Stages of Shock
BP remains within normal limits. Vasoconstriction, increased heart rate, and increased contractility of the heart contribute to maintaining adequate cardiac output.
What is the compensatory stage (stage 1)?
widespread clotting and bleeding occur simultaneously. Ecchymoses (bruises) and petechiae (bleeding) may appear in the skin. Coagulation times (e.g., prothrombin time, activated partial thromboplastin time) are prolonged. Clotting factors and platelets are consumed and require replacement therapy to achieve hemostasis.
What is Disseminated intravascular coagulation (DIC)?
A state resulting from loss of sympathetic tone, causing relative hypovolemia
What is neurogenic shock?
The total osmolality is close to that of the ECF and do not cause cells to shrink or swell. When isotonic fluids are administered, they expand the ECF volume. Examples include 0.9% NS and D5W.
What are Isotonic Solutions?
Bubbling in the water seal chamber indicates this...
What is an air leak?
BP can no longer compensate, and the MAP falls below normal limits (clinically hypotensive) and the patient shows signs of declining mental status.
What is stage two, the Progressive Stage?
The altered function of two or more organs in an acutely ill patient such that interventions are necessary to support continued organ function may ensue, often resulting in patient death.
What is multiple organ dysfunction syndrome (MODS)?
Risk factors for this type of shock include Spinal cord injury, Spinal anesthesia, or the depressant action of medications.
What is neurogenic shock?
This solution is used to treat hypernatremia and other hyperosmolar conditions an example is 0.45% sodium chloride).
What is a hypotonic solution?
The chest tube drainage container should be stored
What is below the level of the chest?
Manifestations include normal blood pressure, anxiety, confusion, and increased RR (due to metabolic acidosis and raised levels of lactic acid).
What is stage one the Compensatory Stage?
Fluid resuscitation used to correct shock may lead to manifestations of this lung condition, which include dyspnea, weakness, fatigue, syncope, occasional hemoptysis, and signs of right-sided heart failure (peripheral edema, ascites, distended neck veins, liver engorgement, crackles, heart murmur).
What is pulmonary edema?
cytokine release syndrome and is often referred to as cytokine storm, results from a clinical insult that initiates an inflammatory response that is systemic, rather than localized to the site of the insult
What is systemic inflammatory response syndrome (SIRS)?
This fluid treats intracerebral edema or intraocular pressure and includes 3% NaCl and IV mannitol.
What is hypertonic solution?
These two settings on the ventilator will be high to support a patient with ARDS?
What are FiO2 and PEEP?
Manifestations of hypotension, rapid shallow respirations, tachycardia and possible arrythmias, sluggish blood flow, metabolic acidosis, coagulation system imbalance, and generalized hypoxemia.
What is stage two the Progressive Stage?
Frequent oral care with a toothbrush, aseptic suction technique, turning, elevating the head of the bed at least 30 degrees to prevent aspiration, and implementing daily interruption of sedation as prescribed to evaluate patient readiness for extubation helps to prevent this complication.
What is ventilator-associated pneumonia (VAP)?
Occurs when intravascular volume pools in peripheral blood vessels. This abnormal displacement of intravascular volume causes a relative hypovolemia because not enough blood returns to the heart, which leads to inadequate tissue perfusion.
What is Disruptive Shock (which includes septic shock, neurogenic shock, and anaphylactic shock)?
This fluid is a vascular expander commonly used as a temporary blood replacement until the correct type of blood is available for infusion. Examples include albumin and dextran.
What are Colloid solutions?
High tidal volumes during mechanical ventilation can lead to lung injury of alveolar rupture. This lung injury is called...
What is barotrauma?
Organ damage is so severe that the patient does not respond to treatment and cannot survive. Despite treatment, BP remains low. Renal and liver dysfunction, compounded by the release of biochemical mediators, creates an acute metabolic acidosis.
What is irreversible (or refractory) stage?
a variety of pulmonary and nonpulmonary insults to the lung; characterized by interstitial infiltrates, alveolar hemorrhage, atelectasis, refractory hypoxemia
What is Acute Respiratory Distress Syndrome (ARDS)?
Heart failure can lead to this type of shock ________, while hypersensitvity can lead to this type of shock ______
What is cardiogenic and anaphylactic shock?
Mineral ions dissolved in water. Examples include normal saline (0.9% NaCl), half normal saline (0.45% NaCl), and lactated Ringer’s solution (Plasma-Lyte).
What are Crystalloid solutions?
Before suctioning a ventilator patient or a patient with a trach the nurse must...
What is pre-oxygenation?