circulatory shock Flashcards
neurogenic shock
wide spread vasodilation which causes a rapid drop in bp which leads to reduced cerebral blood flow which leads to fainting/syncope
this is due to trauma/intense pain
a life threatening vivid experience
results of neurogenic shock
light headiness, loss of consciousness, interrupts when emotional stimulus blocks the ANS
normal functions return when interrupted
other factors that can make neurogenic shock serious
CNS depression
brain damage
spinal cord injury or excess spinal anethesia
secondary shock
more common, signs and symptoms develop slower
involves a combo of CNS depression, spinal cord injury, and brain damage
most common cause of cardiogenic shock
left ventricular failure
if over 80% of death= fatal
other causes of cardiogenic shock
cardiomyopathies bacterial toxins, weaken myocardium narcotic drugs high levels of k mural thrombi cardiac tamponade tension pneumo extensive PE cardiac arrhythmia hemorrhage shock
damage to capillary walls
increased permiability which leads to increased fluid shifting/loss
thrombo embolism and cardiogenic shock
caused by blockage of venous return
gradual vs rapid loss
gradual is better because it allows tie for compensatory echanis to kick in
septic shock
caused by vasodilation which is caused by endotoxins in blood from uncontrolled infection, histamine and kinins are release, tissue damage makes cells less able to deliver nutrients from decreased blood supply and causes further complications
toxic shock
toxins are not from bacterial origin, caused by drugs or liver damage
anaphylactic shock
immune response following a second exposure to a forgein antigen
histamine released from mast cells
caused by blood transfusions, drugs , insect bites, foods
compensation response in shock
barorecpetors in aortic arch and carotid sins
sense pressure changes
sends to medula causes effector cells to adjust BP
effectors= heart and blood vessels (controls Co and constirction of vessels)
dermal and splachnic arterioles
directs blood fro skin to abdominal visceral (brain and heart)
this method functions during normal activity
can result in the doubling of blood volume loss tolerated before hypovolemic shock occurs
central NS ischemic response
when cardiovascular system becomes directly affected by ischemia
get intense increase in sympathetic output
raise bp and avoid anoxic damage
movement from fluid to tissues `
BP is a major moving force
if bp decreases less fluid goes into tissues which causes a drop in BP
as BP decreases even more, this drraws tissues into blood and increases plasma volume while raising BP
kidney compensation in shock
BP- vasoconstriction, less blood to kidneys
activated kidneys water mechanism increase ADH release
increase levels of angiotensin 2 which causes increased secretion of aldosterone and water retention and vasoconstriction
therapy
restore adequate blood flow, second eliminate cause of shock and deal with secondary long ter effects
drugs
whole blood or plasma
norepinephrine (vasoconstriction- use in neurogenic or vascular shock, cannot use in cardiogenic shock (increase work load on heart)
isoproterenol- increases heart rate and contractility, use in cardiogenic shock
shock
antibiotics, used more often to treat secondary effect
shock lung
respiratory infection after one goes through cardiogenic shock
secondary effects of shock
shock lung
kidney problems
pH imbalances (metabolic or respiratory acidosis)
all 3 must be considered when treating shock
kidney problems
reflex vasoconstriction
which causes renal ischemia (decreased bf, uo) possible renal necrosis, increased toxins in bloods and electrolyte imbalances
in circulatory shock
if ntreated leads to death
3 stages
