shock and possible complications

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