Shock

Question 1

Collaborative Care

Answer 1

Focus on treating underlying cause to stop progress through stages of shock
Rapid shock identification; rapid diagnosis of cause; rapid aggressive treatment: better outcome for client

Question 2

Shock

Answer 2

Improving arterial oxygenation and tissue perfusion
Determine type of shock/ cause
Diagnostic tests

Question 3

Anaphylactic/ Septic Shock

Answer 3

Anaphylactic Shock:
- Priority airway, epinephrine (bronchodilation), antihistamines, corticosteroids
Septic Shock:
- Priority causative agent (specimens - urine, wound, sputum), IV therapy counteract massive vasodilation, antibiotics

Question 4

Neurogenic/ Cardiogenic Shock

Answer 4

Neurogenic Shock:
- Priority according to cause, IV reverse vasodilation, pain cause - pain meds
Cardiogenic Shock:
- Oxygen, vasopressor drugs (vasoconstriction raise BP), inotropic drugs (increase force contraction, CO increase), diuretics, digoxin for signs of heart failure, antidysrhythmic

Question 5

Shock: Medications

Answer 5

Inotropic agents: improve cardiac contractility
Vasoactive agents: drugs causing vasoconstriction or vasodilation according to client symptoms
Other meds according to cause such as antibiotics, steroids

Question 6

Shock: Oxygen Therapy

Answer 6

Patent airway and adequate oxygenation critical interventions
Monitor with ABG, pulse goniometry (more accurate in early stage)
Mechanical ventilation assistance may be needed

Question 7

Shock: Fluid Replacement

Answer 7

Essential for hypovolemic shock; also with other types as symptoms indicate

Question 8

Shock: Types of IV fluids (Crystalloid Solutions)

Answer 8

Dextrose of electrolyte solutions
Increase intravascular and interstitial fluid volume
- Examples: Isotonic (0.9% NaCl, lactated Ringer’s)
- Hypotonic (5% dextrose in water, .45% NaCl)

Question 9

Shock: Types of IV fluids (Colloids)

Answer 9

Do not diffuse easily through capillary walls
Fluids stay in vascular compartment; increase osmotic pressure
- Examples: albumin, hetastarch, plasma protein fraction, dextran

Question 10

Shock: Types of IV fluids (Blood and Blood Products)

Answer 10

Treatment of hemorrhage

Restore coagulation properties

Question 11

Shock: Nursing Diagnoses

Answer 11

Decreased cardiac output
Altered tissue perfusion
Anxiety