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Adult Health 1 > Ch.14&15 Quiz > Flashcards

Ch.14&15 Quiz Flashcards

1
Q

what is shock

A

inadequate tissue perfusion to deliver oxygen and nutrients to support vital organs and cell function

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2
Q

In shock, cells use aerobic or anaerobic metabolism?

A

anaerobic

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3
Q

Arterial Blood Gases:

pH?

PaCO2?

HCO3?

PaO2?

O2 sat?

A

7.35-7.45

35-40mm Hg

22-26

80-100mm Hg

>94%

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4
Q

metabolic acidosis ph?

commonly related to what type of failure?

bicarb?

Manifestations?

A

low pH <7.35

renal failure

low bicarb <22 mEq/L

  • HA
  • Confusion
  • Drowsiness
  • ↑ respiratory rate/depth
  • ↓ blood pressure
  • ↓ cardiac output
  • Dysrhythmias
  • Shock
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5
Q

what is metabolic acidosis?

what is metabolic alkalosis?

What is respiratory acidosis?

What is respiratory alkalosis?

A

Metabolic acidosis occurs when the body produces too much acid, or when the kidneys are not removing enough acid from the body.

is a pH imbalance in which the body has accumulated too much of an alkaline substance, such as bicarbonate

is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.

is a condition marked by low levels of carbon dioxide in the blood due to breathing excessively

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6
Q

Metabolic alkalosis ph?

what can cause this? (2)

bicarb?

manifestations?

A

high pH >7.45

Commonly r/t vomiting or gastric suction because it reduces the amount of body fluid

high bicarb>26 mEq/L

  • Symptoms r/t ↓calcium
  • Respiratory depression
  • Tachycardia
  • Symptoms of hypokalemia (potassium deficient)
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7
Q

respitory acidosis ph?

PaCO2?

What is it related to?

manifestations?

what is respiratory acidosis?

A

low pH<7.35

PaCO2 >42 mm Hg

Always r/t respiratory problem with inadequate CO2 excretion

  • Sudden increased pulse
  • ↑ pulse
  • ↑ respiratory rate
  • ↑ BP
  • Mental changes
  • Feeling of head fullness
  • Potential ↑ ICP

is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic

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8
Q

Respiratory alkalosis pH?

PaCO2?

Always related to?

manifestations?

what is respiratory alkalosis?

A

High pH > 7.45

PaCO2 < 35 mm Hg

Always r/t hyperventilation

  • Lightheadedness
  • Inability to concentrate
  • Numbness/tingling
  • Loss of consciousness

is a condition marked by low levels of carbon dioxide in the blood due to breathing excessively

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9
Q

two “types” of shock

A

relevant (body just thinks it doesn’t have enough fluid) & absolute (body doesnt have enough)

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10
Q

types of shock? (5)

A
  1. Hypovolemic: shock resulting from decreased intravascular volume due to fluid loss
  2. Cardiogenic: shock resulting from impairment or failure of myocardium
  3. Septic: shock from overwhelming infection: shock resulting from overwhelming infection causing relative hypovolemia
  4. Neurogenic: shock resulting from loss of sympathetic tone causing relative hypovolemia
  5. Anaphylactic: sever allergic reaction: severe allergic reaction producing vasodilation/relative hypovolemia
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11
Q

4 stages of shock

A
  1. Initial insult
  2. Compensatory
  3. Progressive
  4. Irreversible
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12
Q

Manifestations of compensatory stage of shock?

body pushes/pulls blood from? 3

what happens to BP?

A
  • cool clammy skin
  • decreased urine output
  • hypoactive bowel sounds
  1. skin
  2. kidneys
  3. GI tract

BP remains within normal limits

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13
Q

what happens in progessive stage of shock?

do all organs suffer?

vasoconstriction/ vasodilation?

mental status?

efficiency of lungs?

CO2 increase or decrease?

what happens to the alveoli?

what type of edema occurs?

A
  1. Regulation mechanisms can no longer compensate
  2. All organs suffer from hypoperfusion
  3. Vasoconstriction continues
  4. Mental status further deteriorates
  5. Lungs being to fail
  6. Pulmonary blood flow causes further hypoxemia
  7. Carbon dioxide increases
  8. Alveoli collapse
  9. Pulmonary edema occurs
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14
Q

Irreversible stage of shock:

what organs are damaged?

hypo- or hyper-tension?

what two organs FAIL?

___ acidosis and ___ acidosis occurs

close to death?

A
  1. Severe organ damage with no response to treatment
  2. Hypotension continues
  3. Renal and liver failure
  4. Necrotic tissue toxins
  5. Metabolic acidosis and lactic acidosis
  6. Multiple organ failure
  7. Imminent death
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15
Q

what stage of shock is characterized by a normal BP?

A

Compensatory

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16
Q

what is an early and most accurate indicator of shock?

A
  • increase in pulse pressure
  • Ex: 120/80, pulse pressure would be 40 (120-80)
17
Q

Patients in shock may need _____ cal daily, due to increased metabolic rate from ______ release.

A

3,000 cal

catecholamine

18
Q

When taking Levophed, watch for _______, never stop ________ medications abruptly

A

hypovolemia (decrease in blood volume)

vasoactive

19
Q

Hypovolemic shock decreases ___, ___, ___, ___, and ___.

A

blood volume

venous return

stroke volume

cardiac output

tissue perfusion

20
Q

what are some risk factors for hyovolemic shock?

A
  • Trauma
  • Surgery
  • Vomiting
  • Diarrhea
  • Diuresis
  • Diabetes insipidus
  • Hemorrhage
  • Burns
  • Ascites
  • Peritonitis
  • Dehydration
21
Q

wht postition should a patient with hypovolemic shock be in?

A

modified trndelenburg

22
Q

what happens during circulatory shock?

A

Blood volume pools in peripheral blood vessels causing relative hypovolemia because not enough blood returns to the heart

23
Q

Circulatory shock leads to….

A

vasodilation

activation of inflammatory response

decreased venous return

decreased cardiac output

decreased tissue perfusion

24
Q

Risk factors for septic shock (5)

A
  1. Immunosuppression
  2. Extremes of age (<1 year and >65 years)
  3. Malnourishment
  4. Chronic illness
  5. Invasive procedure
25
Q

risk factors for neurogenic shock (6)

A
  1. Spinal cord injury
  2. Spinal anesthesia
  3. Depressant action of medications
  4. Glucose deficiency
  5. massive dilation
  6. body goes through fluid shifts
26
Q

Risks for anaphylactic shock: (5)

A
  1. Penicillin sensitivity
  2. Transfusion reaction
  3. Bee sting allergy
  4. Latex sensitivity
  5. Severe allergies (foods/medications)
27
Q

what are the 3 managments for all types of shock?

A
  1. fluid replacement: crystalloids, colloids, blood
  2. vasoactive medications: frequent VS, central line, extravasation
  3. nutritional support: enternal, parenteral, H2 blocker
28
Q
A

Adult Health 1 (6 decks)

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