Kaplan General Flashcards
1
Q
Shock
A
** Sudden reduction of oxygen and nutrients **
May be due to failure of the
- flow (fluid volume; hypovolemic shock);
- pump (decreased cardiac output; cardiogenic shock); or
-
pipes (inadequate vascular tone; distributive shock; neurogenic shock)
- Spinal injury leads to massive vasodilation and pooling of blood in vessels (tissue hypoperfusion_
Nursing Considerations (basic ABCs):
- Maintain airway and oxygenation
- Increase tissue perfusion (fluid volume)
- Maintain systolic BP >90
Medications:
- To vasoconstrict and improve myocardial contractility (vasopressors & positive inotropes)
- To maintain adequate urine output (e.g. mannitol, Lasix)
- To treat infection (septic shock)
- Corticosteroids (septic shock)
2
Q
Autonomic Dysreflexia
(Autonomic Hyperreflexia)
A
Manifestations:
- Sudden onset w/ severe, throbbing headache
- Severe hypertension and bradycardia
- Flushing above level of spinal injury
- Pale extremities below level of injury
- Nausea, dilated pupils, sweating, goosebumps
Generally occurs after spinal shock resolves and with injuries above T6
Neurological emergency
Triggered by noxious stimulus most often a distended bladder or constipation
Nursing Considerations
- Raise HOB
- Loosen tight clothing
- Check for bladder distention or other noxious stimulus
- Administer an antihypertensive
3
Q
Spinal Shock
A
Complete but temporary loss of motor, sensory, reflex, and autonomic function that occurs immediately after injury
Lasts from 48hrs to a few weeks
Manifestations
- Flaccid paralysis
- Loss of reflec activity below the level of th einjury
- Bradycardia
- Hyupotension
- Paralytic ileus
