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31 Cards in this Set
- Front
- Back
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What is ARDS
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Is a sudden and progressive form of acute respiratory failure in which the alveolar capillary membrane becomes damaged and more permeable to intravascular fluid
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What is the most common cause of ards
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Sepsis
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What causes DIC
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Infection, cancer, inflammation
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What is DIC
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A disorder in which proteins that control blood clotting become over active
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What happens to the body when you have DIC
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Small blood clots from the vessels become clogged and cuts off blood supply to the brain, kidneys and liver. Lack of oxygen can cause damage to the organs and keep it from working properly
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What happens once the proteins are all used up
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When this happens you have a high risk of bleeding, even from a minor injury or a noninjury. Also health blood cells can break up.
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What are risk factors for DIC
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Cancer, liver disease, pancreatitis, burns, head injuries, pregnancy (placenta left behind), Infection in the blood and large hematoma's
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What are signs and symptoms of DIC
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Bleeding from multiple sites, bruising, blood clots and drop in blood pressure
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What is diagnostic tests for DIC
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CBC with blood smear exam, PT, PTT, serum fibrinogen
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What is the treatment for DIC
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Plasma transfusions and blood thinners to prevent clots. There is no specific treatment
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What is complications of DIC
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Bleeding, stroke, and lack of blood flow to arms, legs or vital organs
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What are two priority nursing diagnosis for DIC
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Ineffective tissue perfusion r/t disruption of blood circulation
Risk for fluid volume deficient d/t blood loss |
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What is infection
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Inflammation response to microorganisms
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What is bacteremia
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Presence of bacteria in the blood
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Systemic inflammatory response syndrome (SIRS)
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Systemic response to a clinical insult ie: trauma, burns, pancreatitis. Manifested by two or more of the following conditions 1)temperature >100.4 or <96.8 or 2heart rate >90 or respiration >20 or PaCO2 <32 mm or WBC's >1200 <4000
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What is sepsis
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Systemic response to infection
Manifested by two or more of the conditions ie: temp >100.4 - <96.8,Heart rate >90, resp >20, PaCO2 <32 mm or WBC's >1200 <4000 |
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What is septic shock
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Sespic with hypotension despite adequate fluid resuscitation manifested by lactic acidosis (not enough oxygen) oliguria (low urinary output - kidneys not being profused) mental status changes ( brain not being profused)
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What does septic shock lead to?
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MODS-multiple organ dysfunction syndrome
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What is MODS?
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Multiple organs failing
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What is the one difference between sepsis and sirs
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Sirs - can come from other things
Sepsis - comes from infection |
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When the body receives a insult the IIR is activated to do what?
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1 - protect the body from invading pathogens
2-limit the extent of injury 3- promote rapid healing of tissues How ever in some patients regulation is lost and an overwhelming IIR response can lead to changes, tissue destruction and organ death. |
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What are some causes of septic shock?
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Uti, pneumonia, blood - trauma patients
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What are the normal response to stressors in shock
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1)Immune /inflammatory cascade responses are initiated (IIR)
2) sympathetic nervous system is activated. ie: catacholimines, epinephrine, nor epinephrine 3) chemical mediators are released |
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What are early signs of septic shock /sirs
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Warmth, restlessness, agitation, increased HR, low B/P, increase cardiac output, vasodilation, low SVR, pressures In the heart are low CVP, PAP, PAOP (wedge), decreased urinary output, hypokalemia, hypoactive bowel sounds, hyperventilating, Co2 will be down, resp alkolisos
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What is late signs of septic shock and sirs
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Impaired blood flow to all body tissues and organs
Lethargic, HR increased, b/P low, dysrhythmias, CO /CI is low, CVP, PA, PAOP are up, SVR is low, increased RR, crackles, increased C02, resp and metabolic acidosis, oliguric /anuric, hyperkalemia, increased BUN /creatinine, decreased clotting factors and platelets, ulcers, decreased bowel sounds, increased ALT /AST ie: liver failure |
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What are some priority nursing diagnosis for septic shock and sirs
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Ineffective breathing pattern
Ineffective tissue perfusion Fear, anxiety, PC: DIC |
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What medications are used for septic shock and sirs
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Vasopressors ie: dobutomine, dopamine, norepinephrine, epinephrine, phenylephrine
They cause vasoconstriction to help raise blood pressure Nitoprusside, nitroglycerine: they decrease preload and after load, use only in the end |
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What is over all treatment for septic shock and sirs
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Vasopressors, fluids NS /Albumin, fluid challenge (large amount of fluids), daily weights, ABG's, increased calories, ATB's
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What are complications of septic shock and sirs
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ARDS, DIC
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What is Peep and Why is Peep Used?
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Positive pressure on expiration. Prevent alveolar collapse, improve oxygenation. Has to be used with other modes.
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What hemodynamic monitoring tells how well the organs are getting profused
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MAP, mean arterial pressure, 70-100
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