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5 Written questions

5 Matching questions

  1. medical management of cardiogenic shock
  2. Use of dobutamine (Dobutrex) in cardiogenic shock
  3. What is septic shock characterized by?
  4. What is contraindicated in ventricular tachycardia with cardiogenic shock
  5. What are the INTRINSIC precipitating factors for septic shock
  1. 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
  2. b O2, control chest pain, selective fluid support, medications (dopamine, dobutamine, isoproterenol, norepinephrine, IV nitro)
  3. c Extremes of age, Immunosuppression, Chronic illness, Malnutrition.
  4. d vasodilation (lowers BP) and increased capillary permeability/leakage d/t cellular injury from bacterial toxins- lose fluid out of vasculature.
  5. e IABP

5 Multiple choice questions

  1. 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
  2. a condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to support vital organs and cellular function- hypoxia
  3. 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.
  4. vasodilation d/t ALLERGIC REACTION causing release of HISTAMINE.
  5. 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

  1. 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.

          

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

          

  3. Use of isoproterenol (Isuprel) in cardiogenic shokLimited to shock associated with slow HR and myocardial depression. Not a first line drug, used when pt not responsive to other meds.

          

  4. 3 requirements for adequate blood flowO-negative

          

  5. 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.