Arnce Shock

Question 1

How is stroke volume determined?

Answer 1

• Preload
• Myocardial contractility
• Afterload

Question 2

How is BP calculated?

Answer 2

CO x SVR

Question 3

How is CO calculated?

Answer 3

HR x SV

Question 4

What is shock?

Answer 4

Inadequate tissue perfusion to meet metabolic demand and tissue oxygenation

Question 5

What is compensated shock?

Answer 5

• Reflex compensatory mechanisms are activated and perfusion to vital organs are maintained
• HR is increased as well as contractility and peripheral blood vessels constrict to shunt blood centrally

Question 6

What is decompensated shock

Answer 6

• Tissue hypo perfusion & onset of worsening circulatory and metabolic derangement including lactic acidosis
• Hypotensioni and metabolic lactic acidosis

Question 7

What is irreversible shock?

Answer 7

• Organ and tissue injury so severe survival is not possible even with hemodynamic resuscitation

Question 8

What is distributive shock categorized into?

Answer 8

• Septic
• Non septic

Question 9

What is cardiogenic shock categorized into?

Answer 9

• Cardiomyopathic
• Arrhythmogenic
• Mechanical

Bad pump (ex cardiomyopathy)

Question 10

What is hypovolemic shock categorized into?

Answer 10

• Hemorrhagic
• Non hemorrhagic

Decreased intravascular volume (ex hemorrhage or dehydration)

Question 11

What is obstructive shock categorized into?

Answer 11

• Pulmonary vascular
• Mechanical

Mechanical obstruction of circ system (ex PE, tension pneumothorax)

Question 12

Describe what happens to CO, SVR , and CVP in cardiogenic shock.

Answer 12

• Decrease CO
• Increase SVR
• Increase CVP

Question 13

Describe what happens to CO, SVR , and CVP in hypovolemic shock.

Answer 13

• Decrease CO
• Increase SVR (systemic vascular resistance)
• Decrease CVP (central venous pressure)

Question 14

Describe what happens to CO, SVR , and CVP in distributive septic & anaphalactic shock.

Answer 14

• Increases CO
• Decrease SVR
• Decrease CVP

Question 15

Describe what happens to CO, SVR , and CVP in Obstructive shock.

Answer 15

• Decreased CO
• Increased SVR
• variable CVP

Question 16

What is the most common cause of cardiogenic shock?

Answer 16

• Heart muscle problem (cardiomyopathy)
  
  • Ischemic (AMI or CHF)
  • Infectious (myocarditis)
  • Drugs or toxins

Question 17

What are the rhytym problems that cause cardiogenic shock?

Answer 17

• HR to fast
  
  • A. fib, A flutter, V. fib, V tachy
• HR to slow
  
  • complete heart block, Type II heart block

Question 18

What are the examples of what causes the specific subtypes of hypovolemic shock?

Answer 18

• Hemorrhagic: Blood loss
• Non-hemorrhagic: Fluid loss
  
  • Dehydration
  • Cirrhosis
  • Burns

Question 19

What are examples of distributive shock in the septic and non septic categories?

Answer 19

• Septic is septic shock
• Non septic:
  
  • Neurogenic: secondary to TBI or spinal injury
  • Anaphylactic
  • Toxin or med induced

Question 20

Describe what happens to CO, SVR , and CVP in Neurogenic shock.

Answer 20

• Part of the distributive shock non septic category
• Decreased CO SVR and CVP

Question 21

What can cause obstructive shock?

Answer 21

• Tension pneumothorax
• Pericardial tamponade
• pulmonary embolism

Question 22

Signs of shock?

Answer 22

• Hypotensioin
• Tachycardia
• Oliguria
• Abnormal mental status
• Tachypnea
• Cool clammy cyanotic skin
• Metabolic acidosis
• Elevated serum lactate