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what are the first sign of shock?
changes of LOC (anxiety, restlessness, confusion)
what neurologic symptom is associated with decreased CO?
SNS stimulation
what are examples of actual blood loss that could cause hypovolemic shock?
trauma and bleeding
what could cause relative blood loss associated with hypovolemic shock?
burns
what are common cardiac symptoms of cardiogenic shock?
JVD and S3/S4
what are common respiratory complications of cardiogenic shock?
crackles
what is a priority med given during cardiogenic shock?
dobutamine
in this type of shock, altered peripheral resistance causes blood vessels to dilate without increasing blood volume - leads to perfusion issues
relative hypovolemia + distributive
in this shock, blood vessels dilate and leak fluid - what do you suspect?
anaphylactic shock
patient presents with edema, itching, light-headiness, and warm/moist skin - you suspect they are in -
early anaphylactic shock
patient presents with laryngeal edema, bronchospasm, wheezing, dyspnea, and air hunger - you suspect they are in what?
late anaphylactic shock
what is a priority medication given during anaphylactic shock?
epinephrine
this occurs due to massive vasodilation -
septic shock
a patient in sepsis is experiencing restlessness, anxiety, and confusion - what stage are they in?
warm sepsis
a septic patient presents with increased cardiac output and full bounding pulses - what stage are they in?
warm septic shock
a septic patient presents with normal or slightly high urine output - what stage are they in?
warm sepsis
patient presents with cold/clammy skin, a narrow PP, and low CO - what stage of sepsis are they in?
late septic shock
what is a hallmark indicator for SIRS?
high lactate
when would you call a code sepsis and request the patient be moved to the ICU?
when they have SIRS with greater than 2 of the sepsis symtpoms
what needs to be done within the first 3 hours following a code sepsis call?
lactate, blood cultures, broad spectrum antibiotics, and fluid replacement
what needs to be done within 6 hours of a code sepsis?
vasopressors, measure CVP and SvO2, remeasure lactate
what medication is given in sepsis?
norepinephrine (vasopressors)
when are steroids given to a patient in septic shock?
when hemodynamic stabilization can not be achieved
what medication is commonly given to patients with COVID19?
dexamethasone
what is the biggest risk following the development of DIC?
bleeding
what is a priority intervention for a patient with DIC?
instating bleeding precautions
what is the goal of MODS?
maintaining a MAP of 65-75
what is the earliest sign of MODS development?
pulmonary - restlessness and difficulty breathing