Shock and Anaphylaxis

3% sodium chloride is a hypertonic crystalloid solution

A full Trendelenburg position makes breathing difficult and does not increase BP or cardiac output

The nurse prepares for the maximum intensity of histamine response (for a PT w/ an anaphylactic reaction) to occur

How may epinephrine be administered

Used for fluid replacement

A MAP below ____ ; GFR cannot be maintained and acute renal failure may occur

With all colloidal solutions, side effects include the rare occurrence of anaphylactic reactions

A patient is being treated for increased ICP. Which activities below should the patient avoid performing

The nurse should report a systolic BP < __ mm Hg or a drop in systolic BP of __ mm Hg from baseline

A normal PaCO2 level is 35-45

Stage of shock that can be reversed

Vital signs should be checked at least every ______ mins in the patient with shock

What is the BEST position for a patient in anaphylactic shock

Which is a cardiovascular effect during the progressive stage of shock

The apical pulse should be assessed before administering Digoxin (Lanoxin)

Digoxin has a narrow therapeutic range of

Which of the following are compensatory mechanisms performed by the body to decrease ICP naturally

S/S of Digoxin, a positive inotrope, toxicity

PT DX w/ shock has a BP of 100/60, 15 mins. later the BP is 88/64. How much narrowing of the client's BP has occurred

In infants and small children, the first signs of Digoxin overdose are usually cardiac arrhythmias

Treatments to reduce bronchoconstriction

Crystalloid solutions include

Stage 3 of shock

Vasoactive medications should never be stopped abruptly; infusion should be weaned

In DIC, abnormal clots use up the blood's clotting factor, which can lead to massive bleeding in other places

A patient is severely allergic to bees and was recently stung by one. This type of anaphylactic reaction is known as a

Colloid that may interfere with platelet aggregation

If a patient has a BP reading of 90/70, what is their pulse pressure

Small blood clots form in vessels and cut off the supply of oxygen to distal tissues

Disadvantages of crystalloid solutions

Select the clinical findings of the 3rd stage of shock

A client is displaying signs of shock, what is the priority intervention

Medical treatment is directed toward identifying the cause of the shock

Patients in shock may require more than _____ calories daily

Epinephrine decreases blood pressure by vasodilation

Most important measurement of shock

Is an indirect measure of tissue hypoxia

Stage 2 of shock

Which are characteristics of the compensatory stage of shock

With shock, the result of inadequate tissue perfusion is a build up of lactic acid, producing

BP and MAP below normal limits, HR > 150, rapid, shallow, respirations, petechiae, lethargy, metabolic acidosis

Is an earlier indicator of shock than a drop in systolic BP 

The immediate intervention is to always

Identify the mechanism (green arrow is pH)

A client should be instructed to carry ____, to prevent anaphylaxis in the event of exposure to an allergen

What is the MOST important step a nurse can take to prevent anaphylactic shock in a patient

Fluid leaks into the intra-abdominal cavity, increasing pressure that is displaced onto surrounding vessels and organs

Normal BP, HR >100, RR >20, cold, clammy, confused, agitated, respiratory alkalosis

The progressive stage of shock can cause stress ulcers, what medication may you anticipate an order for

Vasodilators improve perfusion

What shows that a patient knows how to self-administer their EpiPen

Compensatory (2 words) occurs in the compensatory stage of shock, due to the increased rate of respirations

Administering diphenhydramine

What effects does histamine have on the body during anaphylactic shock

Stage 1 of shock

BP: 80/52, HR: 120, 02 SAT: 87%. Audible wheezing, facial redness and swelling. What is the first initial treatment

Respirations with abdominal compartment syndrome are

Colloidal solutions include

Select all the signs and symptoms associated with anaphylactic shock

Organ damage is so severe that the patient does not respond to treatment and cannot survive

Increased patient survival occurs when therapy begins within 3 hrs of identifying a shock state, especially septic shock

Identify the mechanism

Preshock, 'fight-or-flight', blood will be shunted to the brain, heart, and lungs

The end point of stage 3 of shock is the patient's death

The prognosis for the patient in the compensatory stage of shock is better than in later stages

How many stages of shock are there

Also known as passive leg raising, is recommended in hypovolemic shock

Key to recognizing subtle changes and identifying early signs of shock

Epinephrine is a vasoactive medication

Organ failure with MODS usually starts in the

A patient in the progressive stage of shock has blood in their NG tube. What is suspected

Should not be given in place of epinephrine, but should be given as adjuncts

A client has rapidly increasing symptoms of anaphylactic shock, what is your first intervention

The PT is given Epinephrine intramuscularly. As the nurse, you know this medication will have what effect on the body

Inotropic agents

After administration of penicillin, what S/S might suspect you to think the client is having an anaphylactic reaction

A PT in shock is bleeding from previous venipuncture sites, catheter, rectum, has areas of ecchymosis. What is suspected

After administration of an epipen, the site should be massaged for 10 secs.

Client presents in the ED diaphoretic, has pale, clammy skin, and a BP of 90/70. Which intervention do you do first

S/S of shock

Which stage of shock is characterized by a normal blood pressure

Glycogen (storage form of glucose) begins to become depleted in the patient with shock, what order do you anticipate

By the time BP drops, damage has already been occurring at the cellular and tissue levels

DIC may occur as either a cause or complication of what stage in shock

Doses are tapered when discontinuing corticosteroids to avoid adrenal insufficiency