Patient Care (Ch 9) 10-01-25

What is the number for codes at ThedaCare?

444

Define shock

A condition where blood is shunted away from the lungs, skin, kidneys, and GI tract to prioritize the brain and heart due to a reaction from illness, trauma, or severe physiologic/psychological stress.

What type of shock is caused by a contrast reaction?

Anaphylactic shock

Where is a pulmonary embolism (PE) found?

In the pulmonary artery or veins of the lungs

What can you give someone with hypoglycemia?

Sugar packet under the tongue or orange juice

What does CAB stand for in cardiac arrest?

Circulation, Airway, Breathing

What are the signs of a stroke?

Facial droop, arm weakness, speech difficulty, and headache

What position should a patient having a seizure be placed in?

On their side (Sims' position)

If a patient has dysphasia and unilateral paralysis, what should you do?

Order a CT of the head immediately

What is likely happening with dysphasia and unilateral paralysis?

A blood clot is causing an embolic stroke

What is GFR and what does a low value indicate?

Glomerular Filtration Rate; a value below 60 mL/min indicates kidney dysfunction

What is the normal GFR range?

60-90 mL/min; values below 60 indicate chronic kidney disease

What is the normal BUN range?

8-25 mg/dL

What does a high BUN indicate?

Dehydration or poor kidney function

What is the normal creatinine range?

0.6-1.5 mg/dL

What does high creatinine mean?

Kidneys are not filtering waste properly

What is septic shock?

Shock caused by infection with a 40-50% mortality rate

What causes septic shock?

Infection spreading throughout the bloodstream

What is anaphylactic shock?

Most common type of shock seen in the radiology department, caused by an allergic reaction to IV contrast

What are early signs of anaphylactic shock?

Nasal congestion, itching, and sneezing

What happens as anaphylaxis progresses?

Breathing difficulties that may lead to cardiac arrest

What should technologists do before giving contrast?

Get a thorough patient history to check for allergies or previous reactions

What is cardiogenic shock?

Heart can't pump enough blood to the organs due to heart failure

What is cardiogenic shock?

When the heart cannot pump enough blood to the organs due to heart failure

What is the main cause of cardiogenic shock?

Heart failure that prevents adequate cardiac output

What is distributive shock?

Pooling of blood in peripheral blood vessels due to decreased blood pressure

What happens to blood flow during distributive shock?

Blood pools away from vital organs, reducing perfusion

What is neurogenic shock?

Shock caused by spinal injury, severe pain, diabetic reaction, or anesthesia

What are common causes of neurogenic shock?

Spinal cord injury, anesthesia, diabetic reaction, or severe pain

What is hypovolemic shock?

Loss of fluid due to burns, bleeding, prolonged vomiting, or diarrhea

How much fluid loss can cause hypovolemic shock?

Typically a loss of 750-1300 mL or 15-25% of total body fluid

What are the main signs of hypovolemic shock?

Thirst, cold and clammy extremities, and pale fingernails when pressed

What should you observe in a patient with hypovolemic shock?

Check fingernails for color return when pressing on them

How should a patient with hypovolemic shock be positioned?

In Trendelenburg position if possible (feet elevated)

What is obstructive shock?

Anything that interferes with the normal pumping of the heart, such as PE, arterial stenosis, constrictive pericarditis, or tumors affecting blood flow.

What are causes of obstructive shock?

Pulmonary embolism, arterial stenosis, constrictive pericarditis, or tumors that restrict cardiac function.

What is a PE (pulmonary embolism)?

A clot or foreign body in the pulmonary artery or vein, found in the lungs.

What are symptoms of a pulmonary embolism?

Tachycardia, chest pain, and shortness of breath.

What is a saddle embolus?

A large clot lodged at the bifurcation of the pulmonary artery that blocks blood flow to both lungs.

What is a CVA (stroke)?

Cerebrovascular accident—an interruption of blood flow to the brain resulting in tissue damage.

What is an embolic CVA?

Occurs in older patients; symptoms include unilateral numbness or muscle weakness, dysphasia or aphasia, and headache.

What is an ischemic CVA?

Caused by a narrowed vessel reducing blood flow to brain tissue.

What is a hemorrhagic CVA?

Caused by a ruptured blood vessel; may occur in younger patients and presents with severe headache and similar neurological symptoms.

What is the first imaging test for a suspected stroke?

Immediate head CT to rule out hemorrhagic, ischemic, or embolic CVA.

What causes syncope (fainting)?

Orthostatic hypotension, not eating, stress, or shock.

What is angioneurotic edema?

Allergic reaction characterized by edematous (swollen) skin due to fluid release from blood vessels.

What is anuria?

Absence of urine formation due to kidney failure.

What is glucagon?

Hormone secreted by the pancreas that raises blood sugar during hypoglycemia.

What is hypovolemia?

Low blood volume caused by trauma, burns, vomiting, or diarrhea; leads to cold, clammy skin and thirst.

What is cognitive function?

A patient's ability to understand and perceive directions or concepts.

What is arrhythmia?

Irregular heart rhythm.

What is iodination?

Incorporation of iodine into a compound to make it radiopaque for imaging.

What is perfusion?

Passage of fluid (like blood or air) through an organ or tissue.

What does LOC stand for?

Loss or Level of Consciousness.

What are two meanings of LOC?

Loss of Consciousness or Level of Consciousness.

What should you check before starting any exam on an unstable patient?

Check for baseline vital signs and mental status.

What are early signs of a deteriorating patient condition?

Change in level of consciousness or restlessness.

What are late signs of deterioration?

Cyanosis and loss of consciousness.

When should a technologist call for help?

When the patient shows signs of distress or rapid decline in condition.

What is the purpose of Trendelenburg position?

To increase venous return to the heart in cases of low blood pressure or fainting.

How should the head be positioned for a patient with breathing difficulty?

Elevated (Fowler's position).

What should you do if a patient vomits while supine?

Turn them to the side to avoid aspiration.

What should you do if a patient loses consciousness?

Call for help, check for pulse and respiration, begin CPR if necessary.

What does the body do to compensate for shock?

Increases heart rate and respiration while constricting peripheral vessels.

What vital sign change may indicate shock before BP drops?

Rapid pulse and increased respirations.

What causes the skin to become cool and clammy during shock?

Peripheral vasoconstriction reduces skin blood flow.

What happens to urine output during shock?

It decreases due to reduced kidney perfusion.

What lab values should be checked before giving IV contrast?

BUN, creatinine, and GFR.

What is the first sign of a mild contrast reaction?

Sneezing, itching, or mild rash.

What medication is given for mild allergic reactions?

Diphenhydramine (Benadryl).

What is given for a severe anaphylactic reaction?

Epinephrine (Adrenaline).

What should you do immediately if a patient has a reaction?

Stop the injection and notify the radiologist or code team.

What is the most common cause of death from anaphylaxis?

Airway obstruction due to swelling.

What is the first thing you assess if a patient becomes unresponsive?

Level of consciousness and airway.

What are three parts of the Glasgow Coma Scale?

Eye opening, verbal response, motor response.

What is the highest possible GCS score?

15 (fully alert).

What is the lowest possible GCS score?

3 (deep coma or death).

What neurological sign might indicate a CVA?

Unequal pupils or sudden speech difficulty.

What should not be done if a patient is having a seizure?

Do not restrain or insert anything into their mouth.

What is the normal respiratory rate for an adult?

12-20 breaths per minute.

What is dyspnea?

Difficulty breathing or shortness of breath.

What is cyanosis?

Bluish discoloration of the skin due to lack of oxygen.

What is hypoxia?

Inadequate oxygen supply to tissues.

What device delivers low-flow oxygen?

Nasal cannula.

What oxygen flow rate is typical for a nasal cannula?

1-6 L/min.

What is the oxygen flow rate for a simple face mask?

5-10 L/min.

What causes insulin shock?

Too much insulin or not enough food.

What are signs of insulin shock?

Trembling, confusion, sweating, and irritability.

What is the treatment for insulin shock?

Give sugar immediately.

What causes diabetic ketoacidosis?

Not enough insulin, leading to high blood sugar and dehydration.

What are signs of ketoacidosis?

Rapid breathing, fruity breath, and dry mouth.

What is the difference between a stroke and a TIA?

A stroke causes permanent damage; a TIA resolves within an hour.

What type of stroke is caused by a rupture of a cerebral artery?

Hemorrhagic stroke.

What type of stroke is caused by a clot?

Ischemic or embolic stroke.

What is the first imaging test done for stroke?

CT of the head.

What does FAST stand for?

Face drooping, Arm weakness, Speech difficulty, Time to call 911.

What are the two major types of seizures?

Generalized (tonic-clonic) and partial (focal).

What should you do during a seizure?

Move objects away, protect the head, and wait until it passes.

What should you do after a seizure?

Turn the patient on their side and check airway and breathing.

What causes orthostatic hypotension?

Sudden drop in BP when standing up quickly.