NURS 3290 Lecture Notes - Lecture 31: Metabolic Acidosis, Semipermeable Membrane, Antibiotics
14 Apr 2016
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Clinical syndrome of inadequate perfusion of oxygen and nutriion. Not enough blood low for perfusion: anaerobic metabolism, increased lacic acid. Decreased bp, issue perfusion, cellular metabolism, issue hypoxia, metabolic acidosis. Maldistribuion of blood flow: anaphylacic/neurogenic/sepic shock (luid moving out) Imbalance of sns/pns (vasodilaion decreases bp and bradycardia) Immediately: massive vasodilaion, increased vascular permeability leakage, edema. Keep giving blood if needed unless anaphylacic reacion. Endotoxins: bacteria cause release of cell mediators damage endothelium. Hyperdynamic (early): warm, lushed, high temp, high cardiac output, vasodilaion, tachycardia, tachypnea, alkalosis (breathing out too much co2) Hypodynamic (late): decreased co, rr, temp with correlated acidosis, poor issue perfusion. Sns is intact> so it compensates by increasing hr, further damaging heart. Do not want heart working too hard. Decrease in blood volume in vascular space. Hypovolemic shock: absolute luid loss (actual loss, hemorrhage, vomiing, diarrhea, relaive luid loss (luid shit burns, ascites) Decreased volume, decreased perfusion, decreased oxygenaion > cellular dysfuncion/damage.
