high metabolic rates
What is contraindicated in ventricular tachycardia with cardiogenic shock → IABP
Use of isoproterenol (Isuprel) in cardiogenic shok → 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