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02.17 Septic Shock for CCRN Review

02.17 Septic Shock for CCRN Review

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Laura Gasparis Vonfrolio

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Study Tools For 02.17 Septic Shock for CCRN Review

Shock (Cheatsheet)

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Outline

Nursing Points

General

Septic Shock
1. Caused by bacteria (usually gram -)
2. At-risk
  1. Elders
  2. Severe burn
  3. Alcohol and drug abusers
  4. Surgery
  5. Immunosuppressed
  6. Long hospitalizations
3. Patho
  1. Bacteria releases endotoxin -> many harmful substances released causes vasodilation (pool blood in capillary bed)
4. First stage
  1. Confusion (due to endotoxin)
  2. Increased cardiac output (due to endotoxin)
  3. Increased RR (due to endotoxin)
  4. ABGs normal limits
  5. Normal BP
  6. Increased urine output (vasodilation)

1. Second stage
  1. Endotoxins phase away (30 min.- 72 hrs)
  2. Low BP (blood pooled in capillaries)
  3. Lethargic (lack of blood to brain = lack of oxygen)
  4. Decreased urinary output
  5. ABGs bad
  6. Decreased cardiac output (no endotoxins)
  7. Metabolic acidosis
2. Organ failure
3. Treatment
  1. Fluids
  2. Antibiotics
  3. Vasopressors (Levophed) -> causes vessels to constrict
  4. Goal -> MAP 65

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Concepts Covered:

Shock
Shock
Disorders of the Posterior Pituitary Gland
Endocrine
Disorders of Pancreas
Neurological
Disorders of the Adrenal Gland
Central Nervous System Disorders – Brain
Immunological Disorders
Musculoskeletal Trauma
Renal Disorders
Hematologic Disorders
Integumentary Disorders
Oncology Disorders
Noninfectious Respiratory Disorder
Studying
Postoperative Nursing
Disorders of the Thyroid & Parathyroid Glands
Intraoperative Nursing
Integumentary Important Points
Medication Administration
Lower GI Disorders
Female Reproductive Disorders
Cardiac Disorders
Musculoskeletal Disorders
Preoperative Nursing
Upper GI Disorders
Respiratory System
Vascular Disorders
Urinary System

Study Plan Lessons

02.17 Septic Shock for CCRN Review

03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review

03.02 Diabetes Insipidus for CCRN Review

03.03 Hypoglycemia for CCRN Review

07.10 Neurologic Review questions for CCRN Review

Addisons Disease

Adjunct Neuro Assessments

AIDS Case Study (45 min)

Altered Mental Status Nursing Mnemonic (AEIOU TIPS)

Anion Gap Acidosis 1 Nursing Mnemonic (KULT)

Anti Tumor Antibiotics

Cancer – Early Warning Signs Nursing Mnemonic (CAUTION UP)

Cancer – Nursing Priorities Nursing Mnemonic (CANCER)

Causes of Dyspnea Nursing Mnemonic (The 6 P’s)

Chemotherapy Patients

Coagulation Studies (PT, PTT, INR)

Complications of Immobility

Computed Tomography (CT)

D-Dimer (DDI) Lab Values

Different Dressings

DKA Treatment Nursing Mnemonic (KING UFC)

Epinephrine (EpiPen) Nursing Considerations

Fluid Volume Overload

Fractures (Open, Closed, Fat Embolus) for Certified Emergency Nursing (CEN)

Gout Case Study (45 min)

Hematology/Oncology/Immunology Course Introduction

Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)

Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)

Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)

Hypertonic Solutions (IV solutions)

Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)

Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)

Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)

Hypotonic Solutions (IV solutions)

Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)

Implant Preparation for Certified Perioperative Nurse (CNOR)

Integumentary (Skin) Course Introduction

Integumentary (Skin) Important Points

Integumentary (Skin) Module Intro

IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)

Magnetic Resonance Imaging (MRI)

Methylprednisolone (Solu-Medrol) Nursing Considerations

Metformin (Glucophage) Nursing Considerations

Multiple Myeloma

Morphine (MS Contin) Nursing Considerations

Musculoskeletal Assessment

Musculoskeletal Course Introduction

Naproxen (Aleve) Nursing Considerations

Nursing Care and Pathophysiology for Gout

Nursing Care and Pathophysiology for Osteomyelitis

Post-Anesthesia Recovery

Postoperative (Postop) Complications

Preoperative (Preop) Education

Proton Pump Inhibitors

Respiratory Alkalosis

Respiratory A&P Module Intro

Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)

Routine Neuro Assessments

Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)

Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)

Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)

Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)

Systemic Lupus Erythematosus (SLE)

The 5-Minute Assessment (Physical assessment)

Thrombocytopenia

To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive

Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)

Vancomycin (Vancocin) Nursing Considerations

Warfarin (Coumadin) Nursing Considerations

Wound Care – Assessment

Wound Care – Dressing Change

Wound Care – Selecting a Dressing

Nursing Care and Pathophysiology for Hypovolemic Shock

Fluid & Electrolytes Course Introduction