shock stages
what is the basic reason for shock??????
hypoxia
decreased oxygen perfusion to cell/tissues
name the 3 causes of obstructive shock
cardiac tamponade
pulmonary embolism
tension pneumothorax
MAIN CAUSE OF CARDIOGENIC SHOCK????
MI
warm sepsis / hyperdynamic sepsis symptoms
tachycardia
*bounding pulse
*warm/flushed skin
*febrile
bp may be normal
confused
decreased urine
what methods of oxygen used 4 shock
nonrebreather
mechanical vent
in the compensatory stage of shock WHAT acid - base imbalance occurs?????????
respiratory ALKalosis
"I.... can't.... breath.....alk" (dies)
name one type of medications should be used
extra credit : 2 types
anticoags (heparin, TNK, TPA)
and vasoconstrictors (dopamine, levophed)
levoFED UP W MY LOW BP
UNIQUE SYMPTOMS OF CARDIOGENIC SHOCK
CHEST PAIN
MOTTLED SKIN
N/V
PULMONARY EDEMA
SNAP CRACKLES POP RICE CRISPIES
cold sepsis/ hypodynamic sepsis symptoms
*cool/pale skin
weak/ thready pulses
*hyPOthermia
hypotension
tachy<3
lethargy/coma
anuria
what is distributive shock
AND
what types of shock are DISTRIBUTIVE ????????
Caused by something else like infection, shellfish, broken spine, etc.
SEPTIC
ANAPHYLACTIC
NEUROGENIC
how would one behave while in the compensatory stage of shock ????????
what about the progressive?????????
in the compensatory stage you would be restless, anxious, and confused
(glucose is increased in this stage so think - SUGAR RUSH)
in the progressive stage you would be lethargic, weak, or drowsy
(the condition progresses - u dyin)
DOUBLE JEOPARDY
DODO DODO DODO DODO DO
WHAT DO U ADMINISTER FOR HEMMORHAGIC HYPOVOLEMIC SHOCK
ANY NURSING INDICATIONS OR MANIFESTATIONS???
GIVE BLOOOD DUH
WATCH FOR HYPOCALCEMIA
CAN AFFECT <3 RHYTHM AND CONTRACTABILITY
WHAT TYPA MEDS <3
VASOPRESSORS
VASODILATORS
DUIRETICS
MORPHINE
CARDIAC GLYCOSIDES
IMPORTANT INTERVENTION B4 ANTIBIOTICS
CULTURE X2
AKA IN 2 PLACES !!!1
WHERE DOES ARDS start????
lungs baby!
what lab value should be monitored to show the progression of shock ?????
LACTATE
INCREASES W INCREASED ANAEROBIC ACTIVITY
HIGH = LESS OXYGEN
OBSTRUCTIVE SEPSIS PT WANTS TO GET UP AND GO PP (PP NOT IMPORTANT)
WHAT DO U MAKE SURE U DO
CHANGE POSITIONS SLOWLY R/T BRADY <3
WHAT ACID BASE IMBALANCE W CARDIOGENIC SHOCK ?????
METABOLIC ACIDOSIS
whats brown and sticky
a stick
what lactic acid level should freak u out
anything over 4
name at least 3 changes in the manifestations from compensatory to progressive
respiratory alkalosis -> R+M acidosis (pH drops)
HyperK (high potassium)
drowsy
edema
absent bowel sounds
anuria - no mo pee
worse hypoxia
TRICKED U THIS IS ACTUALLY A HYPOVOLEMIC SHOCK QUESTION
WHAT INTRAVENOUS ACCESS DO U NEED FOR A PT W HYPOVOLEMIC SHOCK
2 LARGE bore (like 18g) ivs
or central line
NURSING CARE FOR CADIOGENDIENDC SHOCK
OXYGEN duhhhhhhh
activity restrictions
to decrease cardiac workload / oxygen consumption
stages of DIC
(disseminated intravascular coagulopathy)
1st stage CLOTTING
2nd stage BLEEDING
-MONITOR H+H
what is a ventricular assistive device
I got no idea tbh
google says it squeezes ur testicles so u can perfuse to the rest of ya body