Critical Care: Shock

Question 0

Communicating when Critically Ill?

Answer 0

1. Use a picture board

- It is very difficult to write so do not give pen and paper and ask them to write

Question 1

1st ICU

Answer 1

1. Came about in the 1950’s with the Iron Lung used to help with Polio outbreak

Question 2

Risk For Ending up in Critical Care

Answer 2

1. Lifestyle - dangerous behavior
2. Habits - smoking, drinking
3. Risk behaviors - street drug use
4. Age - older
5. Co-morbidities
6. Amount of medications someone takes
7. Health disparities - can’t afford to fix the problem

Question 3

MODS

Answer 3

1. Person who had an MI and has renal failure is in MODS

- Want the MODS to be reversible

Question 4

How to Assess Shock?

Answer 4

1. Any patient who has capillary refill >3 seconds should be assumed to be in shock until proven otherwise

Question 5

Compensated Vs Uncompensated Shock

Answer 5

1. Compensated has normal Blood Pressure

2. Uncompensated has low blood pressure

Question 6

Cardiogenic Shock

Answer 6

1. Seen after MI, cardiac surgery or cardiac defects

Question 7

Hypovolemic Shock

Answer 7

1. Lost fluid

- third spacing, diarrhea, bleeding, urinating

Question 8

Septic Shock

-Maldistrubution

Answer 8

1. third-spacing of fluid

Question 9

All Shock

-Treatment

Answer 9

1. All types of shock are treated w/ fluids (Isotonic) 0.9% NS / LR
2. Find the cause and stop the loss
3. Use CVP line to monitor and treat to total body volume
4. Use Antibiotics for Septic shock in addition to fluids
   - Rocephin (Peak:30min) Gentimycin (4hrs) Vanco (12hrs)

Question 10

Signs of SIRS

Answer 10

1. Fever or hypothermia
2. HR >90
3. RR >20
4. WBC >12000 or <4000
5. TREAT THE CAUSE