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Hesi Med Surg Study Guide

This document provides an overview of respiratory failure, shock, and nursing assessment and treatment for patients experiencing these conditions. It defines respiratory failure as a PCO2 over 45 or PO2 under 60 on 50% oxygen. Shock is described as a widespread reduction in tissue perfusion leading to impaired cellular function. The early signs of shock are listed as agitation and restlessness from cerebral hypoxia. Types of shock covered include hypovolemic, cardiogenic, vasogenic, and septic shock. Nursing assessment points for a patient in shock include tachycardia, decreased blood pressure, cool skin, decreased urine output, and changes in mental status. Treatment focuses on rapid fluid resuscitation and restoration of circulating volume.

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335 views1 page

Hesi Med Surg Study Guide

This document provides an overview of respiratory failure, shock, and nursing assessment and treatment for patients experiencing these conditions. It defines respiratory failure as a PCO2 over 45 or PO2 under 60 on 50% oxygen. Shock is described as a widespread reduction in tissue perfusion leading to impaired cellular function. The early signs of shock are listed as agitation and restlessness from cerebral hypoxia. Types of shock covered include hypovolemic, cardiogenic, vasogenic, and septic shock. Nursing assessment points for a patient in shock include tachycardia, decreased blood pressure, cool skin, decreased urine output, and changes in mental status. Treatment focuses on rapid fluid resuscitation and restoration of circulating volume.

Uploaded by

George
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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HESI MED SURG STUDY GUIDE

Respiratory Failure - PCO2 > 45 or PO2 < 60 on 50% O2; a child in severe distress should be on 100%
O2

Shock - Widespread, serious reduction of tissue perfusion which, if prolonged, leads to generalized
impairment of cellular functioning

System Hypotension - Marked reduction in either cardiac output or peripheral vasomotor tone, without a
compensatory elevation in the other results in this

Early signs of shock - Agitation and restlessness that results from cerebral hypoxia

Hypovolemic Shock - Related to external or internal blood or fluid loss

Cardiogenic Shock - Related to ischemia or impairment in tissue perfusion resulting from MI, serious
arrhythmia, or HF; all cause decrease CO

Vasogenic Shock - Related to allergens, spinal cord injury, or peripheral neuropathies, all resulting in
venous pooling and decreased blood return to the heart, which decreases cardiac output over time

Septic Shock - Related to endotoxins released by bacteria, which cause vascular pooling, diminished
venous return, and reduced CO

High fowler position with legs down - Position to reduce venous return in order to decrease further
venous return to the left ventricle

Medical treatment for shock - Rapid infusion of volume-expanding fluids such as whole blood, plasma,
plasma substitutes; isotonic, electrolyte IV solutions; CVP artery catheters; CVP measurements, urine
output, HR, clinical and mental state; immediate attendtion to improvement of perfusion; administration
of drugs is withheld until circulating volume has been restores; O2 administration

Pulmonary edema - If shock is cardiogenic in nature, the infusion of volume-expanding fluids may result
in this

Cardiac Function - When treating a patient with shock, the restoration of what should take priority

Increase Cardiac Contractility - Administration of cardiotonic drugs such as digitalis does what?

Dopamine and digitalis - Increases the contractility

Dopamine (Dopram) and norepinephrine (Levophed) - Vaso-constricting agents that may be used in
cardiogenic shock

Nursing Assessment of patient in shock - Tachycardia, tachypnea, decrease in BP (systolic <80mmHg) ;


mental status changes; cool, clammy skin; diaphoresis, paleness; urine output decreases; CVP <4cm of
H2O; urine SG >1.020

Hypovolemia - Urine SG >1.020 indicates?

Early shock mental status changes - Restless, hyper-alert

Late shock mental status changes - Decreased alertness, lethargy, coma

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