Component 5: Importance and Pathophysiology of Shock

Question 1

Define:

shock

Answer 1

It is defined as a state of hypoperfusion caused by failure or collapse of the cardiovascular system, whatever the cause.

Question 2

Define:

homeostasis

Answer 2

It is defined as the body’s continual effort to balance all of its systems.

Question 3

Describe:

perfusion

Answer 3

It is described as blood passing through (circulating) the vessels or other normal tissues and/or organs

Question 4

List causes of shock.

Answer 4

• decreased volume (volume)
• cardiac or pump failure (pump)
• decreased vessel function (container)

Question 5

Tension pneumothorax, cardiac tamponade, and pulmonary embolisms are what types of shock?

Answer 5

obstructive shock

Question 6

List types of distributive shock.

Answer 6

• Neurogenic shock
• Anaphylactic shock
• Psychogenic shock

Question 7

Differentiate preload and afterload (in reference to the heart).

Answer 7

• Preload: the precontraction pressure increasing the fill of the atria and ventricles.
• Afterload: the pressure or resistance present against the heart during contraction.

Question 8

Fill in the blank.

The hearts’ ability to contract is defined as ________ ________.

Answer 8

myocardial contractility

Question 9

Fill in the blank.

The heart’s ability to produce its own electrical activity is defined as ___________.

Answer 9

automaticity

Question 10

The following signs and symptoms are present in what type of shock?

• Irregular and/or weak pulse
• Chest pain
• Hypotension
• Cool, clammy skin
• Crackles (rales)
• Anxiety

Answer 10

cardiogenic shock

Question 11

List potential causes of obstructive shock.

Answer 11

• Tension pneumothorax
• Cardiac tamponade
• Pulmonary embolism

Question 12

List treatments for cardiogenic and obstructive shock.

Answer 12

• position of comfort
• assist ventilations as needed
• administer high-flow oxygen
• consider advance life support (ALS)
• rapid transport

Question 13

A patient suffering a severe infection may develop what type of shock?

Answer 13

septic shock

Question 14

True or false.

All forms of shock will result in hypotension.

Answer 14

False

Patients in the phase of compensated shock will not have hypotension.

Question 15

Which type of shock may result from a cervical spinal injury?

Answer 15

neurogenic shock

Question 16

Itching, burning skin, vascular dilatation, generalized edema, and rapid death are considered as what type of shock?

Answer 16

anaphylactic Shock

Question 17

True or false.

A patient with an allergy to horses, with recent exposure to horses, is complaining of itchy, watery eyes and dry throat. Their vital signs are:
Pulse - 90 bpm
Respiratory rate - 16 and unlabored
Lung sounds - clear in all fields
Blood pressure - 156/82

This patient is suffering from anaphylactic shock.

Answer 17

False

True and life-threatening anaphylaxis will produce difficulty breathing and the collapse of the vasculature resulting in deathly hypotension.

Question 18

What type of shock may result from excessive vomiting and diarrhea?

Answer 18

hypovolemic shock

Question 19

What type of shock is caused by exsanguination?

Answer 19

hemorrhagic shock

Question 20

Fill in the blank.

Shock will progress from ____________ shock to _____________ shock.

Answer 20

compensated, decompensated

Question 21

Fill in the blank.

The definitive, although late sign of shock is ___________.

Answer 21

hypotension

Question 22

True or false.

We can ignore the presence or possibility of shock until the blood pressure becomes hypotensive.

Answer 22

False

We should always maintain a high index of suspicion that shock will develop. Early recognition and treatment can prolong patient livelihoods.

Question 23

Why does the tourniquet application of an arterial bleed from a patient’s radial artery take precedence over opening the airway?

Answer 23

The patient most likely has been bleeding for some time. Stop the bleed, then assess the airway and breathing.

Question 24

Describe:

The importance of frequent reassessment(s) of a patient showing signs/symptoms of compensated shock.

Answer 24

If the progression of shock is not recognized or managed, the patient may suffer multiple organ failure(s) or damage resulting in death.

Question 25

What type of medication pen (injectable) will a patient(s) with a history of anaphylaxis be prescribed and ideally be carrying on their person?

Answer 25

EpiPens will be prescribed to patients with severe allergies or known history of anaphylaxis.