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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher/
66 - Shock, Sepsis, and Multiple Organ Dysfunction SyndromeAce Your Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | 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
2 mins
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
2 mins
Respiratory Alkalosis Assessment
- Assessment
- Increased pH > 7.45
- Decreased PaCO2 < 35 mmHg
- Hyperventilation
- Brainstem Stimulation
- Head Injury
- Shock
- Lightheadedness
- Tingling Lips or Fingers
- Trousseau's
- Chvostek's Sign
- Anxiety
2 mins
Metabolic Acidosis Assessment
- Characteristics
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Signs & Symptoms
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
2 mins
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Sepsis Assessment
- Signs and Symptoms
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema
2 mins
Inflammatory Response
- Pathogens Infect Tissue
- Mast Cells Release Histamine
- Histamine Dilates and Increases Capillary Permeability
- Macrophages Engulf Pathogens
- Macrophage Signals Cells With Cytokines
- Responding Neutrophils Cross Capillary Wall
- B And T Lymphocytes Arrive At Injury Site
2 mins
Physiologic Dead Space (VD)
- Tidal Volume (VT)
- Partial pressure of arterial CO2 (PaCO2)
- Partial pressure of CO2 in expired air (PECO2)
- VD = TV x (PaCO2-PECO2) / PaCO2
2 mins
IV Solutions
- Hypotonic (< 280 mOsm/L)
- 1/4 Normal Saline (0.225% NaCl)
- 1/2 Normal Saline (0.45% NaCl)
- Isotonic (280-300 mOsm)
- Normal Saline (0.9% NaCl)
- Lactated Ringer's (LR)
- Dextrose 5% in Water (D5W)
- Hypertonic (> 300 mOsm)
- 3% or 5% NaCl
- Dextrose 5% in 0.45% NaCl
- Dextrose 10% in Water (D10W)
3 mins
Nitroglycerin
- Mechanism of Action
- Decreases Preload
- Indications
- Angina
- Up to 3 doses q 5 mins
- Side Effects
- Headache
- Hypotension
- Contraindications
- Viagra (Sildenafil)
- Nursing Considerations
- Assess Blood Pressure
- Protect From Light
- Use Glass Bottle and Special Tubing
- Gloves for Applying Topically
2 mins
Nitroprusside
- Mechanism of Action
- Direct Release of NO
- Increase cGMP
- Short Half-Life
- Indications
- Malignant Hypertension
- Side Effect
- Cyanide Toxicity
1 min
Dobutamine
- Mechanism
- Beta-1 Agonist
- Inotropic
- Indications
- Heart Failure
- Side Effects
- Tachycardia
- Arrhythmias
- Considerations
- Closely Monitor Patients
- Other Meds May Increase Potency
1 min
Norepinephrine (Levophed)
- Mechanism of Action
- Alpha Agonist
- Beta-1 Agonist
- Indications
- Severe Hypotension
- Side Effect
- Decreases Renal Blood Flow
- Arrhythmias
- Hypertension
- Considerations
- Tissue Necrosis
- Last Resort Medication
2 mins
Epinephrine (Adrenaline)
- Mechanism
- Alpha and Beta Agonist
- Indications
- Anaphylaxis
- Primary Open Angle Glaucoma (POAG)
- Bleeding
- Cardiac Arrest
- Side Effects
- Tachycardia
- Hypertension
- Tremors
- Insomnia
- Considerations
- Multiple Strengths
2 mins
Cimetidine and Famotidine (H2 Receptor Blockers)
- -tidine Suffix
- Mechanism
- H2 Receptor Blocker
- Indications
- Suppress Gastric Acid Secretion
- Side Effects (All)
- Pneumonia
- Side Effects - Cimetidine
- Anti-androgen Effects
- CNS Changes
2 mins
Atropine
- Mechanism of Action
- Muscarinic Antagonist
- Indications
- Bradycardia
- Increased Exocrine Secretions
- Smooth Muscle Spasms
- Side Effects
- Tachycardia
- Dry Mouth
- Urinary Retention
2 mins
Hypothermia Interventions
- Remove From Environment
- Remove Wet Clothing
- Passive Rewarming
- Warm Clothing
- Active Rewarming
- Heated Blankets
- Warm IV Solutions
- Heated Oxygen
- Warm Gastric Lavage
- Considerations
- Warm Trunk BEFORE Extremities
2 mins
Systemic Inflammatory Response Syndrome (SIRS) Criteria
- Must have 2 or more of the following:
- Temperature < 36C or > 38C
- Pulse > 90 beats per minute
- Respirations > 20/min or PCO2 < 32
- WBC < 4,000 or > 12,000 or 10% bands
- Mechanism
- Subset of Cytokine Storm and Related to Sepsis
2 mins
Acute Respiratory Distress Syndrome (ARDS) Assessment
- Cause
- Damaged Alveolar-Capillary Membrane
- Assessment
- Restlessness
- Dyspnea
- Refractory Hypoxemia
- Decreased PaO2
- Diffuse Pulmonary Infiltrates
- Atelectasis
- Pulmonary Hypertension
2 mins
Acute Respiratory Distress Syndrome (ARDS) Interventions
- Interventions
- Closely Monitor Patient
- ABG's (Arterial Blood Gases)
- Oxygen
- Assess for O2 Toxicity
- Mechanical Ventilation
- PEEP
- Assess for Pneumothorax
- Permissive Hypercapnia
- Considerations
- High Mortality Rate
2 mins
