Show:
Stages of Shock
SIRS
Sepsis
Septic Shock
MODS
100
Shock is defined as a generalized systemic response to what?
What is inadequate tissue perfusion.
100
SIRS is an abbreviation for what
What is systemic inflammatory response
100
Sepsis can best be defined as
What is a systemic response to infection
100
Septic shock can best be defined as
What is the presence of microorganisms in the blood
100
MODS can be described by:
What is the presence of altered organ function in an acutely ill patient, homeostasis cannot be maintained without interventions, involves progressive dysfunction or 2 or more organs, driven by SIRS
200
Septic shock belongs to this classification of shock states
What is distributive
200
SIRS is manifested by 2 or more of the following findings
What is Temp higher than 38 or lower than 36C, HR greater than 90, Resp Rate greater than 20/min or PaCO2 32mmHg, WBC greater than 12,000 or less than 4000 or bands (immature WBC) increased by 10%
200
Severe sepsis is associated with what 3 potential findings
What is organ dysfunction, or hypotension or hypo-perfusion
200
What 2 phases are associated with septic shock and what are the defining characteristics of each phase
What is high output (massive vasodilation), low output (sympathetic response)
200
MODS is characterized by 3 physiological changes which result in ischemia and organ damage. These changes are
What is mal-distribution of circulating volume, imbalance with oxygen supply and demand, alterations in metabolism
300
In the initial stage of shock the patien's cardiac output is decreased leading to what acid base imbalance
What is metabolic (lactic) acidosis
300
Which of the SIRS criteria can be due to walking up a flight of stairs
What is HR greater than 90, Resp Rate greater than 20 breaths/min
300
The perfusion abnormalities associated with severe sepsis lead to what type of acid base imbalance
What is lactic acidosis
300
During the high output phase thenurse assessing the patient would expect to see what demodynamically?
What is SVR <, CO>, Hypotension,
300
The nurse caring for the patient knows that her assessment findings will reveal signs and symptoms consistent with ARDS within what time frame following the initial insult
What is occurs within 24-72 hours after initial insult
400
In this stage the shock state progresses and individual organs die leading to MODS
What is refractory
400
The vascular endothelial instability associated with SIRS results in what type of shock?
What is hypovolemic
400
The primary ND for the septic patient is
What is inadequate oxygenation or inadequate perfusion
400
During the low output phase the nurse assessthe patient would expect to see what hemodynamically?
What is SVR,
400
The nurse caring for the patient with MODS includes the following nursing intervention to prevent bacterial translocation related to GI failure
What is frequent oral care
500
In the progressive stage of shock irreversible cell damage & auto-digestion occurs due to
What is the inability of cells to use the oxygen being delivered
500
For the patient who is experiencing SIRS and unable to take oral nutrition the preferable route to provide nutrition is
What is enteral feeding
500
Severe can be thought of as a TRIAD of
What is systemic inflammation, coagulation, impaired fibrinolysis
500
Nursing care of the patient in septic shock would include
What is prevention of infection, early identification of patients at risk, early identification of clinical s/s of sepsis
500
The nurse caring for and developing the plan of care for the patient in the hypermetabolic phase knows that adequate nutrition should be initiated in what time frame
What is 24 hours of the initial insult