Question

1.What is the importance of rapid intervention which requires the nurse to be prepared to perform immediate assessment and implement the appropriate medical and nursing interventions?

2. Compare and contrast

• Hypovolemic Shock
• Sepsis
• Septic Shock

3. Describe 5 medications used in the treatment of shock

• Medication/Pharmakinetics/Pharmadynamics/Adverse Effects

4. Develop a plan of care using quality improvement measures for the patient who requires percutaneous or surgical coronary intervention to promote perfusion (Assessment, Diagnosis, Plan, Implementation, Evaluation)

Answer 1

ANSWER 1: IMPORTANCE OF RAPID INTERVENTION WHICH IS REQUIRED BY A NURSE TO PERFORM IMMEDIATE ASSESSMENT AND IMPLEMENT THE APPROPRIATE MEDICAL AND NURSING INTERVENTIONS:

• MONITOR AND RECORD THE PATIENT'S RESPONSE TO THE TREATMENT.
• REGULAR MAINTENANCE OF VITAL SIGNS AND NOTE FOR ANY ABNORMAL CHANGES.
• SHOULD BE AWARE OF THE DISEASE PATHOPHYSIOLOGY AND NURSING INTERVENTION TECHNIQUES RELATED TO THE DISEASE.
• PLAN THE ORDERS EFFICIENTLY AND PROVIDE CARE ACCORDINGLY .
• CERTAIN EMERGENCY INTERVENTIONS CAN BE PERFORMED BY THE NURSE.

ANSWER 2:

HYPOVOLEMIC SHOCK	SEPTIC SHOCK	SEPSIS
RESULTS DUE TO LOSS OF FLUID IN THE BODY	RESULTS DUE TO INFLAMMATORY REACTIONS IN THE BODY DUE TO INFECTION WHICH LEADS TO HYPOTENSION.	IF ANY INFECTION IN THE BODY BECOMES SEVERE LEADS TO ORGAN DYSFUNCTION
LOSS OF EXCESSIVE BLOOD LEADS TO HEMORRHAGIC SHOCK.	DECREASED TISSUE PERFUSION	SPREAD OF INFECTION MAY BE LIFE-THREATENING
DEPLETION OF EXCESSIVE BODY FLUIDS DUE TO DIARRHOE OR VOMITING ALSO LEADS TO HYPOVOLEMIC SHOCK	BLOOD PRESSURE DECREASES. SKIN IS WARM	FEVER, TACHYCARDIA BLOOD PRESSURE REMAINS NORMAL.
PRESENTS WITH LOW BLOOD PRESSURE AND COLD AND PALE SKIN.	HYPERVENTILATION WITH RESPIRATORY ALKALOSIS	BLOOD LEVELS OF C-REACTIVE PROTEINS AND PROCALCITONIN ARE ELEVATED.
COMPLICATIONS:DISSEMINATED INTRAVASCULAR COAGULATION, ARDS, ACUTE TUBULAR NECROSIS.	COMPLICATIONS:ACUTE RESPIRATORY DISTRESS SYNDROME.	COMPLICATIONS:MULTIORGAN DYSFUNCTION

ANSWER 3: FIVE MEDICATIONS USED IN THE TREATMENT OF SHOCK:

• EPINEPHRINE,NOREPINEPHRINE OR DOPAMINE LOWERS THE BLOOD PRESSURE AND RESULTS IN BLOOD FLOW TO VARIOUS ORGANS.
• INTRAVENOUS ANTIBIOTICS LIKE PENICILLIN TO STOP SPREADING OF INFECTION.
• INTRAVENOUS CORTICOSTEROIDS LIKE HYDROCORTISONE TO PREVENT INFLAMMATORY REACTIONS.

ANSWER 4:PLAN OF CARE FOR PERCUTANEOUS OR SURGICAL CORONARY INTERVENTION TO PROMOTE PERFUSION

ASSESSMENT:

• PHYSICAL FINDINGS: CHEST PAIN, PALPITATIONS, BREATHLESSNESS.
• ST SEGMENT ELEVATION MYOCARDIAL INFARCTION(STEMI)
• NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION (NSTEMI)
• NON-ST SEGMENT ACUTE CORONARY SYNDROME (NSTACS)

DIAGNOSIS:

CORONARY ARTERY DISEASE

PLAN, IMPLEMENTATION AND EVALUATION:

• CORONARY ANGIOGRAM: PATIENTS IN DRUG THERAPY SUFFERING FROM CHEST PAIN FOR A LONG TIME SHOULD GO FOR CORONARY ANGIOGRAM AS AN INTERVENTION PROCURE TO EVALUATE THE INTENSITY OF THE DISEASE FOR FURTHER MANAGMENT.
• PTCA AND CORONARY STENT IMPLEMENTATION: INDICATED TO THE PATIENTS WITH STABLE ANGINA AND UNSTABLE ANGINA (EMERGENCY ). IT IS USUALLY PERFORMED IF MORE THAN ONE CORONARY ARTERIES ARE INVOLVED.