Critical Care Flashcards
What are the phases of Shock
- Initial
- Hyperdynamic
- progressive
- Hypodynamic
It is the stage of shock characterized by hypoxia and anaerobic cell respiration leading to lactic acidosis
INITIAL
It is in the early or compensated stage of septic shock. Blood pressure may stil be within lnormal limits, but heart rate and temperature increase due to increased cardiac output and systemic vasodilation/
HYPERDYNAMIN
Occurs in all types of shock — characterized by by decreased cardiac output, hypotension, and anasarca (generalized edema). During this stage, compensatory mechanism begin failing to meet tissue metabolic needs.
Progressive (stage of Shock)
This is the final/irreversable phase — characterized by decreased cardiac output, decreased blood pressure, and vasoconstriction.
Hypodynamin
What are the treatment for septic shock
- Dopamine: first line in shock - used in trauma clients and cold
- Phenylephrine: second line - vasoconstriction = increased BP
- Vasopressin: third line
occurs in the early or compensated stage of septic shock. In this phase, the blood pressure may still be within normal limits, but the heart rate and temperature increase due to increased cardiac output and systemic vasodilation. During this phase, nursing interventions include intravenous fluids to increase the peripheral vascular resistance and administration of prescribed antibiotics as soon as possible. Addressing septic shock appropriately at this stage significantly improves the outcomes.
The hyperdynamic phase
occurs in all types of shock and is characterized by decreased cardiac output, hypotension, and anasarca (generalized edema). During this stage, the compensatory mechanisms begin failing to meet tissue metabolic needs. Elevated catecholamine production increases peripheral vascular resistance as the body attempts to shunt blood away from non-vital organs (gastrointestinal tract, kidneys, muscle, and skin) to the vital organs (brain and heart ). This phase is also described as a cold shock.
The progressive stage
the final/irreversible phase of septic shock, characterized by decreased cardiac output, decreased blood pressure, and vasoconstriction. At this stage, the shock becomes unresponsive to therapies and hence, fatal.
The hypodynamic phase
● Tube inserted in the nare that terminates in the
stomach
● Uses
○ Enteral nutrition ○ Decompression ○ Medication administration ○ Removal of stomach contents after an overdose
Nasogastric tube
● Tube inserted into the pleural space of the lungs
● Helps to remove air or fluid that has caused the lung to collapse
● Also placed after cardiac surgery into the pericardial space to help drain
blood and fluid from around the heart
Chest tube
Why would our client need a chest tube?
Pneumothorax
Effusions (pleural)
Abscess
Cancer (lung)
Hemothorax
● There is something in the pleural space….and we need to get it out
○ Air - pneumothorax ○ Fluid - pleural effusion ○ Blood - hemothorax
● This allows the lung to fully expand
What to expect in Drainage Colelction Chamber
NO TIDALING
Normal: serosanguinous (pink) drainage
No bubbling
What to expect in the Water Seal Chamber
Fluid level moves up and down - “tidaling”
Intermittent bubbling
What to expect in Suction Control Chamber
No tidaling
Monitor level, replace with sterile water as needed
Gentle bubbling
