Acute

Card Set Information

Author:
MarieElise
ID:
272253
Filename:
Acute
Updated:
2014-04-28 13:09:32
Tags:
acute
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Description:
fluid/electrolyte imbalances, shock
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  1. kind of shock from decreased body fluids
    Hypovolemic shock
  2. shock resulting from direct pump failure
    cardiogenic shock
  3. shock resulting from fluid shift away from vascular space
    distributive shock
  4. general description/cause of shock
    widespread abnormal cellular metabolism caused by insufficient oxygenation and tissue perfusion

    usually cardiovascular problem
  5. shock resulting from indirect pump failure + examples
    • obstructive shock
    • cardiac tamponade
    • pulmonary edema
    • thoracic tumors
  6. How does the body respond to shock?  Does this response differ depending on the kind of shock?
    All kinds manifest in the same way

    SNS makes adjustments --> stress response --> activation of endocrine and cardiovascular systems
  7. what is the first indication of shock?
    increased pulse rate
  8. Cardiac S/S of shock
    widespread vasodilation:

    • decreased CO
    • increased pulse rate
    • thready pulse
    • decreased or narrowed blood pressure
    • postural hypotension
    • flat veins in dependent positions
    • decreased peripheral pulses
  9. Respiratory S/S of shock
    • increased respiratory rate
    • shallow respirations
    • increased PaCO2
    • decreased O2
    • cyanosis (blue around mouth, nailbeds)
  10. early neuromuscular S/S of shock
    • anxiety
    • restlessness
    • increased thirst
  11. Late neuromuscular S/S of shock
    decreased LOC (lethargy --> coma)
  12. S/S of shock in kidneys
    • decreased output
    • increased specific gravity
    • sugar/acetone in urine
  13. Integumentary S/S of shock
    • cool-cold skin
    • pale, mottled, cyanotic
    • moist/clammy
    • dry mouth,paste-like coating
  14. GI S/S of shock
    • decreased motility
    • decreased bowel sounds
    • N/V
    • constipation
  15. 4 stages of shock
    • 1)  Initial
    • 2) nonprogressive
    • 3) progressive
    • 4) refractory
  16. interventions for hypovolemic shock
    • ensure airway
    • oxygen
    • head flat (or no more than 30 degrees), feet elevated
    • examine for bleeding and apply direct pressure if present
    • increase fluid rate: crystalloids (NS, RL)
    • do no leave pt
    • drug therapy

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