Shock Prep

595 Words Mar 12th, 2013 3 Pages
David A Daves
SIM PREP……..
02/22/13

Preparation Questions
Differentiate the following terms:
Systemic Inflammatory Response Syndrome (SIRS):
Is aggressive widespread inflammatory response to infection (sepsis) or perceived invader. Also, ischemia, infarction and injury.

Sepsis:
Is a systemic inflammatory response in the presence of a documented infection.

Severe sepsis:
Is sepsis complicated by organ dysfunction, is diagnosed in more than 750,000 patients per year and has mortality rates as high as 28%-50%.

Septic shock:
Is the presence of sepsis with hypotension despite fluid resuscitation along with the presence of inadequate tissue perfusion.

Multiple organ dysfunction syndrome (MODS):
Is the failure of two or
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This causes the ventricles to dilate in order to maintain adequate stroke volume. Usually, this will improve over the next 7-10 days.

Discuss the cascade of host inflammatory responses that produce the major detrimental effects seen in sepsis due to gram-negative bacteria.
Inflammatory variables:
Leukocytosis (WBC > 12 x 10(3) cells
Leukopenia (WBC count <4.0 x 10(3) cells
Normal WBC count with > 10% immature forms
Elevated C-reactive protein
Elevated procalcitonin

What is early-goal-directed therapy in the management of sepsis? 1. Evidence of adequate tissue perfusion 2. Restoration of normal or baseline BP 3. Return/recovery of organ function 4. Avoidance of complications from prolonged states of hypoperfusion

Identify the treatment guidelines currently recommended for the management of sepsis and septic shock.
Discuss how the drug dobutamine affects cardiac output. Identify the nursing implications with the administration of this drug.
Discuss how norepinephrine works and its indications for use. Identify the nursing implications with the administration of this drug.
Discuss how drotrecogin alfa works and its indications for use. Identify the nursing implications with the administration of this drug.
Describe the concept of ScvO 2 monitoring. Identify the significance of abnormally high and low ScvO2 readings.
Describe the nursing responsibilities in

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