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22 Cards in this Set
- Front
- Back
The continuum?
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Infection -> sepsis -> severe sepsis -> septic shock -> MODS
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Systemic response to inflammation that may be triggered by trauma, abscesses, ischemic or necrotic tissue, infection, or decreased perfusion.
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Systemic Inflammatory response Syndrome (SIRS)
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What is the criteria for SIRS?
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Core temp >100.4 or <96.8
HR > 90-100 RR > 20 breaths/min WBC > 10-12,000 |
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Sepsis def?
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Known or suspected infection plus 2 or more of the criteria for SIRS
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Severe sepsis def?
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Sepsis plus failure of 1 or more organ systems
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Septic shock def?
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Sepsis with persistent hypotension despite fluid resuscitation and vasopressor support
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Multiple Organ Dysfunction Syndrome (MODS) def?
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Presence of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention, most often caused by sepsis and severe sepsis
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Syndrome characterized by decreased tissue perfusion and impaired cellular metabolism?
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Shock
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How is blood flow characterized in septic shock?
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Maldistribution of blood flow
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What are the 3 stages of shock?
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1) Compensatory
2) Progressive 3) Refractory |
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During the compensatory phase what happens to blood flow?
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Shunted away from non-essential organs
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Progressive stage of shock?
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Compensatory mechanisms fail
Begin to see symptoms in all organ systems Pulmonary system (first big problem) |
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What patients are at risk for shock?
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Weak immune system
surgery patients Cancer patients Elderly |
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What are complications of fluid resuscitation?
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Hypothermia
Coagulopathhy |
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How do you determine if fluid resuscitation has achieved end-organ perfusion?
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Urine output
Neuro function Peripheral pulses |
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What classes of drugs are used to treat shock?
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Vasopressors
Vasodialators |
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Do you administer drugs or fluids first?
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Push fluids first and then drugs
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Vasopressors?
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Adrenalin
Levophed |
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Vasodilators?
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Nipride
Nitroglycerin |
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Drotrecogin alfa (Xigris) is an antibiotic used to treat septic shock that has what major side effect?
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Bleeding
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Shock nursing diagnosis?
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Ineffective tissue perfusion
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The focus of the collaborative management of septic shock is aimed toward?
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Finding and eradicating the cause of infection
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