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NUR303 STUDY GUIDE WITH COMPLETE SOLUTION

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NUR303 STUDY GUIDE WITH
COMPLETE SOLUTION

Stress - ANSWER a hard push on the body that needs a response from many
organ systems. (Alarm, Resistance, Exhaustion)

Glucocorticoids (cortisol) - ANSWER a group of hormone which are potent
anti-inflammatory and immune suppressant agents.

Where is the production of glucocorticoids produced? - ANSWER naturally in
the adrenal gland because of stress.

Shock - ANSWER the failure of the heart and lungs to meet the metabolic and
oxygen needs of the peripheral tissues. (creates low BP)

6 Types of Shock - ANSWER Distributive (complex), Septic (sepsis),
Cardiogenic, Hypovolemic, Anaphylactic, and Neurogenic.

Distributive Shock - ANSWER A loss of blood vessel tone, dilation and
pooling of the blood in the venous and capillary beds where it can no longer
distribute or deliver oxygen. (blood volume is not lost but cannot circulate).

Type 1 of Disruptive Shock: Complex - ANSWER usually begins as a bacterial
or fungal infection and progresses to a dangerous condition over a period of
days.

Septic Shock - ANS Bacterial endotoxins stimulate an immune response.
(Sepsis)

Sepsis - ANS systemic infection associated with a more generalized
inflammatory response, known as SIRS, which is triggered when an infection

,escapes local control. (temp >100.4 or <96.8, HR <90, RR <20, WBC<12,000).

Cardiogenic Shock - ANSWER caused by CHF, MI, septal or papillary tear,
arythmias, cardiac tamponade, Pump Failure. (decreased sensorium, systolic
blood pressure <90, weak pulse, renal failure, possible dysrythmias).

Pump Failure - ANSWER the heart is unhealthy and pumping is impaired.

Hypovolemic Shock - ANSWER Caused by a large depletion of blood or fluids
from the body (hemorrhage, dehydration, diarrhea in children).

Symptoms: thirst, restlessness, decrease in urine output and low BP.

Anaphylactic Shock - ANSWER Caused by a severe allergic reaction.

Extensive hypoperfusion of tissues.

Presents as urticaria, brochospasms, and angioedema.




Neurogenic Shock - ANSWER Caused by spinal cord or brain injury.

Extensive hypoperfusion of tissues.

Widespread vasodilation reduces venous return and volume of blood that
can be pumped out of the ventricles and a low blood volume causes
widespread hypotension.




If the Neurogenic Shock inducing injury is in the upper thoracic area or
higher. - ANS there is a loss of SNS and PSNS discharge takes over.
(bradycardia occurs instead of tachycardia)

, 3 Stages of Shock - ANS Initial, progressive, and irreversible.




Stage 1 of Shock: Initial - ANS when there is an abrupt decrease in tissue
perfusion, the SNS and RAAS are activated.




Stage 2 of Shock: Progressive - ANSWER the lungs, kidneys, gut, pancreas
and liver suffer decreased perfusion and all available blood is conserved for
the heart and brain.




Stage 3 of Shock: Irreversible - ANSWER heart ad brain begin to sustain
decreased perfusion, myocardial and cerebral ischemia occur.

Widespread cellular hypoxia with extensive anaerobic metabolism occurs
throughout the body.




Diffusion - ANSWER a form of passive transport when particles move across
the cell membrane.




Osmosis - ANSWER a form of passive transport when water moves across the
cell membrane.




Osmotic and Oncotic pressure - ANSWER the drive for water to move in one
direction or another.

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