CH. 8 Shock Flashcards
define perfusion
the supply of oxygen to the cells
define shock
a lack of tissue perfusion that leads to anaerobic metabolism
what is the outcome of shock (2)
cellular death
dysfunction of organs
Causes of shock (3)
caused by one or more…
1. heart not functioing properly
2. inadequate amount of blood circulating
3. intact blood vessels unable to regulate blood flow effectively
pathophysiology of shock
injury or illness can cause blood vessels to lose their ability to change causing a drop in blood volume
organ tolerance to ischemia: heart, brain & lungs
4-6 mins
organ tolerance to ischemia: kidneys, GI tract, liver
45-90 min
organ tolerance to ischemia: muscles, bone, skin
4-6 hours
types of shock (3)
- cardiogenic
- obstructive
- hypovolemic
define cardiogenic shock
result of a problem with the heart itself
-angina
-MI
-cardiac arrest
define obstructive shock
something physically prevents the heart from filling or emptying effectively even if it otherwise pumping normally.
Does not change the volume of blood.
-embolism
-clot
list the types of hypovolemic shock (5)
- hemorrhagic
- neurogenic
- psychogenic
- septic
- anaphylactic
define hypovolemic shock
general term related insufficient volume of blood circulating in the system. Divided into true or relative.
define hemorrhagic shock and example
most common, vascular system loses a large quantity of blood
-major bleed
define neurogenic shock and example
nervous system loses its ability to control the contriction of the bodys blood vessels.
Volume of blood stays the same but blood is not circulating
- very high spinal cord injury/CNS injury
-hematoma
define psychogenic shock
bodys blood vessels dialate due to stress
define septic shock & example
infections release toxins into the blood causing them to dialate
- massive systemic infection
define anaphylatic shock & example
increases the permability of the blood vessels allowing fluid to leech out of the circulatory system reducing the volume of blood
-allergy
defien true hypovolemic shock & name them (2)
Blood leaves the circulatory system
-hemorrhagic
-anaphylactic
define relative hypovolemic shock & name them (3)
dilate blood vessels cause blood to pool in extremities rather than circulating effectively
-neurogenic
-psychogenic
-septic
stages of shock & S/S: compensated
Body detects that perfusion is low & attempts to restore normal circulation
-increase resp. rate
-increase HR
-decrease BP (barely)
-decrease LOR
stages of shock & S/S: Decompensated
Reversible but degressing & life threatening.
Body mechanisms become unsuccessful & the body’s tissues become hypoxic
-increase HR
-Decrease resp. rate (fails & system gives up)
-decrease BP (blood vessels dilate)
-Decrease LOR
stages of shock & S/S: Irreversible
The body’s vascular system is unable to maintain its internal pressure & blood pools in extremities away from vital organs. Patient will not survive regardless of interventions
-decrease and failure in HR, BP, LOR & resp. rate
Treating shock (4)
- early recognition & interventions
- rest in recovery position or supine w/feet elevated (helps improve blood to head & torso)
- maintain normal body temp
- provide oxygen
S/S: compensated (6)
-blood moves away from vital organs
-tachycardia
-tachypnea
-small change in BP
-possible sweating
-anxious/apprehensive
S/S: decompensated (8)
-confused, unresponsive
-slow, shallow & irregular resp.
-pulse is weak and rapid
-BP drops
-body temp decreases
-cyanosis
-dilated pupils
-extreme sweating/thirst
S/S: Irreversible (3)
-unresponsiveness
-chaotic pulse progressing to cardiac arrest
-resp. arrest
domino effect of shock: initial cause (1)
An injury causes a hemmorrhage
domino effect of shock: compensated shock (3)
-heart attempts to compensate by tachycardia, this causes more blood loss. Body’s blood volume decreases & pulse gets weaker
-increased workload on the heart= increased O2 demand which leads to tachypnea
-blood vessels constrict to maintain blood to vital organs= skin goes cold, moist & pale. Body perspires due to stress.
domino effect of shock: decompensated shock (2)
- extremities now have low O2 & their cells start to die. Brain tries to balance out the O2 needs by sending blood to the extremities.
-Vital organs now have O2 difficency. Heart tries to compensate by beating faster & increasing blood loss
domino effect of shock: irreversible shock (2)
-W/o O2 the vital organs stop functioning effectively. Brain tissues become hypoxic & the person becomes unresponsives. Pulse becomes chaotic & person enters cardiac arrest. Respirations will also stop.
-the body’s continous attempts to compensate for severe blood loss eventually results in death
