5 Written questions
5 Matching questions
- 3 requirements for adequate blood flow
- Use of dobutamine (Dobutrex) in cardiogenic shock
- symptoms of shock
- S/s of hypodynamic/cold phase of septic shock?
- What is cardiogenic shock characterized by?
- a 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.
- b 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.
- c Adequate cardiac pump
Sufficient blood volume
- d 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
- e DECREASED: CO, stroke volume, UO, ventricular emptying, tissue perfusion, blood pressure, LOC.
5 Multiple choice questions
- Extremes of age, Immunosuppression, Chronic illness, Malnutrition.
- 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.
- MASSIVE VASODILATION resulting in relative hypovolemia (3 divisions: anaphylactic, neurogenic, septic)
- monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
- vital signs, electrolyte imbalance, I&O, correct acidosis
5 True/False questions
septic shock → vasodilation d/t mediators of inflammatory process in response to overwhelming INFECTION - 40-70% mortality rate depending on organism.
oncotic 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
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.
3 organs most concerned about with shock → monitor HR, BP, LOC, urine output. Recognize early and manage to reduce chance of end-stage organ damage. Provide pt teaching regarding drug therapy.
What is anaphylactic shock characterized by? → Vasodilation, Capillary permeability, Bronchospasm