Exam (elaborations)
RNSG 2432 - Shock/ ER Questions With Complete Solutions
- Course
- Institution
RNSG 2432 - Shock/ ER Questions With Complete Solutions
[Show more]
Content preview
RNSG 2432 - Shock/ ER Questions With Complete SolutionsA patient's localized infection has progressed to the point where
septic shock is now suspected. Which of the following is an
appropriate treatment modality for this patient?
A. Insulin infusion
B. Aggressive fluid resuscitation
C. Intravenous administration of epinephrine
D. Administration of nitrates and β-adrenergic blockers Correct
Answer B)
Patients in septic shock require large amounts of fluid
replacement. Nitrates and β-adrenergic blockers are most often
used in the treatment of patients in cardiogenic shock.
Epinephrine is indicated in anaphylactic shock, and insulin
infusion is not normally necessary in the treatment of septic
shock (but can be).
Anaphylactic shock graph Correct Answer
Cardiogenic shock graph Correct Answer
Cardiogenic shock uses IABP and a VAD as treatment. What is
the goal and how do these work? Correct Answer Goal =
restore blood flow to the myocardium by restoring the balance
between oxygen supply and demand
IABP (intra-aortic balloon pump): mechanical device that
increases myocardial oxygen perfusion while at the same time
increasing CO
,VAD (ventricular assist device): mechanical pump that's used to
support heart function and blood flow
Compensatory shock graph Correct Answer
Describe MODS. How does it manifest? Correct Answer
Failure of 2 or more organ systems, such that homeostasis
cannot be obtained without intervention
- *Results from SIRS*
- Often culminates in *ARDS!!*
- Can cause massive vasodilation & myocardial depression
Commonly manifests as changes in LOC
- AKI is common
- ALL organs are susceptible!
Describe the 5 ESI Level Triage. Correct Answer LEVEL 1 =
*Resuscitation* - pts requiring immediate evaluation and
management (ie trauma, stroke, MI)
LEVEL 2 = *Emergent* - pts require evaluation within 15 min
for potential threat to life or limb
LEVEL 3 = *Urgent* - pts have conditions that cause
significant discomfort and should be evaluated within 30 - 60
min
LEVEL 4 = *Less urgent* - pts do not require rapid
intervention, but should be evaluated within 60 min
LEVEL 5 = *Non-urgent* - pts may be seen in a delayed
fashion and could be referred to other areas of the health care
system
, Diagnostic tests & Meds: ED care Correct Answer Diagnostic:
Blood (type & cross), BAC,Urine drug test, Preg test, X-ray,
CT/MRI
- DPL (diagnostic peritoneal lavage) = surgical diagnostic
procedure to determine if there is free floating fluid (most often
blood) in the abdominal cavity via aspiration technique
- *FAST = Focused assessment w/ sonography for trauma:*
screening test for blood around heart (pericardial effusion) or
abdominal organs (hemoperitoneum) after trauma)
Medications: Blood, Crystalloids (NS or LR), Volume
expanders (Hespan), Inotropic drugs after IV fluids (dopamine,
dobutamine, isoproterenol),Vasopressors (dopamine,
epinephrine), Opiods (pain control), Tetanus prophylaxis,
Antibiotics, Mannitol, oxygen!
Discuss the stage of shock: Compensatory Correct Answer
Clinical presentation begins to reflect the body's responses to the
imbalance of oxygen supply/ demand:
- Drop in BP & MAP (d/t a decreased in CO & narrowed PP)
- Baroreceptors immediately respond to the low BP by
activating the SNS
- The SNS responds by stimulating vasoconstriction & releasing
potent vasoconstrictors (epi & norepi)
- Blood flow to the vital organs (heart and the brain) is
maintained, while blood flow to the nonvital organs (kidneys, GI
tract, skin and lungs) is diverted, or shunted
- The heart responds to the SNS stimulation by INCREASING
the HR & contractility (increased contractility increases the
myocardial oxygen consumption = coronary arteries dilate in an
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Classroom. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75632 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now