Differentiating shock states Flashcards
1
Q
what is preload
A
wall stress at the end of diastole
2
Q
what is afterload
A
wall stress during systole
3
Q
what is distributive shock
A
a loss of tone
4
Q
what are the 2 types of obstructive shock
A
- loss preload
- increased afterload
5
Q
what are the 2 types of hypovolemic shock
A
- loss of volume
- loss of blood
6
Q
what are the 3 types of cardiogenic shock
A
- cardiomyopathy
- arrhythmia
- mechanical
7
Q
-hallmarks dependant on underlying cause
A
- pulse pressure(wide then narrow)
- JVD(decreased)
- hemoglobin/hematocrit (decreased hemoglobin and hematocrit and increased hemoglobin and hematocrit)
- sodium(increased or decreased)
- orthostasis
- IVC collapse
- eFAST for free fluid
8
Q
1 cause of systolic heart failure
A
MI
9
Q
hallmarks of diastolic HF
A
decreased filling, s3, s4, most important differentiation is LVEF
10
Q
hallmarks of systolic HF
A
decreased LVEF, dyskinetic ventricle or septum, ecg either NSTEMI (4% develop cardiogenic shock) or STEMI
11
Q
MV stenosis
A
- represents incomplete opening
- commonly associated with thematic fever
- high left atrial pressure, lead to right heart failure. a-fib, PND, orthopnea and potential mural thrombus formation
- decreased CO during tachycardia in part due to decreased diastolic filling time
- diatolic murmur is heard as a low pitched murmur, best heard at apex
12
Q
MV regurge
A
- incomplete closure
- papillary muscle rupture 3-7 post LAD MI
- incomplete mitral valve acts as a secondary pathway fro blood ejection
- parsystolic murmur
13
Q
AV stenosis
A
- incomplete opening of AV resulting in increased LV pressure during systole
- s/s associated to low CO
- narrow pulse pressure
- systolic murmur
14
Q
AV regurge
A
- incomplete closure
- most common in endocarditis
- wide PP
- s3
15
Q
Steps to assessing shock
A
1- what is the pulse pressure
2- what is the skin temp
