Chapter 12- Shock Flashcards
What regulates blood flow through the capillary beds?
Capillary sphincters
Perfusion
Circulation of blood within an organ or tissue in adequate amounts to meet cells current needs for oxygen, nutrients, and waste removal
Pulse pressure
The difference between the systolic and diastolic pressures (systolic - diastolic= pulse pressure.
What is in control of the capillary sphincters?
Autonomic nervous system
3 causes of shock
Pump failure
Poor vessel function
Low fluid volume
Pump failure can lead to what kind of shock?
Give some examples of what can cause this
Cardiogenic shock, obstructive shock
- tension pneumothorax
- cardiac tamponade
- pulmonary embolism
What kind of shock does poor vessel function fall under?
What are some causes of poor vessel function?
Distributive shock
- infection
- drug overdose (narcotic)
- spinal cord injury
- anaphylaxis
Edema
Presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.
Cardiogenic shock
Caused by inadequate function of the heart, or pump failure
The ability for the heart to contract is…
Myocardial contractility
Obstructive shock
Caused by a mechanical obstruction which prevents an adequate volume of blood to fill the heart chambers.
Pericardial effusion
A collection of fluid between the pericardial sac and the myocardium
Impaired ventricular filling from a pericardial effusion causes…
Cardiac tamponade
Pulmonary embolism
A blood clot that occurs in the pulmonary circulation and blocks the flow of blood through the pulmonary vessels.
Distributive shock
Results when there is widespread dilation fo the small arterioles, small venues, or both
Septic shock
Occurs as a result of severe infections, usually bacterial, in which toxins (poisons) are generated by the bacteria or by infected body tissues.
Neurogenic shock
Usually a result of high spinal cord injury. When there is injury to the nervous system which results in the loss of control size of the muscular tone of the blood vessels.
Anaphylactic shock (Anaphylaxis)
Occurs when a person reacts violently to a substance to which he or she has bee sensitized
What does sensitization mean?
Becoming sensitive to a substance that did not initially cause a reaction.
Cyanosis
Blue discoloration of the skin
Psychogenic shock
Sudden reaction of the nervous system that produces a temporary, generalized vascular dilation, resulting in fainting
Syncope
To faint
Hypovolemic shock
Results of an inadequate amount of fluid or volume in the circulatory system
Skin during anaphylactic shock
- flushed, itchy, or burning
- urticaria (hives)
- edema
- pallor
- cyanosis
Circulatory system during anaphylactic shock
- dilated peripheral blood vessels
- increased vessel permeability
- drop in blood pressure
- weak, barely palpable pulse
Respiratory system during anaphylactic shock
- sneezing or itching of nose
- strider
- upper airway obstruction
- tightness in the chest with dry cough
- wheezing and difficulty breathing (dyspnea)
- constriction of the bronchi, difficulty breathing
- forced expiration accompanied by wheezing
- cessation of breathing
Other signs and symptoms of anaphylactic shock
- abdominal cramping
- nausea
- vomiting
- altered mental status
- dizziness
- fainting and coma
You should expect a patient to be in shock if he has any one of these:
- multiple severe fractures
- abdominal or chest injury
- spinal injury
- a severe infection
- a major heart attack
- anaphylaxis
Compensated shock
Early stage of shock, when the body can still compensate for blood loss
Decompensated shock
Late stage of shock, when blood pressure is falling
Signs and symptoms of compensated shock
- agitation
- anxiety
- restlessness
- feeling impending doom
- altered mental status
- weak, rapid, or absent pulse
- clammy skin (pale, cool, moist)
- pallor, with cyanosis about the lips
- shallow, rapid breathing
- shortness of breath
- nausea or vomiting
- capillary refill of longer than 2 seconds in infants and children
- marked thirst
- narrowing pulse pressure
Signs and symptoms for decompensated shock
- falling blood pressure (systolic pressure of 90 or lower in adult)
- labored or irregular breathing
- cyanotic skin
- thready or absent peripheral pulses
- Dull eyes, Diana Ted pupils
- Poor urinary output
Signs and symptoms fo cardiogenic shock
- chest pain
- irregular pulse
- weak pulse
- low blood pressure
- cyanosis
- cool, clammy skin
- anxiety
- crackles (rales)
- pulmonary edema
Treatment for cardiogenic shock
- position comfortably and administer high-flow oxygen
- assist ventilations
- transport promptly
- consider ALS
Signs and symptoms for obstructive shock
- Dyspnea
- rapid, weak pulse
- decreased lung compliance
- unilateral, decreased, or absent breath sounds
- decreased blood pressure
- jugular vein distention (JVD)
- subcutaneous emphysema
- cyanosis
- tracheal deviation toward unaffected side
Treatment for obstructive shock
- ALS assist and/or rapid transport
- administer high-flow oxygen
Signs and symptoms of septic shock
- warm skin or fever
- tachycardia
- low blood pressure
Treatment for septic shock
- transport promptly and administer high-flow oxygen
- assist ventilations
- keep patient warm
- consider ALS
Signs and symptoms for neurogenic shock
- bradycardia
- low blood pressure
- signs of neck injury
Treatment for neurogenic shock
- secure airway
- spinal immobilization
- assist ventilations with high-flow oxygen
- preserve body heat
- transport promptly
- consider ALS
Signs and symptoms for anaphylactic shock
- can develop within seconds
- itching or rash
- burning skin
- vascular dilation
- generalized edema
- coma
- rapid death
Treatment for anaphylactic shock
- manage the airway
- assist ventilations and administer high-flow oxygen
- determine cause
- assist with administration of epinephrine
- transport promptly
- consider ALS
Signs and symptoms for psychogenic shock
- rapid pulse
- normal or low blood pressure
Treatment for psychogenic shock
- determine duration of unconsciousness
- position patient supine
- record initial vital signs and mental status
- suspect head injury if patient is confused or slow to regain consciousness
- transport promptly
Signs and symptoms for hypovolemic shock
- rapid, weak pulse
- low blood pressure
- change in mental status
- cyanosis
- cool clammy skin
- increased respiratory rate
Treatment for hypovolemic shock
- secure airway
- assist ventilations and administer high-flow oxygen
- control external bleeding
- keep warm
- transport promptly
- consider ALS
Aneurysm
Swelling or enlargement of a part of an artery, resulting from weakening of arterial wall
Autonomic nervous system controls what?
Involuntary activities of the body such as heart rate, blood pressure, and digestion of food
Distributive shock includes
Septic shock
Neurogenic shock
Anaphylactic shock
And psychogenic shock
