shock

Question 1

anaphylactic shock

Answer 1

from severe alergic rx

Question 2

cardiogenic shock

Answer 2

heart fails to pump normally
s/s hypotenison, crackles, tachypnea

Question 3

hypovolemic shock

Answer 3

reduced circulating blood volume

Question 4

treatment for hypovolemic shock

Answer 4

-increased IV rate RL and NS
-use a colloid (pentaspan, hetastarch)
-blood transfusion/packed red blood cells

Question 5

neurogenic shock

Answer 5

severe damage to CNS

Question 6

obstructive shock

Answer 6

heart or greater blood vessel blocked by obstruction
from PE, pneumothorax, sternosis

Question 7

septic shock

Answer 7

severe immune response to infections

Question 8

cardiogenic shock patho

Answer 8

MI causes necrotic tissue that impaires CO, ischemia from decreased O2, decreased CO and BP, decreased BP leads to pulmonary congestion, pulmonary edema, SIRS, lactic acidosis

Question 9

goal of cardiogenic shock

Answer 9

optimize CO

Question 10

cardiogenic shock interventions

Answer 10

optimize O2 delivery, decrease O2 consumption, administer related drug therapy (dobutamine)

Question 11

neurogenic shock is most often associated with ____ and ______

Answer 11

acute spinal cord injury and nontraumatic causes (tumor, disc degeneration, inflammation/infection)

Question 12

neurogenic shock above T6

Answer 12

SNS impulses are reaching arterioles, no vasoconstriction, only vasodilation, hypovolemia, further damage to spinal cord

Question 13

manifestations of neurogenic shock

Answer 13

hypotenison, bradycardia, hypothermia

Question 14

treatment for neurogenic shock

Answer 14

stabilize spinal cord, optimize O2 delivery, give fluids

Question 15

assessment findings in shock

Answer 15

hypotension, hyperventilation, weak rapid pulse, clammy skin, oliguria, changes in LOC

Question 16

vitals in shock

Answer 16

SBP <90, MAP <60, HR tachycardia, RR rapid

Question 17

chemical burn is from

Answer 17

acids and alkalines

Question 18

thermal burns from

Answer 18

steam, scalds, heat, fire

Question 19

electrical burns

Answer 19

from lightning, electricity

Question 20

radiation burns

Answer 20

from exposure to industrial equipment, sunburn

Question 21

superficial burns

Answer 21

sunburn, minor steam burn

erythema, pain, minimal edema (think sunburn)

Question 22

superficial partial thickness

Answer 22

erythema, blisters, moistness, moderate edema

epidermis and top portion of dermis

Question 23

deep partial thickness burn

Answer 23

wet and weepy, painful, no blisters

epidermis and deep dermis

Question 24

full thickness burn

Answer 24

down to subcutaneous tissue
pale white or charred and leathery
painless and insensitive to palpation

Question 25

zone of coagulation on burn

Answer 25

innermost irreversible skin death

Question 26

zone of stasis

Answer 26

potentially salvageable inflammatory rx

Question 27

zone of hyperemia

Answer 27

outermost layer where early spontaneous recovery occurs

Question 28

major burns rule of 9 %

Answer 28

20% can produce a systemic response and are considered major

Question 29

body's response to burns

Answer 29

inflammatory response, SNS (vasoconstrict), decreased CO, hypovolemic shock, decreased UO, GI stress ulcer, hyperkalemia, hyponatremia

Question 30

circulatory mgmt for burns

Answer 30

LR (parkland formula)

Question 31

renal mgmt for burns

Answer 31

keep UO > 0.5 mL/kg/hr

Question 32

compartment syndrome

Answer 32

pressure builds up around muscles from fluid in extravascular space

Question 33

compartment syndrome treatment

Answer 33

escharotomy

Question 34

increased labs in shock

Answer 34

glucose, lactate, creatinine, WBC

Question 35

decreased labs in shock

Answer 35

serum proteins, bicarbonate, Hbg, platelets

Question 36

cardio effects in burns

Answer 36

tachycardia due to pain and hypovolemia