NSG4330 - Midterm #2 QUESTIONS WITH 100% CORRECT ANSWERS| LATEST
UPDATE 100% VERIFIED
Burn Wound Care Cleanse and debride wound, skin graft, hydrotherapy, tropical agents
(blood vessel damage often prevents systemic abx from reaching wound), dressing changes
(analgesia first)
Jobst Garment Elastic woven material provides pressure up to 23hrs/day x6m. Low
compliance due to warmth of garment.
Shock Signs and symptoms describing a sequence of changes that occur when tissue oxygen
supply does not meet oxygen demand
Inadequate tissue perfusion
Classifications of Shock Low Blood Flow: hypovolemic and cardiogenic
Maldistribution of Blood: neurogenic, anaphylactic, septic
Hypovolemic Shock
Basics and Causes Absolute or relative loss of intravascular fluid volume
Possible causes: absolute (hemorrhage, vomiting/diarrhea, diuresis) ;; relative: third spacing
Circulating volume decreases, decreasing cellular oxygen supply = inadequate tissue perfusion +
cell metabolism
,Hypovolemic Shock
Symptoms Decreased LOC
Cyanosis/ashen skin
Cold + clammy / Hypothermia
Hypotension
Rapid, thready pulse
N/V
Anuria
Hypovolemic Shock
Management Stop loss and restore volume
3:1 replacement rule (3mL isotonic crystalloid for every 1mL of blood loss... NS good, colloids
for plasma, RL affects liver)
Cardiogenic Shock
Basics + Causes Impaired oxygen delivery due to cardiac dysfunction (structural problem,
dysrhythmia)
Structural or functional problem within heart causes ineffective pumping resulting in:
,1) decreased stroke volume and cardiac output AND/OR
2) ineffective ventricular emptying leading to pulmonary edema and decreased oxygenation
End result of either is impaired tissue perfusion and cell metabolism
Cardiogenic Shock
Symptoms Cyanosis
Diminished breath sounds, wheeze or crackles
Dyspnea (white or pink foamy sputum)
Hypotension
Pitting edema
Cardiogenic Shock
Treatment Restore blood flow (thrombolytics, angioplasty)
Hemodynamic monitoring
Drugs therapy (i.e. diuretics to reduce preload)
Circulatory assist devices
Neurogenic Shock
, Symptoms Hypotension
Bradycardia (opposite usually seen with hypotension)
Warm, dry skin
Initial alertness
Diminished peripheral pulses
Neurogenic Shock
Basics + Causes Hemodynamic phenomenon occurring with spinal cord injuries above T5
(can occur upt to 6w post injury). SNS vasocontriction is decreased resulting in major
vasodilation.
SNS affected by injury, decreasing sympathetic tone. This dilates vessels, decreasing venous
return/stroke volume/cardiac output.
End result is inadequate tissue perfusion and cell metabolism
Neurogenic Shock
Treatment Spinal stability
Drug therapy for hypotension and bradycardia (vasopressors and atropine)
Fluids used cautiously as neurogenic shock not usually r/t fluid loss
Monitor for hypothermia
Anaphylactic Shock
UPDATE 100% VERIFIED
Burn Wound Care Cleanse and debride wound, skin graft, hydrotherapy, tropical agents
(blood vessel damage often prevents systemic abx from reaching wound), dressing changes
(analgesia first)
Jobst Garment Elastic woven material provides pressure up to 23hrs/day x6m. Low
compliance due to warmth of garment.
Shock Signs and symptoms describing a sequence of changes that occur when tissue oxygen
supply does not meet oxygen demand
Inadequate tissue perfusion
Classifications of Shock Low Blood Flow: hypovolemic and cardiogenic
Maldistribution of Blood: neurogenic, anaphylactic, septic
Hypovolemic Shock
Basics and Causes Absolute or relative loss of intravascular fluid volume
Possible causes: absolute (hemorrhage, vomiting/diarrhea, diuresis) ;; relative: third spacing
Circulating volume decreases, decreasing cellular oxygen supply = inadequate tissue perfusion +
cell metabolism
,Hypovolemic Shock
Symptoms Decreased LOC
Cyanosis/ashen skin
Cold + clammy / Hypothermia
Hypotension
Rapid, thready pulse
N/V
Anuria
Hypovolemic Shock
Management Stop loss and restore volume
3:1 replacement rule (3mL isotonic crystalloid for every 1mL of blood loss... NS good, colloids
for plasma, RL affects liver)
Cardiogenic Shock
Basics + Causes Impaired oxygen delivery due to cardiac dysfunction (structural problem,
dysrhythmia)
Structural or functional problem within heart causes ineffective pumping resulting in:
,1) decreased stroke volume and cardiac output AND/OR
2) ineffective ventricular emptying leading to pulmonary edema and decreased oxygenation
End result of either is impaired tissue perfusion and cell metabolism
Cardiogenic Shock
Symptoms Cyanosis
Diminished breath sounds, wheeze or crackles
Dyspnea (white or pink foamy sputum)
Hypotension
Pitting edema
Cardiogenic Shock
Treatment Restore blood flow (thrombolytics, angioplasty)
Hemodynamic monitoring
Drugs therapy (i.e. diuretics to reduce preload)
Circulatory assist devices
Neurogenic Shock
, Symptoms Hypotension
Bradycardia (opposite usually seen with hypotension)
Warm, dry skin
Initial alertness
Diminished peripheral pulses
Neurogenic Shock
Basics + Causes Hemodynamic phenomenon occurring with spinal cord injuries above T5
(can occur upt to 6w post injury). SNS vasocontriction is decreased resulting in major
vasodilation.
SNS affected by injury, decreasing sympathetic tone. This dilates vessels, decreasing venous
return/stroke volume/cardiac output.
End result is inadequate tissue perfusion and cell metabolism
Neurogenic Shock
Treatment Spinal stability
Drug therapy for hypotension and bradycardia (vasopressors and atropine)
Fluids used cautiously as neurogenic shock not usually r/t fluid loss
Monitor for hypothermia
Anaphylactic Shock
