Acute Care Nursing: Shock, Oncology, Immunology, and GU Emergencies

Vocabulary flashcards covering acute care concepts including shock classifications and management, oncology treatments and side effects, immunology, and male GU emergencies.

Shock

A life-threatening condition defined by inadequate tissue perfusion to deliver oxygen and nutrients required to support cell function.

Common Responses to All Types of Shock

Physiological responses shared across all shock states, including hypermetabolism, tissue hypoperfusion, and activation of the inflammatory response.

Compensatory Stage of Shock

The initial stage of shock where blood pressure remains normal, but the patient exhibits tachycardia, tachypnea, confusion, and a weak pulse. Management includes identifying the underlying cause, administering IV fluids, and supplemental oxygen.

Progressive Stage of Shock

The stage of shock characterized by hypotension, tachycardia, tachypnea, oliguria, skin mottling, and elevated lactic acid due to anaerobic metabolism. Management focuses on restoring tissue perfusion with IV fluids and providing respiratory support.

Refractory / Irreversible Stage of Shock

The final stage of shock marked by an erratic heart rate, anuria, comatose state, jaundice, and severe hypotension requiring vasopressors. Management requires mechanical ventilation and multiple vasopressor infusions.

Hypovolemic Shock

A state of shock caused by low blood volume ("empty tank"), resulting from external fluid loss (diarrhea, trauma, surgery) or internal fluid loss (hemorrhage, burns). Treatment includes fluid/blood replacement, oxygen, and vasoactive medications.

Cardiogenic Shock

A state of shock caused by heart pump failure leading to impaired cardiac output, commonly triggered by myocardial infarction (MI), angina, or severe arrhythmias. Management requires treating the cause and hemodynamic monitoring.

Distributive Shock

A category of shock where fluid is present in the body but not inside the intravascular space due to excessive blood vessel dilation, leading to decreased blood pressure and poor tissue perfusion. Includes anaphylactic, septic, and neurogenic shock.

Anaphylactic Shock

A severe allergic reaction leading to massive vasodilation, hypotension, and respiratory distress. Primary medical management is epinephrine.

Neurogenic Shock

A type of distributive shock caused by spinal cord injury ($T6$ and above), spinal anesthesia, or autonomic system imbalance, notable for being the only shock state associated with bradycardia ($<60\,\text{BPM}$) and warm, dry skin. Management requires spinal cord stabilization.

Septic Shock

A type of distributive shock caused by infection, distinguished as the only shock state with fever. Management includes isotonic IV fluids, obtaining blood cultures before starting antibiotics, and monitoring lactic acid levels.

Obstructive Shock

A category of shock caused by a physical obstruction to blood circulation, such as pulmonary embolism (PE), cardiac tamponade, or tension pneumothorax.

Systemic Inflammatory Response Syndrome (SIRS)

A systemic inflammatory condition defined by meeting $2$ or more of the following criteria: temperature $<96.8^\circ\text{F}$ ($36^\circ\text{C}$) or $>101^\circ\text{F}$, heart rate $>90$, tachypnea (respiratory rate $>20$), or WBC count $>12{,}000$ or $<4{,}000$.

Cytokine Storm

The release of massive quantities of inflammatory cytokines intended to protect the body, which ultimately leads to severe tissue and organ damage.

Sepsis Continuum

The clinical progression from SIRS ($2+$ criteria) $\rightarrow$ Sepsis (SIRS criteria + confirmed/suspected infection) $\rightarrow$ Septic Shock (persistent hypotension despite fluid resuscitation and elevated lactate) $\rightarrow$ MODS (Multiple Organ Dysfunction Syndrome).

Primary Cancer Prevention

Health promotion measures aimed at preventing cancer development, including tobacco avoidance, healthy diet and exercise, and minimizing carcinogen exposure.

Secondary Cancer Prevention

Screening guidelines for early detection: annual mammograms for breast cancer at age $45$; cervical screening every $5$ years starting at age $25$; annual colorectal screening for ages $45\text{--}75$; and prostate screening for all males age $50+$ (or Black males age $45+$).

Diagnostic Biopsy Methods

Surgical methods used to obtain tissue for cancer diagnosis, including needle biopsy, excisional biopsy (removing entire lesion), and incisional biopsy (cutting into lesion).

External Beam Radiation Therapy (EBRT)

The most common form of radiation therapy, delivering high-energy rays to a tumor from outside the body.

Stereotactic Body Radiation Therapy (SBRT)

A form of radiation therapy that delivers high-dose radiation to deeper tumors that are not surgically treatable.

Proton Therapy

A targeted form of radiation therapy utilized for tumors located in close proximity to critical structures, such as the heart and major blood vessels.

Brachytherapy

A form of internal radiotherapy where radioactive sources are placed inside or near target tissue (intracavitary or interstitial); can be temporary (source removed after treatment) or permanent (implanted seeds remain).

Radiation Safety Principles

Three core precautions to protect healthcare workers: Time (minimize time near source), Distance (stay as far away as possible), and Shielding (use PPE and lead barriers).

Systemic Radiotherapy

Administration of radioactive isotopes orally (PO) or intravenously (IV), used specifically for treating thyroid cancer and prostate cancer with bone metastases.

Radiation Toxicity

Damage to healthy cells within the treatment field occurring when cellular death exceeds tissue regeneration; tissues most affected include skin, GI epithelium, and bone marrow.

Xerostomia

Dryness of the mouth caused by radiation damage to salivary glands in head and neck treatment fields.

Chemotherapy Toxicity

Systemic side effects resulting from cytotoxic agents targeting rapidly dividing cells (bone marrow, epithelium, hair, sperm), leading to myelosuppression, nausea/vomiting, mucositis/stomatitis, renal toxicity, hemorrhagic cystitis, infertility, fatigue, pneumonitis, and cognitive deficits.

Chemobrain

Chemotherapy-induced neurotoxicity affecting the central nervous system and peripheral nerves, characterized primarily by memory issues, concentration problems, and mental fatigue.

Bone Marrow (Immune Function)

A primary lymphoid organ where B-lymphocytes mature and T-lymphocytes originate.

Thymus

A primary lymphoid organ located in the chest where T-lymphocytes undergo maturation.

Neutrophils

Phagocytic leukocytes that serve as the first responders of the innate immune system during acute infection or inflammation.

Eosinophils

Leukocytes involved in immune responses against parasitic infections and allergic conditions.

Basophils

Leukocytes that release histamine during inflammatory and allergic reactions.

Monocytes

Circulating white blood cells that differentiate into macrophages within tissue spaces.

Spleen

A secondary lymphoid organ that helps fight infections, produces antibodies, and filters pathogens along with old or damaged red blood cells from circulation.

Splenectomy Complications

Post-surgical risks following spleen removal, including increased risk for severe infection, hemorrhage/bleeding, and accidental injury to surrounding anatomical structures.

Benign Prostatic Hyperplasia (BPH)

Non-cancerous enlargement of the prostate gland that compresses the urethra, causing urine stream obstruction, urinary retention, weak stream, and recurrent UTIs.

Transurethral Resection of the Prostate (TURP)

A surgical procedure where a scope enters the urethra to excise prostate tissue obstructing urine flow; bleeding is the primary postoperative concern.

Continuous Bladder Irrigation (CBI)

A post-TURP management technique using a 3-lumen catheter (1 balloon, 1 inflow/irrigation, 1 outflow/drainage) to prevent blood clot formation; nurses can titrate the irrigation flow rate without a physician order.

Prostatitis

Inflammation of the prostate gland, occurring as an acute form (sudden onset, fever, dysuria, treated with antibiotics) or chronic form (asymptomatic, no bacteria in urine).

Testicular Torsion

A surgical genitourinary emergency involving twisting of the testicle and spermatic cord, cutting off blood supply; presents with sudden severe pain and requires rapid emergency intervention.

Epididymitis

Inflammation or infection of the epididymis.

Priapism

A persistent, painful, abnormal erection that constitutes a urological emergency.

Sildenafil Contraindication

An erectile dysfunction medication that causes flushing, headache, and dyspepsia, and must NEVER be taken concurrently with nitrates due to the risk of severe, life-threatening hypotension.