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FUNDA Flashcards

1
Q

what are the 4 types of shock

A

cardiogenic, distributive, obstructive and hypovolemic shock

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2
Q

cause by heart pump failure such as MI, CHF, cardiac tamponade

A

Cardiogenic shock

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2
Q

most common causative agent of Nosocomial infection/bacterial such as staphylococcus arena and MSRA

A

Distributive/ septic shock

under of distributive shock are

-Anaphylactic shock- cause of allergic reaction such as meds

-Neurogenic shock- spine above T6 injury lead to Neurogenic shock

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3
Q

type of shock something is obstructing or getting in the way of blood going into and out of your heart or great vessels

A

obstructive shock

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4
Q

shock that is a serious condition caused by losing a large amount of blood or fluids.

A

hypovolemic shock

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5
Q

type of shock phase that is also known Non- progressive, has a adequate perfusion to tissue, it is Increased HR & RR
-warm, dry skin, pinkish skin (-) pallor

A

compensated phase

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6
Q

sign and symptoms compensated phase

A

1.N= BP is slightly elevated
tachy-tahcy- hyper

  1. normal UO, GI and peripheral perfusion
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7
Q

BQ: what is the earliest sign of shock*

A

Tachycardia/ hypertension

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8
Q

late sign of shock

A

hypotension

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9
Q

how many voids does the infants in a day

A

20- diluted

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10
Q

normal urine output?

A

30-60ml/hr or 2000-300ml/day
dependent is weight 0.5-1ml kg/hr
because water is 60% in out body

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11
Q

what is the N peripheral tissue

A

warm, dry skin, pinkish skin (-) pallor

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12
Q

what is the skin of the shock pt

A

moist

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13
Q

what type of shock phase that is progressive/ worsening. Inadequate perfusion to anemia, more blood is shunted to the vital organ

A

decompensated shock

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14
Q

what are the vital organs

A

brain, heart and lungs

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15
Q

s/sx of decompensted shock

A

Tach- tachy-Hypotension
-Decreased UO,GI, peripheral tissue- COOL CALMY SKIN, [+] pallor and cyanosis
-capillary refill 3 sec and above
-altered mental status (disorientation)
-ALOC- sleepy(somnolent)

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16
Q

BQ: what is the first orientation of the PX?

A

Orient Person-Place- Time (PPT)

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17
Q

Reflactory stage, permanent or terminal phase

A

Irreversible phase, last phase of shock

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18
Q

If the px is revive in irreversible phase called?

A

Refractory

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19
Q

Sx/ irreversible phase

A

1.Hypo-brady-brady
2. Anuria
3. GI-paralytic ilues
4. Peripheral tissue=pulselessness
5. Cell injury= increased hyperkalemia affect the heart
6. Anaerobic metabolism (no oxygen)
=lactic acid= metabolic acidosis

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20
Q

BQ: px in shock (assumed th worst) what is the findings?

A

Cool moist skin

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21
Q

If the pt is in irreversible phase and they’re revived, they will be

A

Amputated peripheral tissue

22
Q

It is cause by burns, plasma in interstitial, hase edema but decrease BV

A

Fluid volume defecit

Dse’s with FVD
-Liver Dse- r/t decreased albumin and oncotic

-dehydration
-shock
-DKA
-Addisons Dse
-DI

23
Q

Causes by SIADH, cushing, CHF, pulmonary edema, CKD/Renal failure

A

Fluid volune overload

24
Q

Fluids in the alveoli with PINK FORTHY SPUTUM

A

Pulmonay edema

25
Q

BQ: which fluid compartment get depleted first*

A

intravascular

26
Q

BQ: how does your body compensated depleted intracellular

A

Interstitial

27
Q

BQ:Intracellular is the last fluid comparted

A

Most severe in shock

28
Q

What part of the body you assess if the elderly px has FVD*

A

Clavicle and forehead

29
Q

What part of the body you assess if the adult px has FVD

A

Clavicle, sternum, forearm

30
Q

What part of the body you assess if the infant px has FVD*

A

Abdomen

31
Q

What part of the body you assess if the child px has FVD*

A

Thigh

32
Q

Normal Cardiac output

A

4-11L/min

33
Q

Normal BP

A

90/60 lowest normal
119/179 highest normal
120/80 boarderline

34
Q

Normal Central venous pressure

A

2-8mmhg

35
Q

Normal MAP (mean arterial pressure

A

70-100

Formula
SBP+ BDP (2)
———————-
3

36
Q

What is yhe position in assessing JVD*

A

Semi fowlers

37
Q

(+) edema and JVD

A

FVO

38
Q

Lab findings in FVD

A

All is down
CO, BP, CVP, MAP

39
Q

Labs in FVO

A

All is up
CO BP CVP MAP

40
Q

Labs in hemodilution

A

All down
BUN NA Hgb Hct

41
Q

Position in px has hemodilution

A

Upright to decrease the workload of your heart

42
Q

Mgt for FVO

A

O2, restrict fluid, give diuretics and anti hypertension (betablocker) ace inhibitors

43
Q

Labs of hemoconcentration

A

Increased all
BUN Na Hgb & Hct

44
Q

What will happen the Hgb and Hct in bleeding

A

Decreases

45
Q

Mgt for shock

A
  1. Airway &breathing
    Head- tilt-chin -lift
    Position in recovery position: left sidelying pisition

2.circulation
-lower extremity- femoral artery
Upper extremity- brachial artery
If infant- brachial artery (middle part of the upper arm)

46
Q

Will you lossen the tourniquet in life and death situation

A

Never losen/ remove if not in the ER/DR

47
Q

BQ: in ER room the ER nurse with px with multiple gunshot wound. What will you do first? Stop the bleeding or establish IV site?

A

Established IV site

48
Q

2 large bore access

A

16-14G, isotonic and PNSS
In severe shock use Central line

49
Q

Fastest in All route position

A

Intraosseus- to the bones, modified trendelenburg for rapid venous return to circulatory O2

50
Q

If decreases BP what would you give

A

Epinephrine ( vasopressors) given only in FVD
C/I in FVO

51
Q

what is the best indicator of fluid status?*

A

weight in the morning after voiding before meal
WOF: >1kg in 24hrs
weekly >3-5lbs

monitor I & O: accurate catheterization

52
Q

pathognomonic sign of hypoxia

A

restlessness- keeping moving in the bed
N O2 level 95-100%

53
Q

RAAS is triggered by

A

decreased BP

  1. hypothalamus- increased thirst and drinking
  2. blood vessels- vasoconstriction
  3. adrenal gland- Na & H2o retention

result: increase BP

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