Blood pressure

Question 1

When is a patient considered hypotensive?

Answer 1

Systolic blood pressure less than 90mmHg

Question 2

When is a patient considered hypertensive?

Answer 2

Sustained blood pressure above 140/90 mmHg

Question 3

What term is used for severe bleeding?

Answer 3

Haemorrhage

Question 4

How do we manage haemorrhage?

Answer 4

Position - lying down and raise legs
Examine - identify source of bleeding
Elevate - raise limb
Pressure - put pressure over site of bleeding if venous and compress the artery proximal to site of bleeding if arterial
Establish intravenous access
Give IV fluids until blood arrives
O neg then cross match

Question 5

What is the definition of shock?

Answer 5

Inadequate tissue perfusion

Question 6

What causes tachycardia during shock?

Answer 6

Baroreceptor reflex

Question 7

What is the significance of shock if prolonged?

Answer 7

Cellular dysfunction
Ischaemia to infarction to necrosis
Multi-organ failure

Question 8

How does haemorrhage cause shock?

Answer 8

Cardiac Output (CO) = HR X Stroke volume
Stroke Volume is dependent on venous return
Decreased circulating volume has led to decreased venous return to the heart leading to a fall in
cardiac output and therefore a fall in BP
Low BP means there is less pressure to push red blood cells through capillary beds in tissues and organs at a rate sufficient to meet their metabolic demands.
This is poor perfusion and is called
shock.

Question 9

What do we find on examination that leads us to suspect shock?

Answer 9

Signs of increased sympathetic nerve activity and decreased perfusion
Tachycardia, pallor, cool peripheries, increased respiratory rate