Flashcards in Exam 1 chapter 54 Deck (62)
what are some postoperative complications?
fluid and electrolyte imbalances-deficit
nausea and vomiting
ineffective breathing pattern
risk for infection
risk for peripheral neurovvascular dysfunction
which two organs are the first to show signs of dysfunction during shock?
A urine output of less than 30 mL/hr is indicative of
renal hypoperfusion and or hypovolemia
clinical findings in pre-shock
Near normal BP
> 100bmp HR
cold, clammy skin
mildly decrease urinary output
clinical findings in shock
systolic <80 to 90
100 to 150 HR
RR-rapid, shallow, crackles
severely decreased urinary output
clinical findings in End-organ dysfunction
requires mechanical or pharmacologic support
HR-Erratic or asystole
Anuric, requires dialysis
Syndrome characterized by decrease tissue perfusion and impaired cellular metabolism. Imbalance in supply/demand for O2 and nutrients?
Management of shock in all types and phases.
fluid replacement to restore intravascular volume
vasoactive medications to restore vasomotor tone and improve cardiac function.
what happens when alpha adrenergic receptors are stimulated?
blood vessels constrict in cardiorespiratory
Medications commonly used to treat cardiogenic shock
How is supplemental O2 administered in the early stages of shock?
saturation exceeding 90%
Monitoring of ABG values
pulse oximetry values
if a patient is experiences chest pain, what IV analgesic should be administered for pain relief?
morphine dilates the blood vessels.
Monitor for decreased BP
what are the primary pathophysiology outcome in shock?
end organ dysfunction
Medications to be given when shock is due to septic.
Antibiotics- if the organism is unknown, empiric broad-spectrum are started.
blood, urine, sputum and drainage of any kind should be sent for culture.
medications to vasoconstrict and improve myocardial contractility
medication to maintain adequate urine output in a shock patient.
medication to restore blood pressure in shock patients
sympathomimetics -Dopamine (Intropin)
when administering Dopamine (Intropin), what is an early symptom of drug excess?
what are some side effects of Diphenhydramine HCl (Benadryl)?
How should the RN administer Dobutamine hydrocholoride (Dubutrex)?
Through central venous catheter or large peripheral vein with and infusion pump.
Don't infuse through line with other meds.
what type of solution should be infused with Norepinephrine?
some side effects of Dopamine (Intropin)
Increased ocular pressure
Tx: monitor BP, pulses, urinary output. Use infusion pump
Side effects of Epinephrine (Adrenalin)
local necrosis of skin
Tx: adequate hydration, carefully aspirate syringe before IM and SC doses.
effects of shock on the heart?
decreased coronary artery perfusion: decreased function of the heart muscle as a pump.
decreased SV, CO and BP.
Effects of shock on the brain.
decrease O2 and nutrient supply: decreased brain function; confusion, unconsciousness.
Effect of shock on the lungs
decrease blood volume=decreased O2.
decrease gas exchange at the capillary level.
Effects of shock on the liver
Glycogen stores are depleted by an excess of circulating epinephrin - metabolic acids that are normally detoxified in the liver cause ACIDOSIS.
inability of the heart to pump blood forward?
Inability of the heart to fill during diastole?
Eg. pericardial tamponade