5 Written questions
5 Matching questions
- Use of norephinephrine (Levophed) in cardiogenic shock
- Two symptoms common to all types of shock?
- What is contraindicated in ventricular tachycardia with cardiogenic shock
- hypovolemic shock
- Body's compensatory mechanisms for shock
- a Increased HR, vasoconstriction, activates renin angiotensin mechanisms, ADH increases, increase secretion of epinephrine and norepinephrine to increase BP and HR.
- b absolute volume loss or relative volume loss as with ascites (3rd spacing) - 10-31% mortality rate.
- c IABP
- d Vasoconstriction alpha 1 stimulator
- e mental confusion and oliguria
5 Multiple choice questions
- Spinal cord injury, Spinal anesthesia, depressant action of medications, lack of glucose (insulin reaction or shock), Severe pain.
- VS, elastic compression stockings, HOB elevated 30 degrees.
- monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
- O2, control chest pain, selective fluid support, medications (dopamine, dobutamine, isoproterenol, norepinephrine, IV nitro)
- Increased HR and pulse, Decreased BP; flushed skin; Increased respirations/hyperventilation; Restlessness and confusion; increased urine output; Increased temperature. Legs may feel cool and mottled.
5 True/False questions
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.
Nursing considerations for hypovolemic shock → I&O, VS (especially temp), labs.
Medical management of anaphylactic shock → 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.
hydrostatic pressure → also called 'colloid osmotic pressure', is the 'pulling force', pulling fluids from the surrounding tissue into the capillaries. It's the result of a difference in the concentration of solutes in the fluid inside the capillaries as opposed to outside them
symptoms 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.