Podcast
Questions and Answers
Which of the following is not an adverse effect associated with vasoactive medications?
Which of the following is not an adverse effect associated with vasoactive medications?
- Chest pain
- Weight gain (correct)
- Dizziness
- Dry mouth
Which laboratory test is commonly performed to evaluate possible myocardial injury in urgent clinical assessment?
Which laboratory test is commonly performed to evaluate possible myocardial injury in urgent clinical assessment?
- Urinalysis
- Troponin (correct)
- Blood cultures
- D-Dimer
What is the primary goal of collaborative care in managing cardiogenic shock?
What is the primary goal of collaborative care in managing cardiogenic shock?
- Decrease respiratory rate
- Reduce heart rate
- Restore blood flow to the myocardium (correct)
- Enhance blood volume
Which of the following procedures is indicated if a flail valve is present in a patient with cardiogenic shock?
Which of the following procedures is indicated if a flail valve is present in a patient with cardiogenic shock?
Which of the following imaging studies is commonly used to rule out a pulmonary embolism (PE)?
Which of the following imaging studies is commonly used to rule out a pulmonary embolism (PE)?
What is the appropriate intervention for cardiac tamponade?
What is the appropriate intervention for cardiac tamponade?
Which intervention should be prioritized for a patient with obstructive shock due to a tension pneumothorax?
Which intervention should be prioritized for a patient with obstructive shock due to a tension pneumothorax?
What is a key nursing intervention for venothromboembolic disease?
What is a key nursing intervention for venothromboembolic disease?
What is the primary use of an epinephrine ampule in an anaphylaxis kit?
What is the primary use of an epinephrine ampule in an anaphylaxis kit?
Which diagnostic tool is essential for confirming a pulmonary embolism?
Which diagnostic tool is essential for confirming a pulmonary embolism?
In the context of spinal cord injury, what is a critical nursing intervention for neurogenic shock?
In the context of spinal cord injury, what is a critical nursing intervention for neurogenic shock?
Which medication may be ordered to prevent rebound or biphasic reactions in anaphylaxis?
Which medication may be ordered to prevent rebound or biphasic reactions in anaphylaxis?
What symptom indicates that a patient may require further monitoring when managing venothromboembolic disease?
What symptom indicates that a patient may require further monitoring when managing venothromboembolic disease?
What is a potential risk associated with antihistamines in the context of anaphylaxis?
What is a potential risk associated with antihistamines in the context of anaphylaxis?
What is a primary goal for nursing interventions in patients with obstructive shock?
What is a primary goal for nursing interventions in patients with obstructive shock?
Which type of solution is generally preferred for patients experiencing hypovolemic shock not caused by bleeding?
Which type of solution is generally preferred for patients experiencing hypovolemic shock not caused by bleeding?
When teaching a patient about self-administration of anticoagulants at home, which point should be emphasized?
When teaching a patient about self-administration of anticoagulants at home, which point should be emphasized?
What happens to a cell when placed in a hypertonic solution?
What happens to a cell when placed in a hypertonic solution?
What is the primary function of isotonic solutions in relation to cells?
What is the primary function of isotonic solutions in relation to cells?
Which of the following is NOT a use of crystalloid solutions?
Which of the following is NOT a use of crystalloid solutions?
What should be avoided when using antihistamines post-anaphylaxis treatment?
What should be avoided when using antihistamines post-anaphylaxis treatment?
What is the primary goal of interventions for patients experiencing septic shock?
What is the primary goal of interventions for patients experiencing septic shock?
Which laboratory assessments should be performed immediately for a patient in septic shock?
Which laboratory assessments should be performed immediately for a patient in septic shock?
In patients with septic shock, what is a critical consideration for enteral nutrition?
In patients with septic shock, what is a critical consideration for enteral nutrition?
What is a recommended approach to monitoring patients in septic shock?
What is a recommended approach to monitoring patients in septic shock?
What constitutes the ongoing documentation needed for patients in septic shock?
What constitutes the ongoing documentation needed for patients in septic shock?
Which group of patients is at a greater risk for developing septic shock?
Which group of patients is at a greater risk for developing septic shock?
What is an important ongoing care consideration for patients with septic shock regarding nutrition?
What is an important ongoing care consideration for patients with septic shock regarding nutrition?
Which of the following statements best reflects a key preventative strategy against septic shock?
Which of the following statements best reflects a key preventative strategy against septic shock?
What is the primary goal in treating Disseminated Intravascular Coagulation (DIC)?
What is the primary goal in treating Disseminated Intravascular Coagulation (DIC)?
Which laboratory finding is indicative of Disseminated Intravascular Coagulation (DIC)?
Which laboratory finding is indicative of Disseminated Intravascular Coagulation (DIC)?
What should be monitored in patients undergoing treatment for hypotension?
What should be monitored in patients undergoing treatment for hypotension?
Which of the following is NOT typically included in the urgent clinical assessment for respiratory failure?
Which of the following is NOT typically included in the urgent clinical assessment for respiratory failure?
In acute respiratory distress syndrome (ARDS), which nursing intervention is essential?
In acute respiratory distress syndrome (ARDS), which nursing intervention is essential?
Which of the following therapies is crucial in managing severe bleeding associated with DIC?
Which of the following therapies is crucial in managing severe bleeding associated with DIC?
What is a common nursing intervention in the care of a patient with respiratory failure?
What is a common nursing intervention in the care of a patient with respiratory failure?
What immediate investigation is crucial when assessing a patient’s risk for pulmonary embolism?
What immediate investigation is crucial when assessing a patient’s risk for pulmonary embolism?
Which type of shock is characterized by confusion, agitation, and decreased urine output?
Which type of shock is characterized by confusion, agitation, and decreased urine output?
In treating cardiogenic shock, which medication is primarily used to support heart function?
In treating cardiogenic shock, which medication is primarily used to support heart function?
What is the primary approach in the management of hypovolemic shock?
What is the primary approach in the management of hypovolemic shock?
Which type of shock requires aggressive fluid resuscitation and immediate administration of epinephrine?
Which type of shock requires aggressive fluid resuscitation and immediate administration of epinephrine?
In septic shock, what laboratory test is critical for obtaining cultures?
In septic shock, what laboratory test is critical for obtaining cultures?
What is primarily monitored when providing aggressive fluid resuscitation in septic shock?
What is primarily monitored when providing aggressive fluid resuscitation in septic shock?
In neurogenic shock, what is a key treatment strategy to maintain hemodynamics?
In neurogenic shock, what is a key treatment strategy to maintain hemodynamics?
Which complication follows the progression from infection to septic shock?
Which complication follows the progression from infection to septic shock?
Which supportive therapy is essential for treating cardiogenic shock?
Which supportive therapy is essential for treating cardiogenic shock?
What is the initial management strategy for a patient in septic shock?
What is the initial management strategy for a patient in septic shock?
Which of the following is a central nervous system adverse effect of vasoactive medications?
Which of the following is a central nervous system adverse effect of vasoactive medications?
Which laboratory test is NOT included in the urgent clinical assessment for patients suspected of cardiogenic shock?
Which laboratory test is NOT included in the urgent clinical assessment for patients suspected of cardiogenic shock?
What is an essential procedure indicated for managing a flail valve in a patient with cardiogenic shock?
What is an essential procedure indicated for managing a flail valve in a patient with cardiogenic shock?
Which of the following adverse effects is commonly observed in the cardiovascular system due to vasoactive medications?
Which of the following adverse effects is commonly observed in the cardiovascular system due to vasoactive medications?
What is the purpose of thrombolytic therapy in the context of collaborative care for cardiogenic shock?
What is the purpose of thrombolytic therapy in the context of collaborative care for cardiogenic shock?
What is a primary intervention required to restore adequate mean arterial pressure (MAP) in shock management?
What is a primary intervention required to restore adequate mean arterial pressure (MAP) in shock management?
Which clinical presentation is most commonly associated with cardiogenic shock?
Which clinical presentation is most commonly associated with cardiogenic shock?
In managing neurogenic shock, which symptom distinguishes it from other types of shock?
In managing neurogenic shock, which symptom distinguishes it from other types of shock?
What are the common respiratory symptoms observed in anaphylactic shock?
What are the common respiratory symptoms observed in anaphylactic shock?
During your assessment, which complication should you anticipate in a patient experiencing septic shock?
During your assessment, which complication should you anticipate in a patient experiencing septic shock?
Which statement best describes the priority of safety equipment location in patient care?
Which statement best describes the priority of safety equipment location in patient care?
What does the baseline head-to-toe assessment ideally include at the beginning of a shift?
What does the baseline head-to-toe assessment ideally include at the beginning of a shift?
In the context of hypovolemic shock, which of the following is a common nursing observation?
In the context of hypovolemic shock, which of the following is a common nursing observation?
What is the primary goal when managing a patient in septic shock regarding vital signs?
What is the primary goal when managing a patient in septic shock regarding vital signs?
Which laboratory test is essential to perform immediately in suspected septic shock?
Which laboratory test is essential to perform immediately in suspected septic shock?
What should be monitored closely to prevent complications during the management of septic shock?
What should be monitored closely to prevent complications during the management of septic shock?
When should enteral nutrition ideally begin in a patient with septic shock?
When should enteral nutrition ideally begin in a patient with septic shock?
What is a key prevention strategy to reduce the risk of septic shock in at-risk populations?
What is a key prevention strategy to reduce the risk of septic shock in at-risk populations?
Which nutritional consideration is important for patients in septic shock?
Which nutritional consideration is important for patients in septic shock?
What is a common complication that nursing staff should monitor for in patients with septic shock?
What is a common complication that nursing staff should monitor for in patients with septic shock?
What should be prioritized in the immediate action plan for a patient experiencing septic shock?
What should be prioritized in the immediate action plan for a patient experiencing septic shock?
What is a common nursing intervention for patients diagnosed with venothromboembolic disease?
What is a common nursing intervention for patients diagnosed with venothromboembolic disease?
What procedure is typically performed for cardiac tamponade?
What procedure is typically performed for cardiac tamponade?
Which of the following interventions should be prioritized for managing obstruction in obstructive shock caused by a tension pneumothorax?
Which of the following interventions should be prioritized for managing obstruction in obstructive shock caused by a tension pneumothorax?
When monitoring a patient with venothromboembolic disease, what symptom should prompt further evaluation?
When monitoring a patient with venothromboembolic disease, what symptom should prompt further evaluation?
What is an essential nursing intervention for a patient with a spinal cord injury and neurogenic shock?
What is an essential nursing intervention for a patient with a spinal cord injury and neurogenic shock?
What is a key focus in the nursing evaluation for patients receiving treatment for venothromboembolic disease?
What is a key focus in the nursing evaluation for patients receiving treatment for venothromboembolic disease?
Which symptom indicates a potential deterioration in a patient with obstructive shock?
Which symptom indicates a potential deterioration in a patient with obstructive shock?
What should be monitored continuously in a patient experiencing venothromboembolic disease?
What should be monitored continuously in a patient experiencing venothromboembolic disease?
What is the main purpose of using vasopressor medications?
What is the main purpose of using vasopressor medications?
Which adrenergic drug primarily stimulates β₁ receptors on heart muscles to increase contractility?
Which adrenergic drug primarily stimulates β₁ receptors on heart muscles to increase contractility?
What does an increased serum osmolality indicate?
What does an increased serum osmolality indicate?
Why should vasoactive medications ideally be administered through a central line?
Why should vasoactive medications ideally be administered through a central line?
Which of the following statements about urine osmolality is true?
Which of the following statements about urine osmolality is true?
What effect does norepinephrine have when administered?
What effect does norepinephrine have when administered?
At low doses, what effect does dopamine have on the body's arteries?
At low doses, what effect does dopamine have on the body's arteries?
What should be closely monitored when administering vasoactive medications?
What should be closely monitored when administering vasoactive medications?
What is the primary function of antihistamines in the management of anaphylaxis?
What is the primary function of antihistamines in the management of anaphylaxis?
Which of the following describes the tonicity of a hypertonic solution?
Which of the following describes the tonicity of a hypertonic solution?
In the case of severe hypovolemic shock not caused by bleeding, which solution is generally preferred?
In the case of severe hypovolemic shock not caused by bleeding, which solution is generally preferred?
What is a potential risk associated with the use of antihistamines after epinephrine treatment for anaphylaxis?
What is a potential risk associated with the use of antihistamines after epinephrine treatment for anaphylaxis?
Which component is specifically identified for IM use in an anaphylaxis kit?
Which component is specifically identified for IM use in an anaphylaxis kit?
What is a characteristic of crystalloids compared to colloids in fluid management?
What is a characteristic of crystalloids compared to colloids in fluid management?
When using antihistamines post-anaphylaxis, which symptom should not be expected?
When using antihistamines post-anaphylaxis, which symptom should not be expected?
What role do glucocorticoids play in the management of anaphylaxis?
What role do glucocorticoids play in the management of anaphylaxis?
Flashcards
Septic Shock Prevention
Septic Shock Prevention
Strategies to avoid septic shock, focusing on minimizing infection risks.
Septic Shock Recognition
Septic Shock Recognition
Identifying early signs of septic shock to initiate prompt treatment.
Septic Shock Immediate Action
Septic Shock Immediate Action
Taking immediate steps like communication and interventions as soon as septic shock suspected.
Septic Shock Interventions
Septic Shock Interventions
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Septic Shock Monitoring
Septic Shock Monitoring
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Septic Shock Labs
Septic Shock Labs
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Septic Shock Nutrition
Septic Shock Nutrition
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Septic Shock Collaborative Care
Septic Shock Collaborative Care
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Cardiogenic Shock Urgent Assessment
Cardiogenic Shock Urgent Assessment
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Cardiogenic Shock Treatment Approaches
Cardiogenic Shock Treatment Approaches
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Vasoactive Medications Adverse Effects
Vasoactive Medications Adverse Effects
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Cardiogenic Shock and Its Causes
Cardiogenic Shock and Its Causes
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Urgent Lab Tests for Shock
Urgent Lab Tests for Shock
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Anaphylaxis Kit Contents
Anaphylaxis Kit Contents
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Epinephrine Use
Epinephrine Use
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Adjunct Medications (Anaphylaxis)
Adjunct Medications (Anaphylaxis)
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Crystalloids in Shock
Crystalloids in Shock
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Isotonic Solution
Isotonic Solution
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Hypertonic Solution
Hypertonic Solution
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Antihistamines in Anaphylaxis
Antihistamines in Anaphylaxis
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Needle Sizes (Anaphylaxis)
Needle Sizes (Anaphylaxis)
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Cardiac Tamponade Treatment
Cardiac Tamponade Treatment
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Tension Pneumothorax Treatment
Tension Pneumothorax Treatment
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Pulmonary Embolism Treatment
Pulmonary Embolism Treatment
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Neurogenic Shock in SCI
Neurogenic Shock in SCI
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VTE Diagnosis
VTE Diagnosis
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VTE Nursing Interventions
VTE Nursing Interventions
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Monitoring in VTE
Monitoring in VTE
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Patient Comfort in Obstructive Shock
Patient Comfort in Obstructive Shock
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Cardiogenic Shock Treatment
Cardiogenic Shock Treatment
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Hypovolemic Shock Treatment
Hypovolemic Shock Treatment
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Septic Shock Treatment
Septic Shock Treatment
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Neurogenic Shock Treatment
Neurogenic Shock Treatment
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Anaphylactic Shock Treatment
Anaphylactic Shock Treatment
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Septic Continuum
Septic Continuum
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Shock Type: Obstructive
Shock Type: Obstructive
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Urgent Clinical Assessment
Urgent Clinical Assessment
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Laboratory Diagnostic Tests
Laboratory Diagnostic Tests
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Shock
Shock
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DIC Cause
DIC Cause
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DIC Symptoms & Diagnoses
DIC Symptoms & Diagnoses
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DIC Treatment
DIC Treatment
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Hypotension/Bradycardia Treatment
Hypotension/Bradycardia Treatment
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Hypothermia Prevention
Hypothermia Prevention
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Respiratory Failure/ARDS treatment
Respiratory Failure/ARDS treatment
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Skin Breakdown Prevention
Skin Breakdown Prevention
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Vasoactive Medication Effects
Vasoactive Medication Effects
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Revascularization for Cardiogenic Shock
Revascularization for Cardiogenic Shock
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What is Cardiogenic Shock?
What is Cardiogenic Shock?
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Glucocorticoids for Anaphylaxis
Glucocorticoids for Anaphylaxis
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Crystalloid Solutions
Crystalloid Solutions
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Needle Sizes for Anaphylaxis
Needle Sizes for Anaphylaxis
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Shock: What is it?
Shock: What is it?
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Shock Types: Cardiogenic
Shock Types: Cardiogenic
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Shock Types: Hypovolemic
Shock Types: Hypovolemic
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Shock Types: Septic
Shock Types: Septic
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Shock Types: Neurogenic
Shock Types: Neurogenic
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Shock Types: Anaphylactic
Shock Types: Anaphylactic
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Shock Treatment: Fluids
Shock Treatment: Fluids
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Shock Treatment: Vasopressors
Shock Treatment: Vasopressors
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Septic Shock Early Warning Signs
Septic Shock Early Warning Signs
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Septic Shock: What is the Goal?
Septic Shock: What is the Goal?
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Septic Shock: Why Are Antibiotics So Important?
Septic Shock: Why Are Antibiotics So Important?
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Septic Shock: What Are Vasopressors Used For?
Septic Shock: What Are Vasopressors Used For?
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Septic Shock: Blood Cultures - Why Are They Done?
Septic Shock: Blood Cultures - Why Are They Done?
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Septic Shock: What is MAP?
Septic Shock: What is MAP?
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Prevent Septic Shock: What are Universal Precautions?
Prevent Septic Shock: What are Universal Precautions?
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Serum Osmolality
Serum Osmolality
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Urine Osmolality
Urine Osmolality
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Vasopressor Use
Vasopressor Use
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Dobutamine
Dobutamine
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Dopamine
Dopamine
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Norepinephrine or Phenylephrine
Norepinephrine or Phenylephrine
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Vasopressor Administration
Vasopressor Administration
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Vasopressor Monitoring
Vasopressor Monitoring
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Obstructive Shock
Obstructive Shock
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Cardiac Tamponade
Cardiac Tamponade
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Tension Pneumothorax
Tension Pneumothorax
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Pulmonary Embolism
Pulmonary Embolism
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Venothromboembolic Disease (VTE)
Venothromboembolic Disease (VTE)
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Neurogenic Shock
Neurogenic Shock
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C-spine Precautions
C-spine Precautions
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Computed Tomography Pulmonary Angiogram (CTPA)
Computed Tomography Pulmonary Angiogram (CTPA)
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Study Notes
Nursing 488: Supporting People with Life-Threatening Health Challenges - Multisystem Dysfunction
- Course covers the nursing process for individuals with acute multi-system dysfunction, focusing on common pharmacological interventions and complex alterations like shock and acid/base imbalance.
Objectives
- Demonstrate understanding of the nursing process across the lifespan for individuals with acute multi-system dysfunction.
- Explore, discuss, and identify common pharmacological interventions for individuals with complex acute multi-system dysfunction, including shock and acid/base imbalance.
Shock
- Features: Insufficient tissue perfusion (blood delivery) leading to cellular hypoxia and death; life-threatening medical emergency.
- May be reversible with urgent interventions but can progress to multi-organ failure and death.
- Multiple possible causes, grouped into categories.
- Hypotension is a key clinical finding.
Multiple Organ Dysfunction Syndrome (MODS)
- Target Organs: Cardiovascular, lung, gastrointestinal, liver, central nervous system (CNS), renal, and skin dysfunctions.
- Multiple causes and resulting organ dysfunction patterns vary across patient populations. Pre-existing conditions (e.g., kidney disease) increase the likelihood of specific organ dysfunction.
Main Abnormalities in Shock Forms
- Hypovolemic: Loss of blood volume.
- Distributive: Inappropriately dilated arteries resulting in inappropriate blood flow distribution.
- Cardiogenic: Inability of the heart to adequately pump blood.
- Obstructive: Obstruction to blood flow.
Upstream Considerations
- Planning: Know the patient's GOC designation, identify patients at risk for shock (anticipate symptoms), and monitor vital signs, I/O and labs.
- Safety/Baseline Head-to-Toe Assessment: Complete this ASAP, document for the multidisciplinary team.
- Safety Equipment Check: Know location of emergency equipment (e.g., crash cart, O2, suction equipment), and supplies in each patient room.
Goals for Shock
- Prevention
- Early recognition
- Restoration of MAP > 65 mmHg to achieve adequate oxygenation and perfusion.
Clinical Presentation in Major Types of Shock (Table)
- Presents a table summarizing cardiovascular, respiratory, skin, neurological and renal symptoms in different shock types (cardiogenic, hypovolemic, neurogenic, anaphylactic, septic, obstructive).
Oxygenation, Circulation, Drug Therapy and Supportive Therapy (Table)
- Provides a table to describe oxygenation, circulation, drug therapy, and supportive therapies in various shock types. Includes specifics, e.g., restoring blood flow (cardiogenic), rapid fluid replacement (hypovolemic), and use of antibiotics/vasopressors (septic).
Septic Continuum
- A graphic illustrating the continuum from infection to bacteremia to sepsis to septic shock to multiple organ dysfunction syndrome to death.
Urgent Clinical Assessment and Common Lab/Diagnostic Imaging Investigations (Table)
- Lists the STAT laboratory tests (ABG, CBC, electrolytes, creatinine, GFR, liver panel, calcium, phosphate, magnesium, INR, PTT, troponin, D-Dimer, CRP, blood cultures, sputum culture, urinalysis, C&S, CXR, ECG, CTPE) and diagnostic imaging investigations (e.g., CXR, CTPE).
Nursing Interventions (Septic Shock)
- Emphasizes immediate communication and collaboration, including identifying patients at risk, and using protocols like maximizing oxygenation and fluid resuscitation (maintain MAP > 65 mmHg). Ongoing assessment of vital signs and head-to-toe assessment is key.
Collaborative Care (Septic Shock)
- Key points for collaborative care, including nutritional support, treatment of associated complications, fluid replacement (e.g., crystalloids and colloids). Continuous monitoring of the patient's condition for any changes in their status; providing emotional support to the patient/family; collaboration with the health team to coordinate care.
Key Points (Prevention)
- Universal Precautions
- Aseptic ports of entry precautions
- Advocating for removal of catheters at earliest opportunity.
- Identifying patients at risk: Elderly and immunocompromised patients
- Actively monitoring for early signs of septic shock.
Nursing Interventions (Hypovolemic Shock)
- Prevention, recognition, immediate communication/collaboration, and immediate action to restore fluid volume (e.g., IV access, monitoring of vital signs). Focuses on managing the underlying cause of volume deficit. Common fluid replacement classes include crystalloids and colloid solutions.
Nursing Interventions (Anaphylaxis)
- Prevention by noting patient allergies, ensuring accuracy of allergy information matching Connect Care and proper medication administration and purpose clarification. Recognition of symptoms and immediate calling for help (clear closed-loop communication).
- First-line treatment: intramuscular (IM) epinephrine administration, supplemental oxygen, and immediate intravenous (IV) access.
Anaphylaxis - Immediate/Treatment
- Prompt removal and stop the cause of the reaction. Communicate, assess, and immediately administer intramuscular epinephrine, supplemental oxygen, and establish IV access. Document pertinent data and plan for follow-up.
Anaphylaxis - Adjunct Medications
- Discusses glucocorticoid therapy to prevent reaction rebound and/or biphasic reactions.
- Discusses that antihistamines can alleviate some symptoms but are not a primary treatment or cure during an anaphylactic reaction.
Crystalloids
- Solutions containing electrolytes and fluids (normally found in the human body), used to compensate for insensible fluid losses as maintenance fluids and to correct specific electrolyte and fluid disturbances. They do not contain proteins and do not carry a risk of viral transmission or anaphylaxis.
Tonicity
- Briefly explains isotonic, hypertonic and hypotonic solutions (effects on cell shape and fluid content).
IV Solutions
- Discusses isotonic, hypotonic and hypertonic solutions and their respective concentrations (osmolarity). Key examples include 0.9% Normal Saline, Lactated Ringer's solutions, and D5W. Includes specifics about associated osmolarity levels.
Fluid Shifts and Edema
- Explains osmotic force in drawing water across semipermeable membranes (e.g., solutions like Normal Saline and Lactated Ringers). Discusses oncotic pressure (plasma protein effect) and hydrostatic pressure (force exerted on blood vessel walls). Describes factors contributing to capillary permeability impacting fluid shifts (e.g., burns and allergic inflammation). Mentions how increased permeability leads to fluid shift.
- Discusses serum and urine osmolality, their importance to evaluate fluid volume imbalances, and how these tests can be used to further understand fluid balance.
Vasopressor Medications
- Key point: Adrenergic drug class use (dobutamine, dopamine, epinephrine, norepinephrine or phenylephrine) to increase blood pressure (MAP above 65 mmHg).
Vasoactive Medications - Nursing Considerations
- Vasopressors are ideally administered through a central line.
- If extravasation occurs, it can lead to tissue ischemia or necrosis.
- Ongoing, stringent monitoring of vital signs necessary while the patient is in a specialized critical care unit (e.g., ICU, CCU, trauma or ER).
Vasoactive Medications - Adverse Effects
- Lists common adverse effects (CNS, cardiovascular and gastrointestinal) related to the use of vasoactive medications.
Cardiogenic Shock - Collaborative Care
- Interventions to restore blood flow to the heart muscle include thrombolytic therapy, angioplasty with stenting, emergency revascularization (CABG), valve replacement (flail valves), pericardiocentesis (tamponade), and pacemaker (heart block).
Obstructive Shock - Treatment Interventions
- Treatment interventions are aimed at the cause; this may involve pericardiocentesis for cardiac tamponade; needle decompression, or placing chest tubes for tension pneumothorax; thrombolytics or embolectomy for pulmonary embolism.
Venothromboembolic Disease - Nursing Interventions
- Key is to encourage mobility if appropriate, assess for and manage symptoms such as syncope/presyncope, shortness of breath and other complications. Implement passive range-of-motion exercises, encourage coughing, and teach the patient about their daily medications, restrictions, and signs/symptoms to watch for.
Nursing Implications
- Includes considerations on continuous observation of the patient, planning and implementing nursing interventions and therapies, providing emotional support and collaboration with other health team members. Includes details about how to continuously observe the patient's condition to identify any changes in their status.
Neurogenic Shock - Nursing Interventions (Spinal Cord Injury)
- Includes C-spine precautions, treatment of hypotension and bradycardia (vasopressors), cautious use of fluids, preventing hypothermia, and monitoring for complications like pressure injuries.
Disseminated Intravascular Coagulation (DIC)
- Highlights that DIC is caused by an underlying disease or condition and its rapid evolution (hours- days), including significant bleeding symptoms such as thrombocytopenia, elevated PTT/INR, elevated D-Dimer and decreased fibrinogen levels. Points to supportive therapy like platelet and coagulation factor replacement (e.g., fresh frozen plasma and cryoprecipitate).
Respiratory Failure/Acute Respiratory Distress Syndrome (ARDS) - Nursing Interventions
- Focuses on treating the underlying disorder, providing oxygen, maintaining fluid balance, administering medications, patient/family teaching, and ensuring appropriate family-centered care. Includes consideration for patients who are CO2 retainers.
Acute Respiratory Failure - Drug Therapy
- Covers bronchodilators for bronchospasm relief, corticosteroids to decrease airway inflammation, and possibly diuretics or nitrates for pulmonary congestion caused by heart failure. IV antibiotics may also be used for infections. Oxygen therapy should consider whether the patient is a carbon dioxide retainer.
Acute Respiratory Distress Syndrome (ARDS) - Collaborative Care
- Patient transfer to the ICU and management, including intubation, mechanical ventilation with positive end-expiratory pressure (PEEP), and specific considerations like awake proning.
Health Promotion Priorities
- Encourages coughing, deep breathing, notifying the nurse immediately about chest pain, tightness or shortness of breath, promoting regular movement and ROM exercises, and discouraging venous stasis.
- Addresses risk factors to respiratory conditions
- Encourages mobility
Immediate Support (Code 66/Blue)
- Defines the purpose, activation criteria, goals and interventions for Code 66 and Code Blue situations (life-threatening emergencies).
Common "STAT" Tests
- Lists common "STAT" blood tests frequently ordered for patients with potential severe conditions, like CBC, electrolytes, creatinine, troponins, ECG, ABG, CXR and blood cultures.
SBAR Reporting
- Describes SBAR as a structured communication tool for healthcare professionals.
IPASS
- Presents the IPASS structure for passing critical information about a patient to other healthcare providers.
Thank You
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Test your knowledge on the management of cardiogenic shock and related medical interventions. This quiz covers crucial topics such as myocardial injury evaluation, the role of vasoactive medications, and the priority actions during various shock types. Learn about essential nursing interventions and diagnostic approaches to improve patient outcomes in critical care settings.
