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12 Cards in this Set
- Front
- Back
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Describe pathophys of what happens to cell membs.
What would help the problem going on? |
Lack of intracellular ATP -->> inhibs Na/K-ATPase -->> cell memb dysfunc -->> influx of fluid -->> cellular swelling
Lactated Ringers help by fighting this process |
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Why does fluid resuscitation -->> interstitial edema?
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bc of BV endothel damage -->> leaky
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Class I Hemorrhage.
a) % blood loss b) mL blood loss c) Sx? d) Tx? |
a) < 15%
b) < 750 mL c) nml vitals. slightly anxious d) Tx: crystalloid soln. ex: LR |
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Class II Hemorrhage.
a) % blood loss b) mL blood loss c) Sx? d) Tx? |
a) 25-30%
b) 750-1500mL c) bp: NORMAL HR: 100-120 PP: decreased RR: 20-30 UOP: 20-30 mL/hr cap refill: increased MS: mildly anxious d) Tx: crystalloid soln. ex: LR |
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Class III Hemorrhage.
a) % blood loss b) mL blood loss c) Sx? d) Tx? |
a) 30-40%
b) 1500-2000mL c) DECREASED SBP HR: 120-140 PP: decreased RR: 30-40 UOP: 5-15 mL/hr cap refill: increased MS: anxious/confused Tx: crystalloid soln (ex: LR) AND blood transfusion |
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Class IV Hemorrhage.
a) % blood loss b) mL blood loss c) Sx? d) Tx? |
a) > 40%
b) > 2L c) SBP decreased HR: > 140 PP: decreased RR: > 35 UOP: negligible cap refill: increased MS: confused/lethargic d) Tx: crystalloid AND blood |
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How much blood (L) does avg 70kg person have?
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5L
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In children < 6 y/o, what other IV accesss options do you have besides 2 large-bore IVs?
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You can start an intraosseous line into marrow cavity of a long bone, usu tibia
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How much fluid & blood is needed to resuscitate a pt?
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- technically, the rule is 3:1, give 3mL crystalloid fluid per 1 mL blood loss
- practically, start w/ 1 L LR wide open. If VS don't stabilize give a 2nd L LR & O neg blood (or typed blood if ready) |
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In neurogenic shock,
bp is... HR is... |
Hypotensive WITHOUT tachycardia (due to loss of symp reflex AND lack of symp inerv to heart -->> bradycardia)
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Tx for neurogenic shock?
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- vasopressors (ex: phenylephrine)
- atropine (to counteract bradycardia) |
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Hypoadrenal shock?
a) caused by? b) occurs in these pts... c) Dx? e) Tx? |
a) caued by Adrenal Insufficiency
b) usu in pts taking steroids, bc of adrenal suppression c) Dx: Cosyntropin (ACTH) stimulation test d) Tx: IV hydrocortisone (100mg q 6-8 hr) |
