5 Written Questions
5 Matching Questions
- Sequence of events for anaphylactic shock
- distributive shock
- Medical management of anaphylactic shock
- cardiogenic shock
- What is anaphylactic shock characterized by?
- a Vasodilation, Capillary permeability, Bronchospasm
- b MASSIVE VASODILATION resulting in relative hypovolemia (3 divisions: anaphylactic, neurogenic, septic)
- c 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.
- d pump failure - 80-100% mortality rate
- e previous exposure to allergen with resulting antibody formation - exposure again to substance - develops a systemic antigen-antibody reaction - mast cells are provoked to release potent vasoactive substances, ie histamine or bradykinin - widespread vasoD and cap perm - Decreased venous return to heart - Decreased stroke volume - Decreased CO - Decreased BP - Decreased tissue perfusion - Respiratory arrest - Cardiac arrest - Death
5 Multiple Choice Questions
- Dilates vessels to enhance blood flow to the myocardium. Drug of choice for chest pain during MI.
- absolute volume loss or relative volume loss as with ascites (3rd spacing) - 10-31% mortality rate.
- to reverse low BP effect of nitroglycerin and morphine (MS) by elevating BP to perfuse vital organs. Causes peripheral vasoconstriction (alpha 1) and increases the force of contraction (beta 1 w/ IV fusion only). Potential to cause tachycardia.
- vasodilation d/t ALLERGIC REACTION causing release of HISTAMINE.
- 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 True/False Questions
Body's compensatory mechanisms for shock → mental confusion and oliguria
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.
What is contraindicated in ventricular tachycardia with cardiogenic shock → IABP
Nursing considerations for septic shock → vital signs, electrolyte imbalance, I&O, correct acidosis
Nursing considerations during cardiogenic shock → vital signs, electrolyte imbalance, I&O, correct acidosis