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15647062
Septic Shock
Descripción
Mapa Mental sobre Septic Shock, creado por Renee Vanderhoeden el 19/10/2018.
Mapa Mental por
Renee Vanderhoeden
, actualizado hace más de 1 año
Más
Menos
Creado por
Renee Vanderhoeden
hace casi 6 años
196
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0
Resumen del Recurso
Septic Shock
Diagnosis
complication of sepsis
dysregualtion response to an infection
infections of: pneumonia, urinary tract infection,, influenza, skin infections ect.
Blood PH decreases
Less than 7.35
adrenal insufficiency
persistant hypotension
Blood pressure of Systolic <90, mean arterial pressure of <65
culture results showing infection
Complete blood count, BUN and serum electrolytes and creatinine levels
sputum culture
to rule out pneumonia
Lumbar puncture
To rule out meningitis, and obtain a culture of cerebral spinal fluid
life threatening organ dysfunction
critical reduction in tissue perfusion
acute failure of multiple organs
liver
lungs
kidneys
Features of systematic inflammatory response syndrome
mental changes, hyperventilation distributive hemodynamics, hyperthermia or hypothermia, reduced, shifted or elevated WBC
obtaining patients medical history
imaging scans
X-rays: pneumonia or damage around the lungs
MRI and CT Scan: Swelling or inflammation around the brain caused by meningitis
Pathogenisis
Inflammatory stimulus
production of proinflammatory mediatiors
tumor necrosis factor (TNF) & interlekin-1 (IL-1) cytokines
causing cell adhesion
activates the clotting mechanism
generates microthrombi
warm shock arteries and arterioles dilate
decreasing peripheral arteriol resistance
cardiac output may decrease
Blood pressure falls
features of shock appear
Increased cardiac output
blood flow bypasses capillary exchange vessels
decreases delivery of oxygen
impairs removal of C02 and waste products
decreased perfusion
dysfunction or failure of organs
Collaborative care
Fluid resuscitation
Optimize oxygen delivery
Optimize cardiac output
central venous pressure monitoring
Vasopressors
Correct acidosis
Obtain cultures
Antibiotics
prevent infection
Asepsis
foley catheter
central venous catheter
Causes
pneumonia
exposure to invasive devices
urinary tract infection
urospesis
catheter removed and new one put in
stomach infections
skin infections
chronic illnesses
diabetes
cirrhosis
cancer
AIDS/HIV
heart disease
kidney disease
meningitis
Complications
Respiratory failure
lungs not taking in enough oxygen
Heart failure
heart cannot effectively pump blood to bodies organs
stroke
Kidney failure
abnormal clotting
body tissues start to die
amputations
post-sepsis symptoms
depression
insomnia
fatigue
cognative decline
Post-tramatic stress disorder (PTSD)
Death
mortality rate of 40%-60%
complete organ failure
Assessment
medical history
clinical presentation
difficulty breathing
>20 per minute
inflammatory response syndrome
Low blood pressure/ orthopenia
palpitations, thready pulses
oliguria
disseminated intravascular coagulation and low BP= AKF
Hyperthermia or hypothermia
temp higher than 38C or lower than 36C
cool, pale arms and legs
decreased tissue perfusion
peripheral cyanosis and molting
delayed cap refill >3 seconds
Abdomen pain
organ dysfuncation
altered mental status
diagnostic imaging
Laboratory findings
platelet count, prothrombin time and D-Dimer
platelets to low= unwanted tiny clots. PTT too high = blood not clotting well. D-Dimer too high= clots
CBC
increase WBC = infection
Nursing Interventions
patient status
explain procedures and routines
decrease stress
decrease fear and anxiety
encouraging feelings of expression
involve family in patient's care
establish contacts with necessary resources
facilitate problem solving and decision making
address goals of care
treatment plans
end-of life planning
Treatment
oxygen support
hypoxemia
IV therapy
Broad-spectrum antibioitics
monitor response to therapy
IV fluids
crystalloid fluid challenge of 30 mL/kg
assessment of response
initial bolus
vasopressors
Norepinephrine
blood products
Source control
debridment
surgery
Supportive measures
corticosteroids
insulin
DVT propholaxis
mechanical ventilation
nutrition
Recursos multimedia adjuntos
Sick Face Septic Shock (binary/octet-stream)
Doctors Nurses Team Cartoon Medical Staff Medical Team Cg2p16008746c Th (binary/octet-stream)
Thermometer Hot (binary/octet-stream)
800px Colourbox25336499 (binary/octet-stream)
B9c92fc56e916d70d9e520b3fff14352 Irish Sepsis (binary/octet-stream)
44054779 Stock Vector Lung Cancer Diagram In Detail Illustration (binary/octet-stream)
95147160 Cartoon Human Kidney Sick Character Vector Illustration (binary/octet-stream)
Liver Clipart Animated 6 (binary/octet-stream)
Hypotenstion (binary/octet-stream)
Biodegradable Imaginary Agama Small (binary/octet-stream)
Arrow Pointing Down Vector Clip Art M Ct42z Clipart 8610 (binary/octet-stream)
Depositphotos 34754579 Stock Illustration Hot And Cold Girls (binary/octet-stream)
L9f Ps Sme (binary/octet-stream)
29157029 A Very Cold Cartoon Man Frozen In The Snow (binary/octet-stream)
Small Size Emoticon It Is Too Small Emoticon Showing Small Size With Fingers Vector Clipart Csp38609805 (binary/octet-stream)
29643244 A Cartoon Man S Open Head Reveals No Brain (binary/octet-stream)
Spectacles (binary/octet-stream)
4b9024817b9a824f7c70b12e85c7013b (binary/octet-stream)
Fragile Heart 300x267 (binary/octet-stream)
745053 Christian054 Ssc C (binary/octet-stream)
Unknown (binary/octet-stream)
21453041 Illustration Of Sad Boy (binary/octet-stream)
Zzzz (binary/octet-stream)
Stock Illustration 17458572 Cartoon Brain Sick (binary/octet-stream)
Screen Shot 2018 10 21 At 6.31.12 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.35.15 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.37.10 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.38.27 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.39.59 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.41.29 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.42.36 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.52.30 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.54.34 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.56.06 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.57.28 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.58.37 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 6.59.52 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 7.01.52 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 7.04.17 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 7.07.35 Pm (binary/octet-stream)
Screen Shot 2018 10 21 At 7.09.24 Pm (binary/octet-stream)
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