Exam 1 chapter 54 Flashcards Preview

Nursing 130 Perioperative > Exam 1 chapter 54 > Flashcards

Flashcards in Exam 1 chapter 54 Deck (62)
Loading flashcards...
1

what are some postoperative complications?

fluid and electrolyte imbalances-deficit
nausea and vomiting
shock
ineffective breathing pattern
urinary retention
constipation
acute pain
risk for infection
risk for peripheral neurovvascular dysfunction

2

which two organs are the first to show signs of dysfunction during shock?

heart
kidneys

3

A urine output of less than 30 mL/hr is indicative of

renal hypoperfusion and or hypovolemia

4

clinical findings in pre-shock

Near normal BP
> 100bmp HR
>20 RR
cold, clammy skin
mildly decrease urinary output
confusion
respiratory alkalosis

5

clinical findings in shock

systolic <80 to 90
100 to 150 HR
RR-rapid, shallow, crackles
skin-mottled, petechiae
severely decreased urinary output
lethargy
metabolic acidosis

6

clinical findings in End-organ dysfunction

requires mechanical or pharmacologic support
HR-Erratic or asystole
RR-requires ventilation
Skin-Jaudice
Anuric, requires dialysis
Unresponsive
Profound acidosis

7

Syndrome characterized by decrease tissue perfusion and impaired cellular metabolism. Imbalance in supply/demand for O2 and nutrients?

Shock

8

Management of shock in all types and phases.

fluid replacement to restore intravascular volume
vasoactive medications to restore vasomotor tone and improve cardiac function.
nutritional support.

9

what happens when alpha adrenergic receptors are stimulated?

blood vessels constrict in cardiorespiratory
GI systems
skin
kidneys

10

Medications commonly used to treat cardiogenic shock

dobutamine
dopamine
nitroglycerin

11

How is supplemental O2 administered in the early stages of shock?

nasal cannula
saturation exceeding 90%
Monitoring of ABG values
pulse oximetry values

12

if a patient is experiences chest pain, what IV analgesic should be administered for pain relief?

morphine sulfate
morphine dilates the blood vessels.

Monitor for decreased BP

13

what are the primary pathophysiology outcome in shock?

Hypoperfusion
tissue hypoxia
acidosis
end organ dysfunction

14

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.

15

medications to vasoconstrict and improve myocardial contractility

dopamine
norepinephrine
phenylephrine
dobutamine
milrione

16

medication to maintain adequate urine output in a shock patient.

Lasix

17

medication to restore blood pressure in shock patients

adrenergics
sympathomimetics -Dopamine (Intropin)

18

when administering Dopamine (Intropin), what is an early symptom of drug excess?

Headache

19

what are some side effects of Diphenhydramine HCl (Benadryl)?

Drowsiness
confusion
insomnia
headache
vertigo
photosensitivity

20

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.

21

what type of solution should be infused with Norepinephrine?

dextrose solution

22

some side effects of Dopamine (Intropin)

Increased ocular pressure
Ectopic beats
nausea
Tachycardia
chest pain
dysrhythmias

Tx: monitor BP, pulses, urinary output. Use infusion pump

23

Side effects of Epinephrine (Adrenalin)

Nervousness
Restlessness
Dizziness
local necrosis of skin

Tx: adequate hydration, carefully aspirate syringe before IM and SC doses.

24

effects of shock on the heart?

decreased coronary artery perfusion: decreased function of the heart muscle as a pump.
decreased SV, CO and BP.

25

Effects of shock on the brain.

decrease O2 and nutrient supply: decreased brain function; confusion, unconsciousness.

26

Effect of shock on the lungs

decrease blood volume=decreased O2.
decrease gas exchange at the capillary level.

27

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.

28

inability of the heart to pump blood forward?

systolic dysfunction

29

Inability of the heart to fill during diastole?

diastolic dysfunction

Eg. pericardial tamponade

30

External loss of whole blood?

Absolute hypovolemia shock

Eg. hemorrhage, GI bleeding, surgery

loss of other body fluids (vomiting, diarrhea, excessive diuresis, diabetes insipidus, diabetes mellitus (DM)