NURS 225 Lecture Notes - Lecture 15: Septic Shock, Fluid Replacement, Distributive Shock
Document Summary
Map decreases as well as systolic decreases (bc of poor stroke volume) Surgery to repair heart fluids: hypovolemic. Loss of blood plasma or fluids. (by injury or other) (15-20% blood loss) Sympathetic compensatory response of maintaining co and bp (increased hr, contractility, vasoconstriction) this also mobilizes blood stored in venous circulation. Overstimulation of parasympathetic, under stimulation of sympathetic. Caused by: spinal cord injury, vasomotor depression by pain or drugs. Slow hr, skin is dry and warm. Severe infection, and systemic response to infection (cid:1688)sepsis(cid:1689) = infection + inflammatory response (cid:1688)severe sepsis(cid:1689) = sepsis + organ dysfunction (cid:1688)septic shock(cid:1689) = severe sepsis + hypotension even after fluid resuscitation. Sirs = systemic inflammatory response syndrome (temp, o2, hr, wbc) * needs 2/4 to be diagnosed. Patho: release of proinflammatory cytokines (tnf and il) Activation of immune response > tnf and il activate and cause lactic acidosis > endothelial cells release no (potent vasodilator) > increased procoagulation and decreased anticoagulation.
