PN3 EXAM 3 QUESTIONS AND
ANSWERS
What is shock?
a condition, not a disease
Main types of shock
hypovolemic, cardiogenic, septic, neurogenic, and anaphylactic
CHANS
cardiogenic, hypovolemic, anaphylactic, neurogenic, and septic
Hypovolemic Shock
decrease in circulating blood volume. Deprives cells from oxygen resulting in
inadequate tissue perfusion and hypoxia
Causes of hypovolemic shock
most common cause: acute blood loss from trauma, fluid loss from burns, severe
diarrhea/vomiting
Symptoms of hypovolemic shock
subtle changes in vitals signs, anxiety, restlessness, delayed cap. refill, and increased
respiratory rate
treatment for hypovolemic shock
correct circulating blood volume and identify and treat the cause of the volume loss.
Watch for hypokalemia after large volume fluid replacement.
Cardiogenic shock
hypotension, cellular hypoxia, and inadequate tissue perfusion. Resulting from
decreased cardiac output (heart is the cause)
symptoms of cardiogenic shock
early sign: tachycardia
septic shock
inflammatory cascade of events.
cause of septic shock
caused by endotoxins released from bacteria within the body that results in
hypotension, hypo perfusion, and hypoxia. increased risk with age
early symptoms of septic shock
warm flushed skin, fever above 100.4, mild tachycardia, resp rate above 20, WBC count
lower than 4,000 or grater than 10,000
as sepsis progresses...
client may seem anxious, high fever, neurological changes occur
treatment of septic shock
find and treat cause. IV antibiotics, fluid resuscitation, vasopressors, and supplemental
oxygenation. Surgical: incision to expose source
Neurogenic Shock
results in hypotension, bradycardia, low perfusion, and hypoxia to body tissues as a
result of the interruption of the sympathetic nervous system response. all vitals are low.
, symptoms of neurogenic shock
flaccidity and paralysis below the level of injury, loss of bowel and bladder control, loss
of reflex activity, abnormal increase or absence of sweating below the level of injury
Nursing management of neurogenic shock
monitor vital signs for evidence of worsening or improving status, ensure stability of the
client's neck and back during position changes
Anaphylactic Shock
occurs when the body reacts to a foreign substance
Anaphylactic shock- high risk
penicillin. can lead to death
anaphylactic shock nursing management
get EPI administered asap, establish IV site, monitor VS, attend to ABC's, start cardiac
monitoring
symptoms of anaphylactic shock
bronchoconstriction with wheezing, chest pain, arrhythmias, severe hypotension.
itching, hives, nasal congestion
Shock position
trendelenburg: blood to the heart and brain--> feet higher than the heart
medical-surgical management of anaphylactic shock
administer epinephrin, then antihistamines and corticosteroids--> open airway, stop
histamine response, stops inflammation response.--don't need parental consent to bring
child in
Cirrhosis
toxins allowed to circulate freely in brain (ammonia) producing hepatic encephalopathy
Most common causes of cirrhosis
chronic alcohol abuse
treatment for cirrhosis
lactulose
cirrhosis of the liver
replacement of liver tissue by scar tissue
cirrhosis S&S
fatigue, weight loss, bleeding easily, jaundice, confusion (build up of waste body/brain),
ascites (water around belly)
cirrhosis treatment
alcohol avoidance, low protein diet, lactulose promotes ammonia excretion through GI
tract, abdominal paracentesis to relieve pressure from fluid of ascites
abdominal paracentesis
bag to get water off the liver. Diagnosis purposes is to relieve ascites and fluid.
Therapeutic abdominal tap
esophageal varices
swollen, fragile blood vessels in the esophagus. When varies hemorrhage, it is a
medical emergency associated with high mortality (people can choke on their own
blood)
Parkinson's Disease
ANSWERS
What is shock?
a condition, not a disease
Main types of shock
hypovolemic, cardiogenic, septic, neurogenic, and anaphylactic
CHANS
cardiogenic, hypovolemic, anaphylactic, neurogenic, and septic
Hypovolemic Shock
decrease in circulating blood volume. Deprives cells from oxygen resulting in
inadequate tissue perfusion and hypoxia
Causes of hypovolemic shock
most common cause: acute blood loss from trauma, fluid loss from burns, severe
diarrhea/vomiting
Symptoms of hypovolemic shock
subtle changes in vitals signs, anxiety, restlessness, delayed cap. refill, and increased
respiratory rate
treatment for hypovolemic shock
correct circulating blood volume and identify and treat the cause of the volume loss.
Watch for hypokalemia after large volume fluid replacement.
Cardiogenic shock
hypotension, cellular hypoxia, and inadequate tissue perfusion. Resulting from
decreased cardiac output (heart is the cause)
symptoms of cardiogenic shock
early sign: tachycardia
septic shock
inflammatory cascade of events.
cause of septic shock
caused by endotoxins released from bacteria within the body that results in
hypotension, hypo perfusion, and hypoxia. increased risk with age
early symptoms of septic shock
warm flushed skin, fever above 100.4, mild tachycardia, resp rate above 20, WBC count
lower than 4,000 or grater than 10,000
as sepsis progresses...
client may seem anxious, high fever, neurological changes occur
treatment of septic shock
find and treat cause. IV antibiotics, fluid resuscitation, vasopressors, and supplemental
oxygenation. Surgical: incision to expose source
Neurogenic Shock
results in hypotension, bradycardia, low perfusion, and hypoxia to body tissues as a
result of the interruption of the sympathetic nervous system response. all vitals are low.
, symptoms of neurogenic shock
flaccidity and paralysis below the level of injury, loss of bowel and bladder control, loss
of reflex activity, abnormal increase or absence of sweating below the level of injury
Nursing management of neurogenic shock
monitor vital signs for evidence of worsening or improving status, ensure stability of the
client's neck and back during position changes
Anaphylactic Shock
occurs when the body reacts to a foreign substance
Anaphylactic shock- high risk
penicillin. can lead to death
anaphylactic shock nursing management
get EPI administered asap, establish IV site, monitor VS, attend to ABC's, start cardiac
monitoring
symptoms of anaphylactic shock
bronchoconstriction with wheezing, chest pain, arrhythmias, severe hypotension.
itching, hives, nasal congestion
Shock position
trendelenburg: blood to the heart and brain--> feet higher than the heart
medical-surgical management of anaphylactic shock
administer epinephrin, then antihistamines and corticosteroids--> open airway, stop
histamine response, stops inflammation response.--don't need parental consent to bring
child in
Cirrhosis
toxins allowed to circulate freely in brain (ammonia) producing hepatic encephalopathy
Most common causes of cirrhosis
chronic alcohol abuse
treatment for cirrhosis
lactulose
cirrhosis of the liver
replacement of liver tissue by scar tissue
cirrhosis S&S
fatigue, weight loss, bleeding easily, jaundice, confusion (build up of waste body/brain),
ascites (water around belly)
cirrhosis treatment
alcohol avoidance, low protein diet, lactulose promotes ammonia excretion through GI
tract, abdominal paracentesis to relieve pressure from fluid of ascites
abdominal paracentesis
bag to get water off the liver. Diagnosis purposes is to relieve ascites and fluid.
Therapeutic abdominal tap
esophageal varices
swollen, fragile blood vessels in the esophagus. When varies hemorrhage, it is a
medical emergency associated with high mortality (people can choke on their own
blood)
Parkinson's Disease
