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Med Surg - Exam 2 > Shock & Sepsis > Flashcards

Flashcards in Shock & Sepsis Deck (19)
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1

Define shock.

When circulatory system is unable to supply adequate amounts of oxygen to the tissues.

2

What can result without immediate treatment of shock?

Organ system failure and death.

3

Define hypovolemic shock.

Rapid intravascular fluid loss resulting in inadequate circulating volume.

Examples: hemorrhage, severe GI or renal fluid loss (vomiting/diarrhea), burns.

4

Define cardiogenic shock.

Inadequate pumping ability of the heart muscle .

Examples: acute MI, severe heart failure, stroke.

5

Define obstructive shock.

Mechanical barrier to ventricular filling or emptying resulting in decreased cardiac output.

Examples: cardiac tamponade (chest trauma- pressure on the heart), pneumothorax, severe valvular disease, arterial stenosis.

6

Define distributive shock.

Vasodilation and poor vascular tone, results in venous pooling, decreased venous return to the heart and decreased intravascular volume.

Examples: anaphylaxis, sepsis, neurogenic or spinal shock

7

Define anaphylactic shock.

Life-threatening systemic hypersensitivity reaction.

(Distributive/hypovolemic shock)

8

What happens to the body during an allergic reaction?

Release of histamine-
< widespread vasodilation
> increased capillary permeability
< smooth muscle contraction

9

What are clinical manifestations for anaphylactic shock?

Respiratory distress: tachypnea, wheezing, stridor, cyanosis,hypoxia, airway edema, agitation and confusion.

Hypovolemia: tachycardia, hypotension, weak pulses, pale cap; and clammy skin.

Systemic: angioedema and urticaria.

10

What nursing management is needed for anaphylactic shock?

Removing trigger, if possible
Maintain airway (O2, incubation)
Prevent shock (IV fluids, CPR)
Prevent resurgence
Medications:
< antihistamines
< epinephrine
< bronchodilators
< leukotriene inhibitors
< steroids

11

What do antihistamines do?

Inhibit vasodilation and vascular permeability.

(Benadryl)

12

What does epinephrine do?

Vasoconstriction and relaxes smooth muscle

13

What does a bronchodilator do?

Relaxes smooth muscle

14

What does a leukotriene inhibitor do?

Deceased smooth muscle contraction

15

What do steroids do?

Decrease inflammation

16

Explain the process of septic shock.

Inflammation
Body unable to control infection
Vasodilation and increased capillary permeability
Cytokines damage blood vessels
Coagulation system is activated
Clotting factors are used up resulting in hemorrhaging
Multiple organ dysfunction
Death

17

List the clinical manifestations of the early phase of septic shock.

Tachycardia
Bounding pulses
Flushed skin
Fever
Increased WBC
Hypotension
Confusion
Decreased urine output

18

List clinical manifestations of the late phase of septic shock.

Tachycardia
Weak pulses
Hypothermia
Peripheral vascular collapse
Multiple organ failure

19

Nursing management for septic shock.

Thorough assessment of: neuro, cardio, respiratory and renal

Monitor labs: WBC, lactate, see rate, renal and LFTs

Hand washing
Aseptic technique
Airway
Oral care
IV fluids
Strict input and output
Teaching