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NUR 405 ( LATEST 2024 / 2025 ) SHOCK | A+ RATED GUIDE | QUESTIONS AND ANSWERS (SOLVED)
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NUR 405 ( LATEST 2024 / 2025 ) SHOCK | A+ RATED GUIDE | QUESTIONS AND ANSWERS (SOLVED)
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NUR 405 Shock1. shock
-life threatening
-results from inadequate tissue perfusion
-causes life threatening cellular dysfunction, HYPOtension, and oliguria
-can lead to multi-organ dysfunction and death
-affects all body systems
-INCREASED survival rate IF identified and treated within 3 HOURS
2. three stages of shock
-compensatory
-progressive
-irreversible
3. compensatory stage
-if caught at this stage - reversible
-BP within normal limits
-INCREASED HR, contractility, and vasoconstriction
-fight or flight response
-blood flow to brain, heart and lungs MAINTAINED
-LOW blood flow to skin, kidneys, GI tract
,-cool pale skin, HYPOactive bowel sounds, DECREASED urinary output
4. compensatory stage clinical manifestations and nursing care
-INCREASED RR results in compensatory respiratory alkalosis
-anxiety and confusion
-identify cause and treat
-oxygen
-fluid replacement and medications to maintain BP
-monitor LOC, UO, skin, VS, labs
-report bp <100 or drop >40mmHg or MAP<65mmHg, RR>22 and altered mental status
(less than 100, greater than 40, less than 65, greater than 22)
-early indicator
narrow pulse pressure (diastolic-systolic BP) should be 30-40mmHg
-maintain SvO2 of 70%
-lab values
Na and BG ELEVATED
-passive leg raises
-reduce anxiety of patient and family
-family presence
-advanced directives
-physician orders for life sustaining treatment (POLST)
, -promote safety
5. progressive stage
-compensatory mechanisms fail, MAP Below normal
-HYPOtension
sys bp less than 90mmHg or greater than 40mmHg drop from baseline and declining mental
status
-myocardial depression, inflammatory response activated, lactic acid build up
-chances of survival DEPEND on underlying HEALTH
-respiratory effect
-lung decompensation
rapid RR, shallow, crackles, LOW PaO2 and HIGH CO2, pulmonary edema (crackles), acute
lung injury, and ARDS
-cardiovascular effects
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