What's That Med? (Pharmacology)
isotonic fluid that is the gold standard for fluid resuscitation in client's with suspected infection who are at risk for circulatory collapse
.9% Normal Saline (NaCl)
monitor that traverses the superior vena cava and terminates at the right atrium to measure right heart preload; a low level may indicate a low volume state in distributive shock, whereas a high reading may indicate high volume/backup associated with cardiogenic or obstructive shock
central venous pressure monitor
formula used to calculate the amount of fluid to give a major burn victim
Parkland formula = 4mL x %TBSA x kg
serum level that is closely monitored to determine development of metabolic acidosis in suspected sepsis/shock
lactic acid
immediate nursing intervention for a patient with an inhalation burn
secure the airway/prepare for intubation
type of preferred antibiotic coverage utilized for clients with sepsis while awaiting culture results
broad spectrum antibiotics (i.e. piperacillin-tazobactam (Zosyn) and/or Vancomycin)
marked by the failure of compensatory mechanisms to maintain adequate blood pressure and circulating fluid volumes; extensive shunting of blood to vital organs, which results in decreased blood flow to the periphery
progressive stage of shock
procedure used to assess the extent of respiratory injury in clients with burns
bronchoscopy
electrolyte imbalance commonly seen in the emergent phase of burns; occurs secondary to cell lysis associated with tissue injury
hyperkalemia
minimal first step and priority intervention if client is in severe hypoxia, experiencing respiratory distress, MAP decreases by 20mmHg or more, significant blood loss d/t trauma, CO poisoning
Apply O2 via 100% nonrebreather mask
medication that reduces gastric acidity and helps prevent stress ulcers in burn patients
proton pump inhibitors (i.e. pantoprazole/Protonix)
renal hormonal compensatory mechanism that responds to a decrease in blood pressure in an effort to induce vasoconstriction and promotes sodium and water reabsorption in the kidneys, which increases the circulating fluid volume
Renin-Angiotensin-Aldosterone System (RAAS)
the most definitive diagnostic test for sepsis
blood cultures
ABG typical of early shock states, associated with hyperventilation
respiratory alkalosis
priority intervention and foundation of treatment for hypovolemic shock
fluid resuscitation
medication used to maintain blood pressure and prevent circulatory collapse in clients with shock
vasopressors (i.e. norepinephrine)
hormone released by the posterior pituitary in response to decreased blood volume; acts on the kidney telling it to conserve water
antidiuretic hormone (aka, ADH or Vasopressin)
procedure necessary for burn patients with circumferential burns that impair circulation
escharotomy
serum level indicative of clot breakdown, typically elevated in shock
D-dimer
two interventions for disseminated intravascular coagulation (DIC) to combat bleeding and clotting cascade
1. Platelet transfusions if platelet count is critically low.
2. Fresh frozen plasma (FFP) to replenish clotting factors.
three types of medication administered to clients to treat significant hyperkalemia
Calcium gluconate, insulin with dextrose, or sodium bicarbonate
mechanism of vasodilation occurring in septic shock
Bacterial toxins trigger an inflammatory response, releasing cytokines and nitric oxide, which cause widespread vasodilation and decreased systemic vascular resistance, impairing perfusion
mechanical device used to support the heart in patients with severe cardiac conditions, such as cardiogenic shock or heart failure; inflaties and deflates in the aorta to improve coronary blood flow and reduce the heart's workload
intra-aortic balloon pump (IABP)
average pressure in a patient’s arteries during one cardiac cycle and is a key indicator of tissue perfusion; a reading of at least 65mmHg is necessary for sufficient perfusion
mean arterial pressure (MAP)
monitoring for this includes the progressive failure of two or more organ systems, leading to significant clinical deterioration, typically characterized by altered organ function, such as respiratory failure, cardiovascular instability, renal impairment, and hepatic dysfunction
multi-organ dysfunction syndrome (MODS)