acute stress reaction

acute

[ah-kūt´] 1. sharp.2. having severe symptoms and a short course. Some serious illnesses that were formerly considered acute (such as myocardial infarction) are now recognized to be acute episodes of chronic conditions.acute care the level of care in the health care system that consists of emergency treatment and critical care. Called also secondary care.acute coronary syndrome a classification encompassing clinical presentations ranging from unstable angina through myocardial infarctions not characterized by alterations in waves" >Q waves; the classification sometimes also includes myocardial infarctions characterized by altered Q waves.acute respiratory distress syndrome (ARDS) a group of symptoms accompanying fulminant pulmonary edema and resulting in acute respiratory failure; called also shock lung, wet lung, and many other names descriptive of etiology or clinical manifestations. Many etiologic factors have been associated with ARDS, including shock, fat embolism, fluid overload, oxygen toxicity, fluid aspiration, narcotic overdose, disseminated intravascular coagulation, multiple transfusions, inhalation of toxic gases, diffuse pulmonary infection, and systemic reactions to sepsis, pancreatitis, and massive trauma or burns.
ARDS is characterized clinically by dyspnea, tachypnea, tachycardia, cyanosis, and hypoxemia. Pa_O_₂/FI_O_₂ remains low (below 2 cc) even with oxygen therapy at high oxygen concentrations. The lung compliance is decreased so that the lung is stiffer and more difficult to ventilate. Chest radiographs show signs of bilateral interstitial and alveolar edema. Cardiac filling pressures are normal, and the pulmonary capillary wedge pressure is below 18 torr.
Most authorities consider that the syndrome has three phases or stages that characterize its progression: the exudative stage, the fibroproliferative or proliferative stage, and the resolution or recovery stage. The exudative stage comes first, two to four days after onset of lung injury, and is distinguished by the accumulation of excessive fluid in the alveoli with entrance of protein and inflammatory cells from the alveolar capillaries into the air spaces. The fibroproliferative stage comes second and is characterized by an increase in connective tissue and other structural elements in the lungs in response to the initial injury. It begins between the first and third weeks after the initial injury and may last up to ten weeks. Microscopic examination reveals lung tissue that appears densely cellular. The patient is at risk for pneumonia, sepsis, and pneumothorax at this time. The third stage is the resolution or recovery stage. During this stage the lung reorganizes and recovers, although it continues to show signs of fibrosis. Lung function may continue to improve for as long as six to twelve months or even longer, depending on the precipitating condition and severity of the injury. It is important to remember that there are often different levels of pulmonary recovery in patients with ARDS.
Some authorities refer to a fourth phase or stage of ARDS, the period after the resolution or recovery stage. Some patients continue to experience health problems caused by the acute illness, such as coughing, limited exercise tolerance, and fatigue. Anxiety, depression, and flashback memories of the critical illness may also occur and be similar to posttraumatic stress disorder.Treatment and Patient Care. Mechanical ventilation must be begun at the first signs of hyperventilation and hypoxemia, before obvious signs of respiratory distress develop. A cuffed endotracheal tube or tracheostomy tube is used to maintain an airway. The patient is ventilated at the lowest oxygen concentration that maintains the arterial oxygen saturation (Sa_O_₂) at 90 per cent. positive end-expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) may be used to increase the number of alveoli that remain open at the end of exhalation and thus decrease pulmonary shunt. hemodynamic monitoring, using a swan-ganz catheter, is done to measure cardiac output, pulmonary capillary wedge pressure, and right atrial wedge pressure. An arterial line is placed to continuously monitor blood pressure and measure arterial blood gases. A diuretic such as furosemide (Lasix) may be administered to reduce fluid volume overload and pulmonary edema. If infection develops, antibiotics are administered. Hemodynamic parameters, arterial blood gas levels, intake and output, breath sounds, vital signs, inspiratory pressure, tidal volume, inspired oxygen concentration, and end-expiratory pressure are all continuously monitored.acute situational reaction a transient, self-limiting acute emotional reaction to severe psychological stress. See acute stress disorder, adjustment disorder, posttraumatic stress disorder, and psychosis" >brief reactive psychosis.acute stress disorder an anxiety disorder characterized by development of anxiety, dissociation, and other symptoms within one month following exposure to an extremely traumatic event, the symptoms including reexperiencing the event, avoidance of trauma-related stimuli, anxiety or increased arousal, and some or all of the following: a subjective sense of diminished emotional responsiveness, numbing, or detachment, derealization, depersonalization, and amnesia for aspects of the event. If persistent, it may become posttraumatic stress disorder.acute stress reaction acute situational reaction.

anx·i·e·ty re·ac·tion

a psychological reaction or experience involving the apprehension of danger accompanied by a feeling of dread and such physical symptoms as an increase in the rate of breathing, sweating, and tachycardia, in the absence of a clearly identifiable fear stimulus; when chronic, it is called generalized anxiety disorder.
See also: panic attack. Synonym(s): acute stress reaction

acute stress reaction

A nonspecific term for an individual response to traumatic external events of 3 months or less in duration.

anx·i·e·ty re·ac·tion

(ang-zī'ĕ-tē rē-ak'shŭn) Psychological reaction or experience involving the apprehension of danger accompanied by a feeling of dread and such physical symptoms.
Synonym(s): acute stress reaction.

单词	acute stress reaction
释义	DictionarySeeanxiety reactionEncyclopediaSeeacute acute stress reaction acute [ah-kūt´] 1. sharp.2. having severe symptoms and a short course. Some serious illnesses that were formerly considered acute (such as myocardial infarction) are now recognized to be acute episodes of chronic conditions.acute care the level of care in the health care system that consists of emergency treatment and critical care. Called also secondary care.acute coronary syndrome a classification encompassing clinical presentations ranging from unstable angina through myocardial infarctions not characterized by alterations in waves" >Q waves; the classification sometimes also includes myocardial infarctions characterized by altered Q waves.acute respiratory distress syndrome (ARDS) a group of symptoms accompanying fulminant pulmonary edema and resulting in acute respiratory failure; called also shock lung, wet lung, and many other names descriptive of etiology or clinical manifestations. Many etiologic factors have been associated with ARDS, including shock, fat embolism, fluid overload, oxygen toxicity, fluid aspiration, narcotic overdose, disseminated intravascular coagulation, multiple transfusions, inhalation of toxic gases, diffuse pulmonary infection, and systemic reactions to sepsis, pancreatitis, and massive trauma or burns. ARDS is characterized clinically by dyspnea, tachypnea, tachycardia, cyanosis, and hypoxemia. Pa_O_₂/FI_O_₂ remains low (below 2 cc) even with oxygen therapy at high oxygen concentrations. The lung compliance is decreased so that the lung is stiffer and more difficult to ventilate. Chest radiographs show signs of bilateral interstitial and alveolar edema. Cardiac filling pressures are normal, and the pulmonary capillary wedge pressure is below 18 torr. Most authorities consider that the syndrome has three phases or stages that characterize its progression: the exudative stage, the fibroproliferative or proliferative stage, and the resolution or recovery stage. The exudative stage comes first, two to four days after onset of lung injury, and is distinguished by the accumulation of excessive fluid in the alveoli with entrance of protein and inflammatory cells from the alveolar capillaries into the air spaces. The fibroproliferative stage comes second and is characterized by an increase in connective tissue and other structural elements in the lungs in response to the initial injury. It begins between the first and third weeks after the initial injury and may last up to ten weeks. Microscopic examination reveals lung tissue that appears densely cellular. The patient is at risk for pneumonia, sepsis, and pneumothorax at this time. The third stage is the resolution or recovery stage. During this stage the lung reorganizes and recovers, although it continues to show signs of fibrosis. Lung function may continue to improve for as long as six to twelve months or even longer, depending on the precipitating condition and severity of the injury. It is important to remember that there are often different levels of pulmonary recovery in patients with ARDS. Some authorities refer to a fourth phase or stage of ARDS, the period after the resolution or recovery stage. Some patients continue to experience health problems caused by the acute illness, such as coughing, limited exercise tolerance, and fatigue. Anxiety, depression, and flashback memories of the critical illness may also occur and be similar to posttraumatic stress disorder.Treatment and Patient Care. Mechanical ventilation must be begun at the first signs of hyperventilation and hypoxemia, before obvious signs of respiratory distress develop. A cuffed endotracheal tube or tracheostomy tube is used to maintain an airway. The patient is ventilated at the lowest oxygen concentration that maintains the arterial oxygen saturation (Sa_O_₂) at 90 per cent. positive end-expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) may be used to increase the number of alveoli that remain open at the end of exhalation and thus decrease pulmonary shunt. hemodynamic monitoring, using a swan-ganz catheter, is done to measure cardiac output, pulmonary capillary wedge pressure, and right atrial wedge pressure. An arterial line is placed to continuously monitor blood pressure and measure arterial blood gases. A diuretic such as furosemide (Lasix) may be administered to reduce fluid volume overload and pulmonary edema. If infection develops, antibiotics are administered. Hemodynamic parameters, arterial blood gas levels, intake and output, breath sounds, vital signs, inspiratory pressure, tidal volume, inspired oxygen concentration, and end-expiratory pressure are all continuously monitored.acute situational reaction a transient, self-limiting acute emotional reaction to severe psychological stress. See acute stress disorder, adjustment disorder, posttraumatic stress disorder, and psychosis" >brief reactive psychosis.acute stress disorder an anxiety disorder characterized by development of anxiety, dissociation, and other symptoms within one month following exposure to an extremely traumatic event, the symptoms including reexperiencing the event, avoidance of trauma-related stimuli, anxiety or increased arousal, and some or all of the following: a subjective sense of diminished emotional responsiveness, numbing, or detachment, derealization, depersonalization, and amnesia for aspects of the event. If persistent, it may become posttraumatic stress disorder.acute stress reaction acute situational reaction. anx·i·e·ty re·ac·tion a psychological reaction or experience involving the apprehension of danger accompanied by a feeling of dread and such physical symptoms as an increase in the rate of breathing, sweating, and tachycardia, in the absence of a clearly identifiable fear stimulus; when chronic, it is called generalized anxiety disorder. See also: panic attack. Synonym(s): acute stress reaction acute stress reaction A nonspecific term for an individual response to traumatic external events of 3 months or less in duration. anx·i·e·ty re·ac·tion (ang-zī'ĕ-tē rē-ak'shŭn) Psychological reaction or experience involving the apprehension of danger accompanied by a feeling of dread and such physical symptoms. Synonym(s): acute stress reaction.
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