Chapter 10: Shock Flashcards
shock = _____
hypoperfusion
shock means a state of collapse and failure of the ______ system that leads to ____
CV system that leads to inadequate circulation
in the ___ stages of shock, the body attempts to maintain homeostasis
early
as shock progresses _____ slows and eventually ceases
blood circulation
shock can occur because of medial or traumatic events like: 1. 2. 3. 4.
- heart attack
- severe allergic reaction
- automobile crash
- gunshot wound
_____ is the circulation of blood within an organ or tissue in adequate amounts to meet the cell’s current needs
perfusion
list the two circuits in the body
systemic and pulmonic
the _____ circulation carries oxygen-rich blood from the LV through the body and back to the RA
systemic
____ is a passive process in which molecules move from an area with high conc of molecules to an area of lower conc
diffusion
three parts of the CV system, called the “perfusion triangle”
pump (heart)
set of pipes (bv and arteries)
blood
blood flow through the capillary beds is regulated by the _____, circular muscular walls that constrict and dilate
capillary sphincters
these sphincters are under control of the
ANS
perfusion requires more than just having a working CV system. it also requires adequate ____, _____, and ____
oxygen, nutrients, and waste removal
the _____ and _____ are triggered when the body senses that the pressure in the system is failing
ANS and hormones
shock can result from many conditions including; 1. 2. 3. 4.
- bleeding
- respiratory failure
- acute allergic reactions
- overwhelming infection
3 main causes of shock
- pump failure
- low fluid volume
- poor vessel function
_____ is caused by inadequate function of the heart (pump failure)
cardiogenic shock
a major effect of cardiogenic schock is backup of blood in the lungs or ______
pulmonary edema
______ occurs when conditions that cause mechanical obstruction of the cardiac muscle also affect the pump function
obstructive shock
2 examples of obstructive shock
- cardiac tamponade
2. tension pneumothorax
_____ is a collection of fluid between the peridcardial sac and the myocardium
cardiac tamponade
signs and symptoms of cardiac tamponade are known as
beck’s triad (JVD, muffled heart sounds, and systolic and diastolic BP starting to merge)
____ is caused by damage to lung tissue
tension pneumothorax
a tension pneumothorax allows are normally held in the lung to escape into the
chest cavity (which applies pressure to the heart)
_____ results when there is a widespread dilation of small arterioles, venules, or both
distributive shock
4 types of distributive shock
- septic shock
- neurogenic shock
- anaphylactic shock
- psychogenic shock
___ occurs as a result of severe infections in which toxins are generated by the bacteria or by infected body tissues
septic shock
in septic shock the toxins damage the vessel walls causing ___cellular permeability. the vessel walls leak and are unable to contract well.
INC
____ is usually a result of injury to the part of the nervous system that controls the size and muscle tone of the blood vessels
neurogenic shock
in neurogenic shock the muscles in the walls of the blood vessels are cut off from the SNS and nerve impulses that cause them to contract. all vessels below the level of the spinal injury _____ causing blood to ___
dilate widely causing blood to pool
______ occurs when a person reacts violently to a substance to which he or she has been sensitized
anaphylactic shock
______ is the result of an inadequate amount of fluid or volume in the system
hypovolemic shock
____ can cause or aggravate shock
dehydration
______ is when a patient with a severe injury, such as a flail chest or obstruction of the airway, may be unable to breathe in an adequate amount of oxygen
respiratory insufficiency
list the three stages in the progression of shock
- compensated shock
- decompensated shock
- irreversible shock
in compensated shock the body can still compensate for
blood loss
decompensated shock is the late stage where blood pressure is
falling
irreversible shock is the
terminal stage of shock
_____ may be the last measurable factor to change in shock
blood pressure
a rapid pulse suggests _____ shock
compensated
in shock/compensated shock the skin may be
cool, clammy, or ashen
patients in cardiogenic shock usually have ____ blood pressure
low
other signs and sx of cardiogenic shock include; - \_\_\_\_ pulse - - -
- weak/irregular pulse
- cyanosis
- nausea
- anxiety
for treating cardiogenic shock place the patient in a position that…
eases breathing as you give high-flow oxygen
INC ____ should be the priority in treating cardiac tamponade
INC cardiac output
in tension pneumothorax usually the only action hat can prevent eventual death is ____ of the injured side of the chest
decompression (EMTS give high flow oxygen via NRB)
in treating septic shock and neurogenic shock you should keep the patient ____
warm
effective treatment for a sever, acute allergic reaction is to administer _____ via subcutaneous or intramuscular injection
epinephrine
perfusion require an intact ____ system and a functioning ___ system
intact CV system and a functioning respiratory system
fainting is what type of shock
psychogenic
severe thermal burns causes what type of shock
hypovolemic shock
a dec in blood pressure is an early sign of shock (true or false?)
FALSE. late sign of shock, designates decompensated shock
infants and children may lose half their blood volume before having BP drop (true or false?)
TRUE.
what are the 6 general considerations for treating a patient in shock
- keep the patient supine
- control obvious external bleeding
- splint the patient on a backboard
- give high flow oxygen
- keep the patient warm
- elevate the legs
why should you be cautious in giving nitroglycerin to a patient already in cardiogenic shock
patients BP may already be low
The three basic causes for shock are poor pump function, dilating blood vessels, and
blood or fluid loss
Damage to the spinal cord that produces neurogenic shock will cause the blood vessels to
dilate
the following are signs and symptoms of what kind of shock:
urticaria and flushing.
edema of the face, tongue, and lips.
itching and burning.
anaphylactic shock
During decompensated shock, the blood pressures will
fall
At what systolic blood pressure should you recognize that an adult patient is in decompensated shock
90 mm Hg
Anxiety, bad news, or sight of blood can cause ________ shock
psychogenic
In compensated shock, the pulse of the patient usually
INC
When assessing breathing for a patient in shock, an increased respiratory rate can be a sign of
compensated shock
When treating a patient who exhibits signs and symptoms of shock, which of the following actions would not be appropriate?
- Provide high flow oxygen via nonrebreather mask.
- Splint all suspected extremity fractures.
- Request ALS back-up.
Splint all suspected extremity fractures.
When treating a patient in cardiogenic shock, your first step should be to
ensure the patient has an open airway
