Podcast
Questions and Answers
Shock is characterized by widespread reduction of tissue ______ that can lead to organ damage.
Shock is characterized by widespread reduction of tissue ______ that can lead to organ damage.
perfusion
Early signs and symptoms of shock include restlessness and ______ due to cerebral hypoxia.
Early signs and symptoms of shock include restlessness and ______ due to cerebral hypoxia.
agitation
In shock, patients may experience ______ and tachycardia.
In shock, patients may experience ______ and tachycardia.
hypotension
Shock can progress to multiple organ dysfunction ______ if not treated promptly.
Shock can progress to multiple organ dysfunction ______ if not treated promptly.
Disseminated Intravascular Coagulation (DIC) is a coagulation disorder that causes ______ and hemorrhage.
Disseminated Intravascular Coagulation (DIC) is a coagulation disorder that causes ______ and hemorrhage.
Signs and symptoms of DIC include petechia, hemoptysis, and oozing from IV sites and ______.
Signs and symptoms of DIC include petechia, hemoptysis, and oozing from IV sites and ______.
Inadequate tissue perfusion can result in Multi-Organ Dysfunction ______.
Inadequate tissue perfusion can result in Multi-Organ Dysfunction ______.
The body’s ______ levels need to be monitored during DIC to prevent severe complications.
The body’s ______ levels need to be monitored during DIC to prevent severe complications.
Acidosis can be classified into respiratory and ______ acidosis.
Acidosis can be classified into respiratory and ______ acidosis.
High levels of PaCO2 indicate respiratory ______.
High levels of PaCO2 indicate respiratory ______.
Normal Pulmonary Capillary Wedge Pressure (PCWP) is between ______ mm Hg.
Normal Pulmonary Capillary Wedge Pressure (PCWP) is between ______ mm Hg.
For uncontrolled atrial fibrillation, the recommended treatment is ______.
For uncontrolled atrial fibrillation, the recommended treatment is ______.
In cases of ventricular fibrillation or unstable ventricular tachycardia, the appropriate action is to ______.
In cases of ventricular fibrillation or unstable ventricular tachycardia, the appropriate action is to ______.
Sinus bradycardia can be treated with ______.
Sinus bradycardia can be treated with ______.
Patients with an Implantable Cardioverter Defibrillator (ICD) should refrain from lifting their affected arm above ______ until cleared by a physician.
Patients with an Implantable Cardioverter Defibrillator (ICD) should refrain from lifting their affected arm above ______ until cleared by a physician.
When there is an obstruction, the ventilator alarm will trigger a ______ alarm.
When there is an obstruction, the ventilator alarm will trigger a ______ alarm.
Positive End-Expiratory Pressure (PEEP) is used to maintain airway pressure above ______ pressure.
Positive End-Expiratory Pressure (PEEP) is used to maintain airway pressure above ______ pressure.
Before a blood transfusion, you must confirm the patient's blood type and perform a ______ with another RN.
Before a blood transfusion, you must confirm the patient's blood type and perform a ______ with another RN.
If a transfusion reaction is suspected, you must immediately ______ the transfusion.
If a transfusion reaction is suspected, you must immediately ______ the transfusion.
During the first 15 minutes of a blood transfusion, it is critical to monitor the patient for signs of ______.
During the first 15 minutes of a blood transfusion, it is critical to monitor the patient for signs of ______.
Flashcards
Shock
Shock
Widespread reduction in tissue perfusion, leading to organ damage due to lack of oxygen and nutrients.
Early Shock Symptoms
Early Shock Symptoms
Restlessness and agitation, caused by cerebral hypoxia.
Shock S/Sx
Shock S/Sx
Hypotension, tachycardia, and weak peripheral pulses.
DIC
DIC
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DIC Lab Findings
DIC Lab Findings
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DIC Symptoms
DIC Symptoms
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MODS
MODS
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ABG
ABG
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Acidosis
Acidosis
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Alkalosis
Alkalosis
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PCWP Normal Range
PCWP Normal Range
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Atrial Fibrillation Treatment
Atrial Fibrillation Treatment
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Ventricular Dysrhythmias Treatment
Ventricular Dysrhythmias Treatment
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ICD Placement
ICD Placement
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High Ventilator Alarm
High Ventilator Alarm
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Low Ventilator Alarm
Low Ventilator Alarm
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PEEP Purpose
PEEP Purpose
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Blood Infusion Time
Blood Infusion Time
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Transfusion Reaction
Transfusion Reaction
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Trach Care
Trach Care
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Study Notes
Critical Care - Pulmonary & Cardiac
- Pulmonary Capillary Wedge Pressure (PCWP): Normal range 8-13 mm Hg; measures left atrial pressure.
- Cardiac Arrhythmias Treatments:
- Atrial fibrillation: synchronized cardioversion for uncontrolled cases.
- Ventricular dysrhythmias: Lidocaine.
- Ventricular fibrillation/unstable ventricular tachycardia: Defibrillate.
- Sinus bradycardia: Atropine.
- Implantable Cardioverter Defibrillator (ICD): Used for life-threatening dysrhythmias; includes pacemaker capabilities. Pt teaching: avoid lifting affected arm above shoulder until physician says OK.
- Ventilator Alarms:
- High Alarm: Obstruction (secretions, kinked tubing), pt coughing/gagging.
- Low Alarm: Disconnection, leak, pt stops breathing.
- Nursing Interventions: Assess the alarm, address the issue, assess oxygen levels, contact Respiratory Therapist and/or physician if needed.
- Positive End-Expiratory Pressure (PEEP): Used during mechanical ventilation to maintain airway pressure above atmospheric pressure, improving oxygenation while reducing FiO2.
- Tracheostomy Care: Clean inner cannula, suction, and dressing changes are critical; always have suction equipment at bedside.
Critical Care - Blood Transfusions
- Blood Transfusions: Must match patient's blood type within 20 minutes, require two patient identifiers. Administer the blood cautiously, monitoring for and addressing any reactions like nausea, vomiting, chills, hypotension, fever, back and chest pain, dyspnea. Start infusion slowly (15 minutes) and observe closely. Complete blood transfusion within 2-4 hours, and flush tubing.
- Reaction suspected: Immediately stop transfusion, disconnect tubing, monitor symptoms, and stay with the patient. Notify physician and blood bank. Document all events.
Critical Care - Shock
- Shock: Widespread reduction of tissue perfusion due to oxygen and nutrient deprivation.
- Early signs: Restlessness and agitation (cerebral hypoxia).
- General signs: Hypotension, tachycardia, weak pulses.
- Common complications: Multiple organ dysfunction syndrome (MODS), systemic inflammatory response syndrome (SIRS), respiratory distress, pleural effusion, death.
- Nursing Interventions: Oxygen/ventilation, IV fluid resuscitation, assess vital signs, cardiac meds (varies by shock type).
Critical Care - Shock Types
- Hypovolemic Shock: Fluid or blood loss, leads to hypotension and tachycardia, cool, pale skin.
- Cardiogenic Shock: Inability of the heart to pump adequately, leads to diminished cardiac output, hypotension and tachycardia, cool pale skin.
- Distributive (Vascular) Shock:
- Anaphylactic: Allergic reaction causing widespread vasodilation, dyspnea, cough, pruritis (itching), decreased LOC, rapid pulse, hypotension.
- Neurogenic: Spinal cord injury leading to vasodilation, bradycardia, hypotension, unusually warm and dry skin.
- Septic: Infection causing vasodilation, hypotension, tachycardia, pale, cool skin, abnormal pulse.
- Obstructive Shock: Obstruction blocking blood flow, leads to decreased cardiac output, hypotension, tachycardia, and changes in responsiveness, cool pale skin.
Critical Care - ABG Analysis
- ABG (Arterial Blood Gas): Analyzes blood to determine pH balance.
- Acidosis: Low pH.
- Alkalosis: High pH.
- Respiratory Acidosis: High PaCO2 (carbon dioxide) and low pH.
- Respiratory Alkalosis: Low PaCO2 and high pH.
- Metabolic Acidosis: Low HCO3 (bicarbonate) and low pH.
- Metabolic Alkalosis: High HCO3 and high pH.
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