Zap
4 different types of shock?
SHOCK IS CHOD!
cardiogenic, hypovolemic, obstructive, distributive shock
First step to fixing distributive shock?
Fluid resuscitation
Which med can only be given through CVC or central line?
Norepi, can cause necrotic tissue if given IV
Why do we give ACE/ARBS to cardiogenic shock patients?
RAAS needs to be counteracted; RAAS > blood volume which is bad bc it just means the already failing heart has to pump against more fluid
EX: lisinopril/losartan will prevent ventricular remodeling
What alpha 1 agonist RAISES blood pressure?
Norepinephrine (levophed)
How will a patient present with HF?
edema, compensating mechanisms are in full swing
What is it called when a patient SNS/RAAS is not longer performing adequate perfusion and BP is low, HR is skyrocketing?
Decompensated shock, > mortality
What are signs of hypovolemic shock?
Hypotension and tachycardic
Type of cardiogenic shock when a patient is hospitalized because they no longer are managed by meds.
Decompensated shock
Why do we give neprilysin inhibitors to a cardiogenic shock patient?
To keep from natriuretic peptides from being broken down, they help the heart!
They < sodium which < blood volume, less for the heart to pump against
What do we administer for anaphylactic shock?
Epinephrine IM immediately
A burn victim has come in with what appears to be distributive shock. What is the nurses first step to fixing this?
Administer fluids like lactated ringers or saline fluid.
Type of cardiogenic shock when a patient is bale to operate day to day with management of meds?
Compensated shock
What will we observe in a patient with left sided heart failure?
Blood will back flow into lung, pulmonary edema
What potent Alpha 1, Beta 1 & 2 receptor agonist raises BP, HR, vascular resistance, cardiac index, and SV? Useful in profound refractory hypotension.
Epinephrine (Adrenalin)
What are the two types of distributive shock?
Septic and anaphylactic
A nurse has fluid resuscitated and the shock patient is still hypotension. What is the nurses next priority Action?
Administer vasopressors
What will we observe in patient with right sided heart failure?
Blood is back flowing into body, so you’ll see edema and distended neck arteries/veins
A patient has hemorrhaged and lots copious amount of blood. How will the nurse take the first steps in fixing this shock?
Replace blood with BLOOD
Why do we give loop diuretics to a cardiogenic shock patient?
To get rid of excess volume in body
What is it called when a patient’s SNS/RAAS is able to perform perfusion for a bit? (BP okay, heart rate is through the roof)
Compensated shock
What is the steps of administration for meds regarding shock?
Norepi, then epi, then vasopressors
Which shock is a complication of late stage HF?
Cardiogenic shock
Why do we give beta blockers to cardiogenic shock patients?
Undo SNS effects, SNS > HR and BP which isn’t optimal bc heart doesn’t have enough time to fill before contraction
Beta blockers <O2 demand and optimize CO, makes hearty more effective
Name some additional goals for our cardiogenic shock patients. (There is 3 meds to name)
1. Cardiac glycoside (Digoxin)- improves sqYeezy of heart; positive inotrope
2. PDE inhibitor (Milrinone)- TAKE ALONE!
3. Epi- not first line, but if patient is unresponsive to everything else; >HR, > contractility