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5 Written questions

5 Matching questions

  1. anaphylactic shock
  2. Medical management of septic shock
  3. Nursing interventions for shock
  4. oncotic pressure
  5. distributive 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 vasodilation d/t ALLERGIC REACTION causing release of HISTAMINE.
  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 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
  5. e MASSIVE VASODILATION resulting in relative hypovolemia (3 divisions: anaphylactic, neurogenic, septic)

5 Multiple choice questions

  1. Dilates vessels to enhance blood flow to the myocardium. Drug of choice for chest pain during MI.
  2. Loss of sympathetic tone (disruption of SNS)
    Skin warm and dry, decreasd BP, Decreased HR, Decreased Temperature.
  3. 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
  4. O2, control chest pain, selective fluid support, medications (dopamine, dobutamine, isoproterenol, norepinephrine, IV nitro)
  5. Limited to shock associated with slow HR and myocardial depression. Not a first line drug, used when pt not responsive to other meds.

5 True/False questions

  1. S/S of hyperdynamic/warm phase of septic shock?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.

          

  2. Use of norephinephrine (Levophed) 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.

          

  3. Nursing considerations for hypovolemic shockvital signs, electrolyte imbalance, I&O, correct acidosis

          

  4. S/s of hypodynamic/cold 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.

          

  5. 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

          

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