Critical Care Flashcards

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1
Q

What are the phases of Shock

A
  1. Initial
  2. Hyperdynamic
  3. progressive
  4. Hypodynamic
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2
Q

It is the stage of shock characterized by hypoxia and anaerobic cell respiration leading to lactic acidosis

A

INITIAL

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3
Q

It is in the early or compensated stage of septic shock. Blood pressure may stil be within lnormal limits, but heart rate and temperature increase due to increased cardiac output and systemic vasodilation/

A

HYPERDYNAMIN

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4
Q

Occurs in all types of shock — characterized by by decreased cardiac output, hypotension, and anasarca (generalized edema). During this stage, compensatory mechanism begin failing to meet tissue metabolic needs.

A

Progressive (stage of Shock)

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5
Q

This is the final/irreversable phase — characterized by decreased cardiac output, decreased blood pressure, and vasoconstriction.

A

Hypodynamin

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6
Q

What are the treatment for septic shock

A
  1. Dopamine: first line in shock - used in trauma clients and cold
  2. Phenylephrine: second line - vasoconstriction = increased BP
  3. Vasopressin: third line
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7
Q

occurs in the early or compensated stage of septic shock. In this phase, the blood pressure may still be within normal limits, but the heart rate and temperature increase due to increased cardiac output and systemic vasodilation. During this phase, nursing interventions include intravenous fluids to increase the peripheral vascular resistance and administration of prescribed antibiotics as soon as possible. Addressing septic shock appropriately at this stage significantly improves the outcomes.

A

The hyperdynamic phase

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8
Q

occurs in all types of shock and is characterized by decreased cardiac output, hypotension, and anasarca (generalized edema). During this stage, the compensatory mechanisms begin failing to meet tissue metabolic needs. Elevated catecholamine production increases peripheral vascular resistance as the body attempts to shunt blood away from non-vital organs (gastrointestinal tract, kidneys, muscle, and skin) to the vital organs (brain and heart ). This phase is also described as a cold shock.

A

The progressive stage

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9
Q

the final/irreversible phase of septic shock, characterized by decreased cardiac output, decreased blood pressure, and vasoconstriction. At this stage, the shock becomes unresponsive to therapies and hence, fatal.

A

The hypodynamic phase

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10
Q

● Tube inserted in the nare that terminates in the
stomach
● Uses
○ Enteral nutrition ○ Decompression ○ Medication administration ○ Removal of stomach contents after an overdose

A

Nasogastric tube

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11
Q

● Tube inserted into the pleural space of the lungs
● Helps to remove air or fluid that has caused the lung to collapse
● Also placed after cardiac surgery into the pericardial space to help drain
blood and fluid from around the heart

A

Chest tube

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12
Q

Why would our client need a chest tube?

A

Pneumothorax
Effusions (pleural)
Abscess
Cancer (lung)
Hemothorax

● There is something in the pleural space….and we need to get it out
○ Air - pneumothorax ○ Fluid - pleural effusion ○ Blood - hemothorax
● This allows the lung to fully expand

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13
Q

What to expect in Drainage Colelction Chamber

A

NO TIDALING

Normal: serosanguinous (pink) drainage

No bubbling

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14
Q

What to expect in the Water Seal Chamber

A

Fluid level moves up and down - “tidaling”

Intermittent bubbling

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15
Q

What to expect in Suction Control Chamber

A

No tidaling

Monitor level, replace with sterile water as needed

Gentle bubbling

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16
Q

The drainage in chect tube must be no more than ____ ml

A

100

17
Q

What to do if the chest tube comes out

A
  1. Cover the site with a sterile dressing
  2. Tape on three sides
    ○ Air can escape this way
    ○ If taped on 4 sides you might cause
    a tension pneumothorax
  3. Call the primary healthcare provider
  4. STAY WITH THE CLIENT
18
Q

What to do if the tube disconnects from the drainage collection system?

A

● Chest tube is still in the client, but becomes disconnected from
the collection chamber ● Place the end of the chest tube in a bottle of sterile water

19
Q

Steps in suctioning Trach tube

A
  1. Perform hand hygiene and identify the client
  2. Hyperoxygenate the client, if required.
  3. Insert the suction catheter without suctioning to the pre-measured depth
  4. Apply intermittent suction and rotate the suction catheter as it is removed from the tracheostomy
  5. Replace the cap, mist collar, oxygen mask, or other apparatus to the tracheostomy and monitor the client to ensure they return to baseline