Chapter 42: Shock, Sepsis, and Multi Organ Dysfunction Syndrome: Stages of Shock

Question 1

failure of one organ system affects others, recovery unlikely

Answer 1

refractory

Question 2

Ischemic mucosal barrier of GI system causes ulcers, GI bleeding, risk of bacteria migration, decreased nutrient absorption ability

Answer 2

progressive

Question 3

Decreased blood flow to kidneys activates renin-angiotensin system

Answer 3

compensatory

Question 4

Anasarca: fluid leakage affects solid organs and peripheral tissues; decreased blood flow to pulmonary capillaries

Answer 4

progressive

Question 5

myocardial dysfunction causes dysrhythmias, myocardial ischemia, and possible MI, leading to complete deterioration of cardiovascular system

Answer 5

progressive

Question 6

Fluid moves from pulmonary vasculature to interstitium, causing pulmonary edema, bronchoconstriction, and decreased functional residual capacity

Answer 6

progressive

Question 7

Stage that begins when compensatory mechanisms fail

Answer 7

progressive

Question 8

If corrected in this stage, recovery possible with little or no lasting effects

Answer 8

compensatory

Question 9

Metabolism changes from aerobic to anaerobic (buildup of lactic acid cannot be removed by liver due to decreased tissue perfusion)

Answer 9

initial

Question 10

Impaired GI motility increases risk for paralytic ileus

Answer 10

compensatory

Question 11

Sustained hypoperfusion causes weak peripheral pulses and ischemia of distal extremities

Answer 11

progressive

Question 12

Fluid moves into alveoli, causing edema, decreased surfactant, worsening V/Q mismatch, tachypnea, crackles, and increased work of breathing

Answer 12

progressive

Question 13

Hypoperfusion–>renal tubular ischemia–>AKI (worsened by nephrotoxic drugs), decreased urine output, increased BUN, increased creatinine, metabolic acidosis

Answer 13

progressive

Question 14

Causes cool, clammy skin

Answer 14

compensatory

Question 15

Helps maintain homeostasis

Answer 15

compensatory

Question 16

Shunting blood from lungs increases physiologic dead space, which results in V/Q mismatch, decreased arterial O2, increased rate/depth of respirations

Answer 16

compensatory

Question 17

Increased capillary permeability, profound hypotension/hypoxemia, worsened tachycardia

Answer 17

refractory

Question 18

Stage in which patient is in ICU for advanced monitoring/treatment

Answer 18

progressive

Question 19

Attempt to overcome consequences of anaerobic metabolism

Answer 19

compensatory

Question 20

Exacerbation of anaerobic metabolism causes accumulation of lactic acid

Answer 20

refractory

Question 21

liver fails to metabolize drugs and waste, causing jaundice, increased enzymes, decreased immune function, and increased risk for DIC and significant bleeding

Answer 21

progressive

Question 22

Vasoconstriction and maintenance of blood flow to vital organs (heart, brain)

Answer 22

compensatory

Question 23

Characterized by decreased cellular perfusion and altered capillary permeability

Answer 23

progressive

Question 24

Baroreceptors in carotid/aortic bodies activate SNS in response to decreased BP–> increase in myocardial O2 demands

Answer 24

compensatory