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5 Written Questions

5 Matching Questions

  1. What are the EXTRINSIC precipitating factors for septic shock?
  2. S/s of hypodynamic/cold phase of septic shock?
  3. hypovolemic shock
  4. What is cardiogenic shock characterized by?
  5. Medical management of septic shock
  1. 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
  2. b Invasive procedures, Drug therapy, Fluid therapy, Surgical and traumatic wounds, Immunosuppressive therapy.
  3. c DECREASED: CO, stroke volume, UO, ventricular emptying, tissue perfusion, blood pressure, LOC.
    INCREASED: HR
  4. 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.
  5. e absolute volume loss or relative volume loss as with ascites (3rd spacing) - 10-31% mortality rate.

5 Multiple Choice Questions

  1. 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.
  2. monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
  3. 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. vasodilation d/t mediators of inflammatory process in response to overwhelming INFECTION - 40-70% mortality rate depending on organism.
  5. Adequate cardiac pump
    Effective vasculature
    Sufficient blood volume

5 True/False Questions

  1. Shocka condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to support vital organs and cellular function- hypoxia

          

  2. Use of dobutamine (Dobutrex) in cardiogenic shockDrug 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. 3 organs most concerned about with shockbrain, heart, kidneys (cells with high metabolic rates

          

  4. What is contraindicated in ventricular tachycardia with cardiogenic shockIABP

          

  5. Use of isoproterenol (Isuprel) in cardiogenic shokDrug 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

          

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