UNIT 4 - SEPSIS Flashcards
the inability of central perfusion to supply blood to peripheral tissues leading to organ failure. Any condition that compromises the delivery of oxygen to organs and tissues can result in _____. Can progress rapidly and be a life threatening process. can be improved by early detection followed by rapid response.
sepsis
In the older community ______ receptors response to catecholamine secretions is decreased, so it may not improve cardiac contractility or cause vasoconstriction as in the younger adult. This prolonged decrease in the ability to compensate, leads to a sustained low cardiac output and blood pressure.
baroreceptors
heart or pump failure (ex) - heart failure - cardiomyopathy - dysrhythmias - valvular rupture - valvular stenosis
cardiogenic shock
a decrease in the intravascular volume of 10 to 15 % or more.
(ex) :
- dehydration
- hemmorhage
- burns
- diabetic ketoacidosis
- older adult clients and infants
hypovolemic shock
mechanical blockage in the heart or great vessels.
(ex) :
- pulmonary embolism
- cardiac tamponade
- tension pneumothorax
- aortic dissection
- pulmonary artery stenosis
obstructive shock
wide spread vasodilation and increased capillary permeability. There are three kinds of shock in this category: anaphylactic, neurogenic, or septic.
distributive shock
defined as the amount of blood pumped in one minute. It is the heart rate multiplied by the stroke volume. normal range is 4 to 8 L/min with an average of 6 L/min.
cardiac output
is defined as each contraction ejecting a volume of 70 mL into the arterial system. ____ ______ has a major influence on cardiac output and is determined by the preload, afterload, and the contractile of the heart.
stroke volume
evaluates the pressure within the right atrium or within the large veins in the thoracic cavity. A normal CVP may range from 2-6 mm Hg.
central venous pressure
the bottom line is that ___ results in the failure to maintain adequate perfusion to vital organs. It is dynamic. The client is in constant change, either progressively improving or deteriorating.
shock
type of distributive shock that happens with release of histamine, causing vasodilation and relative hypovolemia.
(ex) :
- allergens inhaled, swallowed, contacted or introduced
- transfusion reaction
- insect bites
- side effects of medicaions
- dye/food allergies
anaphylactic shock
type of distributive shock that is can result from trauma, spinal cord injury (T5 or higher), spinal shock. epidural anesthesia, and hypoglycemia
neurogenic shock
type of distributive shock that is a result of gram negative bacteria, urosepsis more in older adults, and older adults with urinary catheters.
septic shock
what is the assessment of someone in the early stages of shock?
Level of Consciousness: anxious Heart Rate/BPM: < 100 (may be WNL) Blood Pressure: normal Respirations/min: normal Urine Output: > or equal to 30 mL/hour Skin: cool, pink, dry
what does the assessment look like of someone in the compensatory stage of shock?
LOC: more restless HR/BPM: trending up > 100 bpm BP: trending up RR: trending to 20-30 breaths/min Urine Output: trending to 20-30 mL/min Skin: cold, pale, dry, moist
