Concepts Exam#2 (Ch. 37) Flashcards
Shock
widespread abnormal cell metabolism occurring when gas exchange with oxygenation and tissue perfusion needs aren’t met sufficiently to maintain cell function.
Progressive stage of Schock
Life-threatening emergency - Vital organs can tolerate this situation for only a short time before being permanently damaged.
MODS
Multiple Organ Dysfunction Syndrome
Multiple Organ Dysfunction Syndrome
Sequence of cell damage caused by massive release of toxic metabolites and enzymes
Shock Syndrome
Problems resulting form it occur in a predictable sequence
Mean Arterial Pressure Factors include
Total blood volume, Cardiac output, size and integrity of the vascular bed, esp. capillaries. If TBV and CO increase, so does MAP, vice versa.
Hypovolemic Shock
Occurs when too little circulating blood volume decreases MAP, resulting in inadequate total body perfusion and oxygenation.
Common Problems leading to Hypovolemic Shock
Poor clotting with hemorrhage and dehydration.
Cariogenic Shock
Occurs when the heart muscle is unhealthy and pumping is impaired.
Distributive Shock
Occurs when blood volume is not lost from the body but is distributed to the interstitial tissues where it cannot perfuse organs. Caused by blood vessel dilation, pooling of blood in venous and capillary beds, and increased capillary leak.
Septic Shock
Widespread infection that triggers whole-body inflammation.
Sepsis
Presence of infection systemic manifestations. Infectious organisms have entered the bloodstream. Results in widespread inflammation, known as system inflammatory response syndrome (SIRS)
Anaphylactic Shock
Extreme type 1 allergic reaction. Begins within seconds to minutes after exposure to a specific allergen in a susceptible person.
Anaphylaxis Results in
Widespread loss of blood vessel tone, with decreased BP and CO.
Neurogenic Shock
Type of distributive shock resulting in low BP, occasionally with a slowed heart rate, that is attributed to the disruption of the autonomic pathways within the spinal cord. It can occur after damage to the CNS such as spinal cord injury.
SIRS
Widespread inflammation from increase of infectious organisms entering bloodstream… Triggered as a result of infection escaping local control.
Multiorgan Dysfunction syndrome (MODS)
When shock conditions continue for longer periods without help, resulting acid-base imbalance and increase metabolites cause so much cell damage in vital organs that they are unable to perform their critical functions. Once MODS occurs, recovery from shock is no longer possible.
MODS Manifestations
Rapid loss of consciousness, non palpable pulse; cold, dusky extremities; slow, shallow respirations; unmeasurable oxygen saturation.
Who should be assigned to assess vital signs of a patient who is at risk for or suspected of having hypovolemic shock?
Registered Nurse rather than a LPN/LVN or UAP.
These organ systems characterize MODS
Respiratory, Renal, Cardio, Neurologic, Hepatic, Hematologic
MODS Causes
Occurs as a secondary phenomenon. Include unrestrained inflammatory reaction or infectious response due to a severe injury or illness. Septic shock is most common reason for MODS.
Main indicators of Shock presence or progression
Systolic Blood Pressure changes, pulse rate changes and quality.
Interventions and Response to Shock
Focus on reversing the shock, restoring fluid volume to normal range, preventing complications.
More interventions to Shock
Oxygen therapy, IV Therapy (Crystalloids), Plasma, Protein-containing colloid fluids restore osmotic pressure and fluid volume (whole blood, packed RBCs, Plasma),
