Lets get Shocky
This is a leading cause of in-hospital death, the 11th cause of all deaths in the US and has a 23-50% mortality rate
What is,
Septic shock
Hypotension, Reflex bradycardia, Temperature dysregulation, Flushed skin
What are clinical manifestations of
neurogenic shock?
These two etiologic factors can lead to hypovolemic shock
What is hemorrhage and loss of body water (dehydration, burns, vomiting, diarrhea)
Shock will cause a ___________ in urine output?
What is,
Decrease
This medication is the first line treatment for anaphylactic shock?
What is
Epinephrine?
Name the most important extrinsic factor that can lead to sepsis
What is
aseptic technique?
Shock from inadequate circulating volume resulting in inadequate cardiac output to meet tissue oxygenation requirements.
What is
Hypovolemic shock?
Hypotension, Wheezing, Itching, Abdominal cramping / Diarrhea
What are clinical manifestations of
anaphylactic shock
A MAP of ____ is needed to adequately perfuse coronary arteries, the brain, and kidneys.
What is
>60 (60-70)
An insufficient amount of oxygen is referred to as this?
What is
hypoxia?
These medications are a first line of defense to restore cardiac function and maintain an adequate MAP?
What are
vasoactive drugs?
This management guideline provides evidence-based practices for treating sepsis and septic shock
What is
Surviving Sepsis Campaign (www.survivingsepsis.org)
These are the 2 most common causes of cardiogenic shock
What is
acute MI and cardiomyopathy
A patient in this stage of shock will have tachycardia, tachypnea, restlessness, and a normal blood pressure
What is
compensated
These 2 granulocytes are responsible for initiating the inflammatory reaction as seen in anaphylactic shock
What are
mast cells and basophils
What is the difference between systolic and diastolic blood pressure?
What is
pulse pressure? (normal 30-50 mmHg)
A patient taking this class of medication will not show tachycardia with shock
What are
beta blockers
No matter what type of shock, this must be done to resolve it
What is treat the underlying cause or correct the cause?
All types of shock may lead to this if the underlying cause of shock is not corrected
What is
Multiple Organ Dysfunction Syndrome (MODS) and death
This is a late vital sign indicator of shock decompensation
What is
hypotension?
In anaphylactic shock, a release of biochemical mediators (histamine, heparin, prostaglandins, cytokines) causes _________ and __________ which lead to edema and hypovolemia
What is
peripheral vasodilation and increased membrane permeability
The amount of blood pumped in 1 minute?
What is
cardiac output?
This medication may be used to treat bradycardia caused by the inhibition of baroreceptors in neurogenic shock
What is
atropine?
This can be used as a quick, noninvasive procedure to diagnosis cardiogenic shock
What is
echocardiography?
The 2 major causes of neurogenic shock
What is any disruption of the SNS with most common being spinal cord injury and spinal anesthesia?
3 physical findings to quickly assess perfusion
What is
capillary refill, skin temperature, and color
An increase in this biomarker signifies a bacterial infection and is used to guide antibiotic treatment
What is
procalcitonin
When the body temperature is dependent on the environment and is responsible for hypothermia for patients in neurogenic shock
What is
poikilothermic?
The time frame for starting broad spectrum antibiotics if sepsis is suspected
What is within
1 hour or less and AFTER blood cultures are drawn.
This is a priority nursing intervention for hypovolemic shock
What is establish 2 large bore IVs?
Regardless of the etiologic factors, death occurs from ________________ because of the failure of the circulation to meet the oxygen needs of the cell.
What is,
Ineffective Tissue Perfusion!!
Symptoms that a patient may complain of when in shock (list 4)
What is
nausea, thirst, weakness, fear, anxiety, dizziness
Adequate delivery of oxygen to tissues are dependent on these three factors
What is
Pulmonary gas exchange (ventilation and oxygenation), cardiac function (CO, contractility, MAP), hemoglobin (carries O2).
This is a byproduct of hypoxic anaerobic metabolism and should be drawn within three hours once sepsis is suspected.
What is
serum lactate
(blood cultures are also needed within 3 hours)
The class of medications that strengthen the force of the heartbeat (contractility)
What are
Postive Inotropes
This is the #1 way to prevent any type of shock
What is identify patients at risk, thorough assessment, notice trends in vital signs and labs