*NURSING > Solutions Guide > NURS 4183Adult Health II - Shock, Sepsis & MODS. / Adult Health II - Shock, Sepsis and MODS. (All)

NURS 4183Adult Health II - Shock, Sepsis & MODS. / Adult Health II - Shock, Sepsis and MODS.

Document Content and Description Below

Shock— - Syndrome characterized by ↓ tissue perfusion and impaired cellular metabolism resulting in an imbalance b/w the supply of and demand for O2 and nutrients (exchange is essential for life)... . When cells experience hypo tissue perfusion, the demand for O2 and nutrients exceeds the supply at the microcirculatory level. - Types of Shock o Distributive shock o Hypovolemic shock o Cardiogenic shock o Obstructive shock Cardiogenic shock - Occurs when systolic or diastolic dysfunction of the heart’s pumping action results in reduced CO o Most common cause is acute MI o Early clinical presentation can be  Tachycardia  Hypotension  Tachypnea with crackles & cyanosis - Manifestations to include o Decreased cap refill o Increased Na+ and water retention o Decreased urine output o Decreased bowels, N/V o Increased blood glucose o Increased BUN Hypovolemic Shock - Occurs after a loss of intravascular fluid volume o Absolute – loss through hemorrhage, GI loss, body drainage, diabetes insipidus or diuresis  Loss of blood, loss of other body fluids through vomiting, diarrhea, GI bleeding, excessive diuresis o Relative – when fluid volume moves out of the vascular space into the extravascular space  fluid shift, internal bleeding, massive vasodilation and pooling of blood or other body fluids - Manifestations to include o Tachypnea leading to the late sign of bradypnea o Decreased urine output o Pallor, cool clammy skin o Anxiety, confusion, agitation o Absent bowels o Decreased HCT & HGB o Increased lactate Neurogenic Shock - Can occur within 30 minutes of a spinal cord injury an can last up to 6 weeks - Most important clinical manifestations are o Hypotension o Bradycardia - Manifestations to include o Skin will initially be warm from massive vasodilation, then risk for hypothermia once heat disperses o Flaccid paralysis o Bladder dysfunction Anaphylactic Shock - An acute, life threatening hypersensitivity allergic reaction. - Reactions causes massive vasodilation, release of vasoactive mediators (can constrict or dilate) and increased capillary permeability leading to fluid leaks from the vascular space into the interstitial space - Can lead to respiratory distress - Sudden onset of symptoms include o Dizziness o Chest pain o Incontinence o Swelling of lips and tongue o Wheezing and stridor o Flushing skin o Pruritus and urticaria o Confusion o Metallic taste Septic Shock - Sepsis is defined as a set of symptoms or syndrome in response to an infection - Shock is a subset of sepsis with an increased mortality. It is characterized by persistent hypotension and inadequate tissue perfusion - Manifestations to include o Hyperventilation o Crackles o Respiratory alkalosis leading to acidosis o Pulmonary HTN o Respiratory failure o Warm & flushed skin leading to the late sign of cool & mottled o Confusion & agitation, can lead to coma (late) o Increase glucose o Increased lactate o Decreased platelets Sepsis/Shock Continuum » SIRS = initial insult (inflammatory response) » Sepsis = SIRS + suspicion or confirmed infection » Severe Sepsis = SIRS + infection + hypoperfusion or organ dysfunction » Septic Shock = SIRS + infection +organ dysfunction + refractory hypotension o Invasion of microorganism with an amplified response to the infection  Bacteria (most common)  Fungus, virus or parasites o Septic shock is the end result Obstructive Shock - Develops when a physical obstruction to blood flow occurs with a decreased CO - Manifestations to include o JVD o Pulsus Paradoxus o Hypotension o Tachypnea leading to late bradypnea o SOB o Decreased urine output o Pallor cool and clammy skin o Decreased or absent bowels o Decreased cerebral perfusion Stages of Shock » Initial stage o Metabolism changes from aerobic to anaerobic causing lactic acid buildup  Lactic acid is usually removed by the liver, however this process requires O2, which is unavailable due to the decrease in tissue perfusion » Compensatory stage o The body activate compensatory mechanisms in attempt to overcome the increasing consequences and maintain homeostasis o The pt clinical presentation begins to reflect the body’s response to imbalanced O2 supply and demand o Classic sign of shock is drop in BP (hypotension) o The SNS is activated which stimulates vasoconstriction and release of Epi and NorEPi  Blood flow to the most vital organs (heart and brain) is maintained & blood flow to nonvital organs such as kidneys, GI tract, skin, lung is diverted or shunted • This effect, is reason for clinical manifestations » Progressive stage o This stage begins as compensatory mechanisms fail o In this stage, aggressive intervention are necessary to prevent the development of MODS o Changes in pt mental status are important in this stage and a move to ICU is necessary o Cardiovascular system is profoundly affected at this stage  Continued decreased cellular perfusion and resulting altered capillary permeability are the distinguishing features of this stage  Myocardial dysfunction and decreased perfusion results in dysrhythmias, myocardial ischemia and possible MI. End result is complete deterioration of the CV system o The respiratory system is usually the first to display signs of critical dysfunction [Show More]

Last updated: 1 year ago

Preview 1 out of 9 pages

Reviews( 0 )

Recommended For You

 Managerial Economics> Solutions Guide > Managerial Economics in a Global Economy 8th Edition By Dominick Salvatore (Solutions Manual ) (All)

preview
Managerial Economics in a Global Economy 8th Edition By Dominick Salvatore (Solutions Manual )

Reflecting the highly globalized nature of tastes, production, labor markets, and financial markets in today's world, Managerial Economics in a Global Economy, Eighth Edition, presents the theory of t...

By eBookSmTb , Uploaded: Jun 01, 2022

$20

 Business Administration> Solutions Guide > Australasian Business Statistics 4th Edition By Black, Asafu ,Adjaye, Burke, Khan, King, Perera, Papadimos, Sherwood, Wasimi (Solution Manual All Chapters) (All)

preview
Australasian Business Statistics 4th Edition By Black, Asafu ,Adjaye, Burke, Khan, King, Perera, Papadimos, Sherwood, Wasimi (Solution Manual All Chapters)

Data-driven decisions are driving the global knowledge economy. To get the edge, graduates need the power of statistical analysis to create business insight. This fourth edition of Australasian Busine...

By eBookSmTb , Uploaded: Nov 23, 2021

$20

 Business Law> Solutions Guide > International Economics Theory and Policy 12th edition By Paul R. Krugman, Maurice Obstfeld, Marc Melitz (Solutions Manual ) (All)

preview
International Economics Theory and Policy 12th edition By Paul R. Krugman, Maurice Obstfeld, Marc Melitz (Solutions Manual )

1. Introduction PART 1: INTERNATIONAL TRADE THEORY 2. Word Trade: An Overview 3. Labor Productivity and Comparative Advantage: The Ricardian Model 4. Specific Factors and Income Distribution 5....

By eBookSmTb , Uploaded: Nov 05, 2022

$25

 Education> Solutions Guide > Essentials of Accounting for Governmental and Not-for-Profit Organizations, 14th Edition By Paul Copley (Solutions Manual ) (All)

preview
Essentials of Accounting for Governmental and Not-for-Profit Organizations, 14th Edition By Paul Copley (Solutions Manual )

The focus of Copley's Essentials of Accounting for Governmental and Not-for-Profit Organizations, 14th edition is on the preparation of external financial statements which is a challenge for governmen...

By eBookSmTb , Uploaded: Oct 07, 2022

$20

 Urban Policy and Planning> Solutions Guide > Dental list Yellow pages (All)

preview
Dental list Yellow pages

HumanaDental PPO dental directory Location: 15 miles from 07304 May 16, 2018 Dentist Locations: 4638 Get the most out of your dental plan. the covered person must send us a letter requesting a...

By Academia1434 , Uploaded: Mar 30, 2021

$1

 Statistics> Solutions Guide > MAT 240 Module Five Assignment Hypothesis Testing for Regional Real Estate Company (All)

preview
MAT 240 Module Five Assignment Hypothesis Testing for Regional Real Estate Company

Scenario You have been hired by the Regional Real Estate Company to help them analyze real estate data. One of the company’s Pacific region salespeople just returned to the office with a newly desi...

By ACADEMICTUTORIAL , Uploaded: May 26, 2022

$4

 Finance> Solutions Guide > Week 4 Mini Case Complete The Chapter 9 (All)

preview
Week 4 Mini Case Complete The Chapter 9

During the last few years, Jana Industries has been too constrained by the high cost of capital to make many capital investments. Recently, though, capital costs have been declining, and the company h...

By ACADEMICTUTORIAL , Uploaded: May 26, 2022

$3.5

 Accounting> Solutions Guide > ACCT370 Excel Project Part 3 (All)

preview
ACCT370 Excel Project Part 3

EXCEL PROJECT: PROJECTING FINANCIAL STATEMENTS ASSIGNMENT INSTRUCTIONS OVERVIEW Common Sized Balance Sheets (Tabs 12), Common Sized Income Statements (Tab 13), Horizontal Analysis Balanc...

By ACADEMICTUTORIAL , Uploaded: Feb 14, 2023

$6.5

 Business> Solutions Guide > Read the Chapter 19 Mini Case in Financial Management: Theory and Practice (All)

preview
Read the Chapter 19 Mini Case in Financial Management: Theory and Practice

Chapter 18 leasing and financing Chapter 19 Mini Case in Financial Management Lewis Securities Inc Read the Chapter 19 Mini Case in Financial Management: Theory and Practice. Using complete sen...

By ACADEMICTUTORIAL , Uploaded: May 01, 2023

$5.5

 Calculus> Solutions Guide > Applied Calculus, 6th Edition By Hughes-Hallett, Lock, Gleason (Solutions Manual) (All)

preview
Applied Calculus, 6th Edition By Hughes-Hallett, Lock, Gleason (Solutions Manual)

A text for interactive Calculus courses, featuring innovative problems This sixth edition of Applied Calculus engages students with well-constructed problems and content to deepen understanding. The R...

By eBookSmTb , Uploaded: Dec 09, 2022

$25

$10.00

Add to cart

Instant download

Can't find what you want? Try our AI powered Search

OR

GET ASSIGNMENT HELP
67
0

Document information


Connected school, study & course



About the document


Uploaded On

Feb 16, 2021

Number of pages

9

Written in

Seller


seller-icon
CoursesExams

Member since 3 years

316 Documents Sold


Additional information

This document has been written for:

Uploaded

Feb 16, 2021

Downloads

 0

Views

 67

Document Keyword Tags

THE BEST STUDY GUIDES

Avoid resits and achieve higher grades with the best study guides, textbook notes, and class notes written by your fellow students

custom preview

Avoid examination resits

Your fellow students know the appropriate material to use to deliver high quality content. With this great service and assistance from fellow students, you can become well prepared and avoid having to resits exams.

custom preview

Get the best grades

Your fellow student knows the best materials to research on and use. This guarantee you the best grades in your examination. Your fellow students use high quality materials, textbooks and notes to ensure high quality

custom preview

Earn from your notes

Get paid by selling your notes and study materials to other students. Earn alot of cash and help other students in study by providing them with appropriate and high quality study materials.


$10.00

WHAT STUDENTS SAY ABOUT US


What is Browsegrades

In Browsegrades, a student can earn by offering help to other student. Students can help other students with materials by upploading their notes and earn money.

We are here to help

We're available through e-mail, Twitter, Facebook, and live chat.
 FAQ
 Questions? Leave a message!

Follow us on
 Twitter

Copyright © Browsegrades · High quality services·