Cardiac pt 4 Flashcards
what is the progressive stage of shock
compensatory mechanisms no longer enough to sustain adequate perfusion to tissues
what are the three things that can cause hypovolemic shock
hemorrahage
burns (plasma loss)
interstitual fluid loss via emesis, dieuresis, diaphoresis, diarrhea etc
what are some clinical manifestations of atrial flutter and fibrillation
typically asymptomatic unless ventricular response is affected
atrial fibrillation
completely disorganized and irregular atrial rhythem + irregular ventricular rhythm
first degree heart block
prolonged PR interval - takes longer between start of atria depolar and ventric depolar
what are the 3 stages of shock
compensatory
progressive
refractory
what do PVCs do
depolarize the ventricle without affecting the atria or SA node
how would atrial impulses appear with atrial fibirllation
small squiggly waves of various sizes and shapes
what is distributive shock characterized by
excessive vasodilation and perioheral pooling of blood
what is atrial flutter
rapid atrial rate of 04-350bpm
what are the clinical manifestations of hypovolemic shock
thirst
inc HR
cool clammy skin
dec art BP
oliguria
confusion
third degree heart block
no impulses conducted from atria to ventricle
hypovolemic shock
loss of blood volume
when does hypovolemic shock start to develop
when intravasculr volume has decreased by about 15 percent
what can alter the acid-base balance of the blood with the progressive stage of shcok
lactate productiion from anaerobic metabolism
name 2 causes of disorders of impulse formation
dysfunction of the SA node
development of abnormal electrical activity somewhere else in the heart
what is the progressive stage of shock marked by
hypotension and marked tissue hypoxia
what are the 4 kinds of shock
cardiogenic
obstructive
hypovolemic
distributive
what has the sawtooth pattern of atrial depolarization
atrial flutter
cardiogenic shock
cardiac dysfunction causing hypotension and lack of tissue perfusion
what is ventricular fibrillation
rapid uncoordinated cardiac rhythm - no effetive contraction
second degree heart block
some p wves are not conducted to the ventricles
why is the CO inadequate in distributive shock
due to reduced preload
a lack of atp with progressive stage of shock leads to waht
cell swelling, dysfunction and death
neurogenic shock
loss of sympathetic activation of arteriolar SM
what are the three forms of distributive shock
anaphylactic
neurogenic
septic
what does obstructive shock manifest as
right side HF
name some causes of disorders of impulse conduction
inherited abnormalities
ischemia
infection
disease
meds
injury from surgery
septic shock
sever systemic inflammatory response to infection
what is the compensatory stage of shock
homeostatic mechanisms are enough to maitain adequate tissue perfusion
what two things occur during the compensatory stage of shock
baroreceptor activation - activates SNS
RAAS activates to inc BP
what is the refractory stage of shock
vascular system failure leading to widespread vasodilation
what does obstructive shock result from
mechanical obstructions that prevent effective cardiac filling and stroke volume
anaphylactic shock
excessive mast cell degranulation mediated by IgE antibodies in response to antigen
dysrhythmia
disturbance of heart rhythm affecting impulse formation or conduction
what is the most common cause of cardiogenic shock
acute MI
severe episode of myocardial ischemia
what causes organ failure in the refractory shock
release of inflammatory mediators plus vessel oclusion
where do premature ventricular complexes arise
ventricular myocardium
what are the clinical manifestations of cardiogenic shock
end-stage heart failure-cyanosis
low MAP and SBP due to lower SV
