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Perfusion Exam > Class 3 > Flashcards

Class 3 Flashcards

1
Q 
inadequate tissue perfusion
anaerobic metabolism
cellular and tissue injury
organ damage
mutli-system organ failure
death
complications of what?
A

shock

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2
Q

condition in which there is decreased systemic blood flow and decreased cardiac output

A

shock

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3
Q

shock that occurs due to direct or indirect pump failure

A

cardiogenic

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4
Q

most common type of shock

A

hypovolemic

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5
Q

shock that occurs due to loss of vascular volume

A

hypovolemic

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6
Q

ways that vascular volume can be lost

A

hemorrhage
dehydration
burns
third spacing

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7
Q

shock that occurs due to maldistribution of vascular volume or decreased vascular tone, blood pools in peripheral BVs

A

circulatory

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8
Q

3 types of circulatory shock

A

septic
anaphylactic
neurogenic

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9
Q

most common type of circulatory shock

A

septic

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10
Q

temp parameters for septic shock

A

less than 36 or greater than 38 (96.8, 100.4)

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11
Q

HR to be considered septic shock

A

> 90

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12
Q

severe sepsis

A

sepsis PLUS sepsis-induced organ dysfunction or hypoperfusion

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13
Q

septic shock

A

severe sepsis PLUS hypotension not reversed with fluid resuscitation

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14
Q

type of shock in which there is an immediate, exaggerated immune response to an allergen/antigen

A

anaphylactic

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15
Q

s/s of anaphylactic shock

A

urticaria
pruritus
angioedema
laryngeal edema

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16
Q

type of shock in which there is SNS depression/block leading to vasodilation and bradycardia

A

neurogenic

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17
Q

type of shock in which the heart’s ability to contract and pump is impaired, the supply of o2 is inadequate for the heart and tissues

A

cardiogenic

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18
Q

s/s in initial stage of shock

A

vasoconstriction

increased HR

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19
Q

in what type of shock is there vasodilation in the initial stage

A

circulatory
neurogenic
anaphylactic

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20
Q

when will the HR not be increased in the initial stage of shock

A

MI with damaged SA node
neuorgenic shock
taking certain meds

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21
Q

main compensatory mechanism in initial stage of shock

A

cardio

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22
Q

main compensatory mechanism in non-progressive stage of shock

A

renal

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23
Q

s/s of non-progressive stage of shock

A

increased norepi and epi
renal induced vasoconstriction and retention of Na and h2o
interstitial fluid moving to intravascular space

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24
Q

stage of shock in which there is decreased urine output and a fluid shift

A

non-progressive

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25
Q

s/s in progressive stage of shock

A

cellular hypoxia
pooling and stasis of blood
DIC

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26
Q

in which stage of shock is DIC seen

A

progressive

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27
Q

in which stage of shock is there vasodilation

A

progressive

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28
Q

in which stage of shock does the Na/K pump fail

A

progressive

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29
Q

s/s in refractory stage of shock

A

myocardial deterioration
vascular failure
tissue/organ necrosis
MSOF

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30
Q

in which stage of shock is there MSOF

A

refractory

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31
Q

important to discuss in refractory stage of shock

A

advanced directives, living will, etc

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32
Q

when can hypothermia be seen in relation to shock

A

neurogenic shock
rapid fluid replacement
sepsis
septic shock

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33
Q

when can hyperthermia be seen in relation to shock

A

sepsis

septic shock

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34
Q

when can bradycardia be seen in relation to shock

A

MI with SA node damage

neurogenic shock

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35
Q

when can hypotension be seen in relation to shock

A

distributive shock

late sign when compensatory mechanisms fail

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36
Q

skin characteristics in vasoconstriction

A

pale
cool
clammy/moist

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37
Q

skin characteristics in vasodilation

A

pink
warm
flushed

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38
Q

why would there be diminished peripheral pulses in shock

A

blood being diverted to vital organs

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39
Q

ABGs in relation to respiratory system in shock

A

respiratory alkalosis

metabolic acidosis with compensation

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40
Q

normal pH

A

7.35-7.45

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41
Q

normal paCO2 (acid/resp)

A

35-45

42
Q

normal HCO3 (base/metabolic)

A

22-26

43
Q

ABG indicative of respiratory alkalosis

A

pH increased
PaCO2 decreased
HCO3 decreased

44
Q

ABG indicative of metabolic acidosis with compensation

A

pH decreased
PaCO2 decreased
HCO3 decreased

45
Q

hallmark signs of ARDS

A

noncardiac pulmonary edema

refractory hypoxemia

46
Q

ABGs seen in ARDS

A

respiratory acidosis

mixed resp/metabolic acidosis

47
Q

ABG indicative of respiratory acidosis

A

pH decreased
PaCO2 increased
HCO3 increased

48
Q

ABG indicative of mixed resp/metabolic acidosis

A

pH decreased
PaCO2 increased
HCO3 decreased

49
Q

GI issues with shock

A

stress ulcers

impaired liver fxn

50
Q

albumin, clotting factors, glucose: increased or decreased in shock

A

decreased

51
Q

liver enzymes, ammonia, bilirubin: increased or decreased in shock

A

increased

52
Q

BUN and creatinine: increased or decreased in shock

A

increased

53
Q

hypo or hyperkalemia in shock

A

hyperkalemia

54
Q

is SNS stim increased or decreased in early stages of shock

A

increased

55
Q

s/s of increased SNS stim in early shock

A

restless
irritable
anxious

56
Q

neuro s/s in later stages of shock

A 
confusion
lethargy
obtunded (extremely drowsy, sluggish)
stuporous
comatose
57
Q

what labs are indicative of fibrin clot breakdown

A

increased FDP
increased FSP
increased d-dimer

58
Q

these lab values will be decreased in DIC

A

fibrinogen

platelets

59
Q

bleeding, clotting, lysis: s/s of what

A

DIC

60
Q

when there is a shift to the L, there is an increase in what

A

immature neutrophils (bands)

61
Q

when there is a shift to the R, there is an increase in what

A

mature netrophils (segments)

62
Q

main interventions for shock

A

support oxygenation
improve CO
prevent malnutrition

63
Q

ways to improve CO

A

fluids
positive inotropes
vasopressors

64
Q

a venous blood o2 sat below what indicates shock

A

70%

65
Q

evaluates severity of tissue hypoperfusion

A

central venous o2 monitor

66
Q

percent of blood ejected by left vent under normal conditions

A

25%

67
Q

normal MAP

A

70-105

68
Q

normal CO

A

4-8 L/min

69
Q

normal SV

A

60-120 ml/beat

70
Q

normal ejection fraction

A

50-60%

71
Q

normal left vent preload

A

4-12 mmHg

72
Q

normal right vent preload

A

0-8 mmHg

73
Q

pulmonary artery wedge pressure measures what

A

L vent preload

74
Q

central venous pressure monitor can measure what

A

R vent preload

75
Q

when should you draw ABGs

A

when there is a change in the amount of o2 being administered

76
Q

a PAWP greater than what indicates severe pulmonary edema

A

25

77
Q

isotonic crystalloid solutions

A

0.9% NS

LR

78
Q

hypertonic crystalloid solutions

A

3% sodium chloride

79
Q

examples of colloids

A

dextran
hetastarch
albumin
plasma protein fraction

80
Q

this class of med improves perfusion to vital organs

A

vasopressors

81
Q

examples of vasopressors

A

dopamine
epinephrine
norepinephrine
neosynephrine

82
Q

meds that prevent stress ulcers

A

zantax

protonix

83
Q

goals in hypovolemic shock

A

restore fluid volume

correct underlying cause

84
Q

when would modified trendelenburg be used

A

hypovolemic shock

85
Q

goals in cardiogenic shock

A

improve contractility
decrease afterload
limit further myocardial damage
correct underlying cause

86
Q

in what type of shock are positive inotropes most commonly given

A

cardiogenic

87
Q

examples of positive inotropes

A

dopamine
dobutamine
inocor
primacor

88
Q

positive inotropes that vasodilate instead of vasoconstrict

A

inocor

primacor

89
Q

in what type of shock are vasodilators most commonly given

A

cardiogenic

90
Q

examples of vasodilators used in cardiogenic shock

A

nitroglycerin

nitroprusside

91
Q

s/s of nitroprusside toxicity

A

changes in LOC
tinnitus
blurred vision

92
Q

mechanical devices used to manage cardiogenic shock

A

ventricular assist device

intra-aortic balloon pump

93
Q

goals in septic shock

A

early recognition/intervention

correct underlying cause

94
Q

med used to treat septic shock that acts as anti-inflammatory, anti-thrombotic, profibrinolytic

A

xigris

95
Q

goals in neurogenic shock

A

restore sympathetic tone

correct underlying cause

96
Q

hypoglycemia is most commonly seen in which type of shock

A

neurogenic

97
Q

goals in anaphylactic shock

A

eliminate antigen
maintain patent airway
administer meds to alter immune response

98
Q

meds given in anaphylactic shock

A

epi
benadryl
steroids

99
Q

goals in DIC

A

monitor for and stop bleeding

correct underlying cause

100
Q

tx of DIC

A

platelets
fresh frozen plasma
heparin
cryoprecipitate

Perfusion Exam (3 decks)

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