DIC
The most common reason for DIC.
What is sepsis.
Acidosis and ketones are present.
What is DKA.
Cardiovascular disease, diabetes, hypertension, and obesity are examples of?
What are risk factors for chronic kidney disease.
Activation of inflammatory response, hypermetabolic state, and end-organ dysfunction and death may result.
What is response to shock.
When titrating a fentanyl IV drip when should you do a pain assessment?
Every two hours and 30 minutes after changing the rate.
Crush injury, muscle compression, electrical shock, and venom are all ______ causes of Rhabdomyolysis.
What are traumatic causes.
DIC is always secondary to _____.
Another problem.
pancreatitis, malignancy, heat stroke, surgery, hepatic failure, trauma, sever toxic reactions, sepsis.
Mortality rate is about 20% in patients that are in _____.
HHS (hyperosmolar hyperglycemic state)
Due to prolonged hypertension and diabetes the renal arteries become hardened, which is known as?
Nephrosclerosis.
These symptoms are for what stage of shock, rapid and shallow respirations, Crackles upon auscultation, tachycardia sometimes exceeding 150 bpm.
What is Stage 2 the progressive stage.
For this you must put in a nursing communication order and have the provider cosign.
if you initiate any IV medication above what is ordered to start or titrate at higher or lower.
Elevated potassium, irregular heartbeat or cardiac arrest are ______ of rhabdomyolysis.
What are complications.
Excessive bleeding from multiple sites, skin lesions (hematomas or jaundice) are ____.
Symptoms of DIC
Blood glucose greater than 600 mg/dL, weakness or paralysis that may be worse on one side of the body.
What are HHS symptoms.
Rapid loss of renal function due to damage to the kidneys, the categories include pre-renal, intra-renal, and post-renal.
What is acute kidney injury.
Given in all forms of shock to improve the hemodynamic stability when fluid therapy alone cannot maintain adequate MAP.
What are vasoactive medications.
Single dose Levophed (Norepinephrine)
What is the maximum dose of Levophed when you are giving micrograms/minute?
4mg/ 250 ml Normal Saline.
30mcg/min
what are treatments.
The fibrinogen, platelets, and hematocrit will be _______ in patients with DIC.
Decreased.
According to the American Diabetes Association (ADA) when should IV insulin be started.
Used with the goal to extract toxic nitrogenous substances from the blood and to remove excess fluid.
What is hemodialysis.
The most common type of shock, is a result of decreased intravascular volume.
What is hypovolemic shock.
When you are initiating or adjusting titratable drips you must be sure to ______ your order.
Alcohol or illegal drugs, medications, seizures are all forms of _______ causes of rhabdomyolysis.
What are nontraumatic causes.
Patients with DIC may have hypotension, oliguria, or acute kidney injury which are _______ of DIC.
complications.
Develops rapidly over 1-2 days (no insulin production)
What is DKA.
Remove toxins, waste, and excessive fluid from the blood
Leading cause of death in noncoronary ICU patients, the most common type of distributive shock.
Sepsis and septic shock.
What is the concentration of Vasopressin?
What do you mix it in?
20 Units/ 100 mL in Normal Saline.
Rhabdomyolysis is a toxic syndrome caused by a release of _______ from the skeletal muscle.
What is myoglobin.