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M/S 3 > Exam 2 - shock > Flashcards

Exam 2 - shock Flashcards

1
Q

hypovolemic shock occurs when ___ volume has decreased by how much

A

intravascular; 15-30%

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2
Q

types of crystolloids

A

LR, NS

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3
Q

types of colliods

A

albumin
blood products (PRBC, plt, plasma)

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4
Q

causes of hypovolemic shock

A

hemorrhage
D/V
DI
fistula drainage
hyperglycemia
diuresis

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5
Q

when does microcirculation and irreversible tissue damage occur with hypovolemic shock

A

> 40% blood loss

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6
Q

serial things to monitor with hypovolemic shock

A

H&H
electrolytes
lactate
ABG
central venous O2
hourly UOP

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7
Q

what defines cardiogenic shock

A

hearts ability to contract is impaired; supply of O2 is inadequate for the heart and tissues

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8
Q

2 types of cardiogenic shock

A

coronary vs. noncoronary

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9
Q

coronary cardiogenic shock

A

most common

acute MI with L ventricular damage
anterior wall MI

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10
Q

noncoronary cardiogenic shock

A

conditions that stress the heart:
severe hypoxia
acidosis
hypoglycemia
PTX
hypocalcemia

ineffective heart function:
valve damage
cardiac tamponade
arrhythmias

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11
Q

what to monitor with cardiogenic shock

A

BNP
troponin
cardiac enzymes
EKG
echo
CXR

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12
Q

early s/sx of cardiogenic shock

A

tachycardia
low BP
narrow PP
increase myocardial O2 consumption
cool, clammy skin
pallor
decreased cap refill

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13
Q

intravascular volume pools ____ blood vessels with distributive shock

A

peripheral

massive arterial and venous dilation promotes peripheral pooling

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14
Q

what are the 3 types of distributive shock

A

septic
neurogenic
anaphylactic

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15
Q

most common type of distributive shock

A

septic

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16
Q

cause of septic shocl

A

widespread infection or sepsis

commonly originates from bacteremia, PNA, urosepsis

gram +, gram -, parasites, fungi, viruses

17
Q

will fluid resuscitation help with hypotension during sepsis/septic shock

A

No

18
Q

s/sx of septic shock

A

increase coagulation
inflammation
tachycardia/hyperventilation
low UOP
altered neuro status
GI dysfunction
respiratory failure (common)
temperature dysreguation (core temps only)
hyperdynamic state (low CO, high SV)

19
Q

neurogenic shock is a loss of balance between which 2 systems

A

PNS, SNS

predominant PNS stimulation causes vasodilation for an extended period leads to hypovolemic state

20
Q

causes of neurogenic shock

A

spinal cord injury (T5 and above)
spinal anesthesia
depression of vasomotor center of medulla from drugs (opioids, benzos)

21
Q

s/sx of neurogenic shock will be r/t which system

A

PNS

22
Q

s/sx of neurogenic shock

A

warm, dry skin
low BP
bradycardia
temperature dysregulation
poikilothermia

23
Q

will atropine help with bradycardia during neurogenic shock

A

No

24
Q

what is pt with neurogenic shock at risk for and why

A

hypothermia d/t temperature dysregulation and piokilothermia

25
Q

when can neurogenic shock occur after injury and how long can it last

A

30 minutes; up to 6 weeks

26
Q

what interventions should be done for pt with suspected spinal cord injury

A

immobilize the pt

27
Q

what intervention should be done for a pt with spinal anesthesia or epidural

A

keep HOB elevated 30 degrees

28
Q

acute, life-threatening hypersensitivity reaction

A

anaphylactic shock

29
Q

anaphylactic shocks is a ___ meditated response (body produced antibodies against the allergen)

A

IgE

30
Q

anaphylactic shock can lead to ___ distress and ___ failure

A

respiratory distress (d/t laryngeal edema, severe bronchospasms)

circulatory failure (d/t massive vasodilation)

31
Q

anaphylactic shock s/sx may occur ___

A

suddenly

32
Q

s/sx of anaphylactic shock

A

anxiety
confusion
dizziness
CP
sense of impending doom
incontinence
HA
N/V
pruritus
flushing
angioedema

M/S 3 (17 decks)

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