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5 Written questions

5 Matching questions

  1. 3 requirements for adequate blood flow
  2. Nursing interventions for shock
  3. Medical management of septic shock
  4. S/s of hypodynamic/cold phase of septic shock?
  5. mechanical support during cardiogenic shock
  1. a Adequate cardiac pump
    Effective vasculature
    Sufficient blood volume
  2. b intra-aortic ballon pump (IABP)
  3. c monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
  4. d 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
  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. vasodilation (lowers BP) and increased capillary permeability/leakage d/t cellular injury from bacterial toxins- lose fluid out of vasculature.
  2. a condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to support vital organs and cellular function- hypoxia
  3. Stabilization of spinal cord injury, positioning spinal anesthetic patient properly, giving glucose for hypoglycemia.
  4. MI, arrhythmias, valvular disease, cardiac surgery, cardiomyopathy.
  5. 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.

5 True/False questions

  1. Use of dobutamine (Dobutrex) in cardiogenic shockto 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.

          

  2. cardiogenic shockpump failure - 80-100% mortality rate

          

  3. Medical management of hypovolemic shockTreat underlying cause (may need surgery),
    Fluid and blood replacement (colloids-albumin; crystalloids (NS and LR)
    Redistribution of fluid - modified Trendelenburg
    Medications - dopamin (Intropine) & dobutamine (Dobutrex) (only if adequate intravascular fluid)

          

  4. Nursing considerations for septic shockvital signs, electrolyte imbalance, I&O, correct acidosis

          

  5. medical management of cardiogenic shockO2, control chest pain, selective fluid support, medications (dopamine, dobutamine, isoproterenol, norepinephrine, IV nitro)

          

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