Cardiac pt 4 Flashcards

1
Q

what is the progressive stage of shock

A

compensatory mechanisms no longer enough to sustain adequate perfusion to tissues

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2
Q

what are the three things that can cause hypovolemic shock

A

hemorrahage
burns (plasma loss)
interstitual fluid loss via emesis, dieuresis, diaphoresis, diarrhea etc

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3
Q

what are some clinical manifestations of atrial flutter and fibrillation

A

typically asymptomatic unless ventricular response is affected

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4
Q

atrial fibrillation

A

completely disorganized and irregular atrial rhythem + irregular ventricular rhythm

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5
Q

first degree heart block

A

prolonged PR interval - takes longer between start of atria depolar and ventric depolar

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6
Q

what are the 3 stages of shock

A

compensatory
progressive
refractory

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7
Q

what do PVCs do

A

depolarize the ventricle without affecting the atria or SA node

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8
Q

how would atrial impulses appear with atrial fibirllation

A

small squiggly waves of various sizes and shapes

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9
Q

what is distributive shock characterized by

A

excessive vasodilation and perioheral pooling of blood

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10
Q

what is atrial flutter

A

rapid atrial rate of 04-350bpm

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11
Q

what are the clinical manifestations of hypovolemic shock

A

thirst
inc HR
cool clammy skin
dec art BP
oliguria
confusion

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12
Q

third degree heart block

A

no impulses conducted from atria to ventricle

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13
Q

hypovolemic shock

A

loss of blood volume

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14
Q

when does hypovolemic shock start to develop

A

when intravasculr volume has decreased by about 15 percent

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15
Q

what can alter the acid-base balance of the blood with the progressive stage of shcok

A

lactate productiion from anaerobic metabolism

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16
Q

name 2 causes of disorders of impulse formation

A

dysfunction of the SA node
development of abnormal electrical activity somewhere else in the heart

17
Q

what is the progressive stage of shock marked by

A

hypotension and marked tissue hypoxia

18
Q

what are the 4 kinds of shock

A

cardiogenic
obstructive
hypovolemic
distributive

19
Q

what has the sawtooth pattern of atrial depolarization

A

atrial flutter

20
Q

cardiogenic shock

A

cardiac dysfunction causing hypotension and lack of tissue perfusion

21
Q

what is ventricular fibrillation

A

rapid uncoordinated cardiac rhythm - no effetive contraction

22
Q

second degree heart block

A

some p wves are not conducted to the ventricles

23
Q

why is the CO inadequate in distributive shock

A

due to reduced preload

24
Q

a lack of atp with progressive stage of shock leads to waht

A

cell swelling, dysfunction and death

25
Q

neurogenic shock

A

loss of sympathetic activation of arteriolar SM

26
Q

what are the three forms of distributive shock

A

anaphylactic
neurogenic
septic

27
Q

what does obstructive shock manifest as

A

right side HF

28
Q

name some causes of disorders of impulse conduction

A

inherited abnormalities
ischemia
infection
disease
meds
injury from surgery

29
Q

septic shock

A

sever systemic inflammatory response to infection

30
Q

what is the compensatory stage of shock

A

homeostatic mechanisms are enough to maitain adequate tissue perfusion

31
Q

what two things occur during the compensatory stage of shock

A

baroreceptor activation - activates SNS
RAAS activates to inc BP

32
Q

what is the refractory stage of shock

A

vascular system failure leading to widespread vasodilation

33
Q

what does obstructive shock result from

A

mechanical obstructions that prevent effective cardiac filling and stroke volume

34
Q

anaphylactic shock

A

excessive mast cell degranulation mediated by IgE antibodies in response to antigen

35
Q

dysrhythmia

A

disturbance of heart rhythm affecting impulse formation or conduction

36
Q

what is the most common cause of cardiogenic shock

A

acute MI
severe episode of myocardial ischemia

37
Q

what causes organ failure in the refractory shock

A

release of inflammatory mediators plus vessel oclusion

38
Q

where do premature ventricular complexes arise

A

ventricular myocardium

39
Q

what are the clinical manifestations of cardiogenic shock

A

end-stage heart failure-cyanosis
low MAP and SBP due to lower SV