Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid
Types of Shock
- Hypovolemic
- Depleted Volume
- Cardiogenic
- Pump Failure
- Obstructive
- Indirect Pump Failure
- Distributive
- Lost Vascular Tone
- Neurogenic
- Anaphylactic
- Septic
Norepinephrine (Levophed)
- Alpha Agonist
- Beta-1 Agonist
- Severe Hypotension
- Decreases Renal Blood Flow
- Arrhythmias
- Hypertension
- Tissue Necrosis
- Last Resort Medication
Dobutamine
- Beta-1 Agonist
- Inotropic
- Heart Failure
- Tachycardia
- Arrhythmias
- Closely Monitor Patients
- Other Meds May Increase Potency
Nitroprusside
- Direct Release of NO
- Increase cGMP
- Short Half-Life
- Malignant Hypertension
- Cyanide Toxicity
Systemic Inflammatory Response Syndrome (SIRS) Criteria
- Temperature < 36C or > 38C
- Pulse > 90 beats per minute
- Respirations > 20/min or PCO2 < 32
- WBC < 4,000 or > 12,000 or 10% bands
- Subset of Cytokine Storm and Related to Sepsis
Disseminated Intravascular Coagulation (DIC) Assessment
- Improper Initiation of Clotting Cascade
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
Disseminated Intravascular Coagulation (DIC) Interventions
- Risk for Shock
- Renal Failure
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
Sepsis Assessment
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema