5 Written questions
5 Matching questions
- medical management of cardiogenic shock
- Use of dobutamine (Dobutrex) in cardiogenic shock
- What is septic shock characterized by?
- What is contraindicated in ventricular tachycardia with cardiogenic shock
- What are the INTRINSIC precipitating factors for septic shock
- a 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
- b O2, control chest pain, selective fluid support, medications (dopamine, dobutamine, isoproterenol, norepinephrine, IV nitro)
- c Extremes of age, Immunosuppression, Chronic illness, Malnutrition.
- d vasodilation (lowers BP) and increased capillary permeability/leakage d/t cellular injury from bacterial toxins- lose fluid out of vasculature.
- e IABP
5 Multiple choice questions
- 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
- a condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to support vital organs and cellular function- hypoxia
- 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.
- 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 True/False questions
S/S of hyperdynamic/warm phase of septic shock? → 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.
hypovolemic shock → pump failure - 80-100% mortality rate
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.
3 requirements for adequate blood flow → O-negative
Two symptoms common to all types of shock? → 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.