Ch 11 Shock, Sepsis, & Multiple Organ Dysfunction Syndrome

Question 1

Anaphylactic shock

Answer 1

Distributive shock state resulting from a severe allergic reaction producing an acute systematic Vasodilation and relative hypovolemia

Question 2

Cardiogenic shock

Answer 2

Shock state resulting from impairment or failure of the myocardium

Question 3

Colloids

Answer 3

Intravenous solutions that contain molecules that are too large to pass through capillary membrane’s

Blood products

Question 4

Crystalloids

Answer 4

Intervenous electrolyte solutions that move freely between the intravascular compartment and interstitial spaces

Isotonic
Hypotonic
Hypertonic

Question 5

Cytokines

Answer 5

Messenger substances that may be released by a cell to create an action at the site or may be carried by the bloodstream to a distant site before being activated (synonyms biochemical mediators, inflammatory mediators)

Question 6

Distributive shock

Answer 6

Shock state resulting from displacement of intravascular volume creating a relative hypovolemia and an inadequate delivery of oxygen to the cells

Question 7

Hypovolemic shock

Answer 7

Shock state resulting from decreased intravascular volume due to fluid loss

Question 8

Multiple organ dysfunction syndrome

Answer 8

Presence of altered function of two or more organs in an acutely ill patient such that interventions are necessary to support continued organ function

Question 9

Neurogenic shock

Answer 9

Shock state resulting from loss of sympathetic tone causing relative hypovolemia

Question 10

Sepsis

Answer 10

Life-threatening organ dysfunction caused by a disregulated host response to infection

Question 11

Septic shock

Answer 11

A subset of sepsis in which underlying circulatory and cellular metabolic abnormalities are profound enough to substantially increase mortality

Question 12

Shock

Answer 12

Life-threatening physiologic condition in which there is an inadequate blood flow to tissues and cells of the body

Question 13

Systematic inflammatory response syndrome

Answer 13

I syndrome resulting from a clinical insult that initiates an inflammatory response that is systematic, rather than localized to the site of the insult; a type of cytokine release syndrome also referred to as cytokine storm

Question 14

Compensatory Mechanisms in shock

Answer 14

1. Initial insult leading to shock state

Decreased tissue perfusion and oxygenation

3. Increased sympathetic response increased heart rate increased blood pressure increased cardiac contractibility which leads to increased cardiac output. Decreased respiratory rate to increase oxygen saturation saturation and delivery
4. Rennin-angiotensin Activation, which leads to increase reabsorption of sodium and water which leads to increased preload and decreased urine output. Increased catecholamines And cortisol to provide increased glucose for metabolism
5. Restoration of tissue perfusion and oxygenation

Question 15

Stages of shock

Answer 15

1. Initial
2. Compensatory
3. Progressive
4. Irreversible 

Question 16

Inotropic agents

Answer 16

Improve contract reality, increased stroke volume, and increased cardiac output
Increase oxygen demand of the heart
Epinephrine Alpha and beta androgenic agent stimulates sympathetic nervous system, sympathetic agent

Dobutamine Stimulate my cardio beta receptors increase his strength of myocardial activity and improves CO

Dopamine stimulates beta one adrenergic receptors resulting in increased CO, stimulates dopamine receptors resulting in vasodilation

Question 17

Vasodilators

Answer 17

Reduce preload and afterload, reduce oxygen demand on the heart

Causes Hypotension

Nitroglycerin relaxes vascular smooth muscle resulting in decrease in preload and blood pressure

Nitroprusside increases CO by decreasing afterload and producing peripheral and systematic vasodilation

Question 18

Vasopressor agents

Answer 18

Norepinephrine functions as a peripheral Vaso constrictor by acting on alpha adrenergic

Epinephrine Stimulates Sympathetic nervous system

Dopamine

Question 19

Pathophysiology of hypovolemic shock

Answer 19

Decreased blood volume

Decreased venous return

Decreased stroke volume

Decreased cardiac output

Decreased tissue perfusion

Question 20

Circulatory distributive) shock

Answer 20

Septic shock
Neurogenic shock
Anaphylactic shock

Question 21

Cardiogenic shock

Answer 21

Coronary
Noncoronary

Question 22

Pathophysiology of circulatory shock

Answer 22

Precipitating event
Vasodilation
Activation of inflammatory response
Maldistribution of blood volume
Decreased venous return
Decreased cardiac output
Decreased tissue perfusion

Question 23

Dobutamine (Dobutrex)

Answer 23

Adrenergic

Used to treat heart failure

Improves contractility, increases SV, increases CO

Nursing implications monitor for adverse effects, monitor vital signs for improvement, monitor EKG for arrhythmias, intake and outtake and labs for kidney perfusion, monitor LFT for dose adjustments, monitor fluid and electrolyte, monitor IV sites, Monitor MAP, Monitor central lines



Question 24

Dopamine (Inotrpin)

Answer 24

Vasopressor/Adrenergic
Used to treat shock

to treat the symptoms of low blood pressure, and low cardiac output and improves blood flow to the kidneys. Dopamine may be used alone or with other medications. Dopamine belongs to a class of drugs called Inotropic Agents.

Improves contractility , increases SV, increases CO

Nursing implications monitor for adverse effects, monitor vital signs for improvement, monitor EKG for arrhythmias, and taken out taken labs for kidney perfusion, monitor LFT for dose adjustments, monitor fluid and electrolyte, monitor IV site, monitor M a P, monitor central lines

Question 25

Epinephrine 

Answer 25

Vasopressor/Adrenergic

Used to treat shock to increase blood pressure and heart contractility

Improves contractility, increases SV, increases CO

Nursing implications monitor for adverse effects, monitor vital signs for improvement, monitor EKG for arrhythmias, and taken out taken labs for kidney perfusion, monitor LFTs for dose adjustment monitor fluid and electrolytes, monitor IV site, monitor MAP, monitor central lines

Question 26

Norepinephrine

Answer 26

Vasopressor

Used to treat shock, to treat shock during a cardiac arrest to get sympathetic activity

Increases blood pressure by vasoconstriction

Nursing implications monitor for adverse effects, monitor vital signs for improvement, monitor EKG for arrhythmias, and taken out taken labs for kidney perfusion, monitor LFT for dose adjustments monitor fluid and electrolytes, monitor IV sites, monitor MAP, monitor central lines

Question 27

Positive inotropic Medication

Answer 27

Dobutamine
Dopamine

Question 28

Vasoactive medication

Answer 28

Increase BP by increasing vasoconstriction
Increase afterload leading to increase cardiac workload, decreased perfusion to skin kidney lungs and GI tract

Norepinephrine functions as a peripheral vasoconstrictor

Epinephrine stimulates SNS

Dopamine