Shock A clinical syndrome characterized by inadequate tissue perfusion that results in cellular, metabolic, and hemodynamic derangements.
Hypoperfusion -> leads to anaerobic metabolism (higher lactate acid level, send blood down on ice) Hypercoagulability (greater risk for clotting) Activation ...
NURS 460 Shock Review Questions and Answers Shock ✅A clinical syndrome characterized by inadequate tissue perfusion that results in cellular, metabolic, and hemodynamic derangements. Hypoperfusion -> leads to anaerobic metabolism (higher lactate acid level, send blood down on ice) Hypercoagulability (greater risk for clotting) Activation of the inflammatory response ✅similarities of different shock types Resuscitation ✅the process undertaken to restore adequate circulating blood volume and therefore tissue perfusion Hypovolemic Cardiogenic Distributive (massive vasodilation): - anaphylactic - septic - neurogenic ✅types of shock Compensate ✅older adults may be limited in their ability to _____ due to normal physiologic age related changes Glucose (if liver starts failing, glucose will drop) BUN/Cr (kidney function - Cr best indicator) Sodium , potassium, chloride (key components in heart function) Lactacte (increases with anaerobic metabolism) CBC with diff (bleeding, infection) Bilirubin (liver function) Abgs (lung function and oxygenation) Cultures (infection, especially in septic shock) ✅important labs A systolic of 90 A map 65 ✅adequate perfusion must be at least... Vasoconstrictors/vasopressors - Dopamine - Norepinephrine - Vasopressin Vasodilators (if pressure can tolerate, decreases work effort of heart) - Nitroglycerine - ACE Inhibitors Inotropic Agents (cardiogenic) - Dobutamine Antibiotics (septic) ✅medications for shock Hypovolemic shock ✅the circulating volume (blood or fluid) is inadequate for the body's needs = the tank is not full External fluid loss (burn, severe dehydration, trauma) Internal fluid loss (GI bleed, fluid shift) ✅causes of hypovolemic shock Increased: HR, RR, hematocrit (if loss of fluid) Decreased: BP, U/O; cool, pale skin; mentation; flat neck veins, CO, CVP, hematocrit (if loss of blood) ✅clinical presentation of hypovolemic shock If you can feel radial pulse = at least 80 If you can feel femoral pulse = at least 70 If you can feel carotid pulse = at least 60 ✅estimating systolic blood pressure by pulse palpation Eliminate the cause Replace what is lost (need a good working IV) ✅resuscitation of hypovolemic shock Crystalloid ✅hypertonic, hypotonic, isotonic; saline or lactated ringers; add more fluid to the intravascular system; able to diffuse through capillary wall; 3:1 rule (3 ml for every 1ml of blood loss) Colloid ✅blood (gives patient hemoglobin), albumin, volume expanders; can't diffuse through capillary wall and stay in intravascular space Gravity (only basic fluids with no additive): just hang wide open, possibly with pressure bag Pump: highest you can set is 999 ✅How to give fluid bolus Get consent Start within 30 minutes of arrival and must be completed within 4 hours Monitor for reaction (most likely to occur in the first 15 minutes): back pain, fever, tachycardia, etc; stop transfusion if suspected; send back to blood bank 2 nurses check off Can run with NORMAL SALINE ✅How to give blood Cardiogenic shock ✅results when an inefficient heart cannot sustain adequate circulation
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller twishfrancis. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $8.99. You're not tied to anything after your purchase.
