Final 5 - Perfusion Flashcards
Will you have an increase or decrease in MAP in all stages of shock
decreased
Early Signs shock:
- MAP decrease _____ mmHg from Baseline
- Effective Compensation
- O2 -> Vital Organs
- _____ HR
Early Signs shock:
- MAP decrease 10mmHg from Baseline
- Effective Compensation
- O2 -> Vital Organs
- increased HR
Compensatory Signs Shock:
- MAP decrased _____mmHg from Baseline
- _____ Renin
- _____ ADH
- _____ Pulse Pressure
- _____ HR
- _____ pH
- _____
- _____
Compensatory Signs Shock:
- MAP decreased 10-15mmHg from Baseline
- Increased Renin
- Increased ADH
- Decreased Pulse Pressure
- Increased HR
- Decreased pH
- Restless
- Apprehensive
Progressive Signs Shock:
- MAP decreased _____mmHg from Baseline
- Tissue/Organ _____
- _____ Urine (Oliguria)
- _____, Rapid Pulse
- _____ pH
- _____ _____ _____
Progressive Signs Shock:
- MAP decreased 20mmHg from Baseline
- Tissue/Organ Hypoxia
- Decreased Urine (Oliguria)
- Weak, Rapid Pulse
- Decreased pH
- Sensory Neural Changes
Refractory Signs Shock:
- Excessive Cell/Organ _____
- Multi System Organ _____
- _____ pH
Refractory Signs Shock:
- Excessive Cell/Organ Damage
- Multi System Organ Failure
- decreased pH
6 Early signs of shock
- BP
- Pulse
- color
- skin
- face
- lungs
- normal BP
- increased HR
- normal color
- cool/moist skin
- anxious
- increased rate, increased depth
6 late signs of shock
- BP
- Pulse
- color
- skin
- face
- lungs
- < 90mmHg Systolic
- increased rate/weak
- pale
- cold
- coma
- increased rate. increased shallow
How to calculate PP (pulse pressure)
systolic - diastolic
a _____ pulse pressure is an earlier sign of deterioration then a drop in systolic pressure < _____
narrowing
90
normal PP
30-40 mmHg
elevation of the diastolic BP releases catecholamine’s and attempts to increase venous return through _____
vasoconstriction
_____ diastolic BP = _____ release = _____ venous return = _____
increased
catecholamine
increased
vasoconstriction
Which stage of shock do you want to be in to try and fix things
compensatory stage
With shock, you want to _____ BP do you don’t lose it
hold
usually _____ alkalosis comes first, then _____ acid accumulates = _____ acidosis, but usually with _____ shock, it is mixed
respiratory
lactic
metabolic
septic
which stage of shock does the LOC really change
progressive
- become more restless & confused
which stage of shock do you get vasoconstriction
compensatory, continues in progressive
which stage of shock do you get shunting of blood
compensatory
which stage of shock do you really get a drop in BP
progressive
which stage of shock does it affect lungs, heart, kidneys, and other areas
progressive
which stage of shock can they go into acute renal failure
progressive
which stage of shock is irreversible
refractory
Shock state resulting from decreased intravascular volume due to fluid loss
hypovolemia
Shock state resulting from impairment or failure of myocardium
cardiogenic
Circulatory shock state resulting from overwhelming infection causing relative hypovolemia.
septic
Shock state resulting from loss of sympathetic tone causing relative hypovolemia.
neurogenic
Circulatory shock state resulting from severe allergic reaction producing overwhelming systemic vasodilation, relative hypovolemia.
anaphylactic
_____ shock: don’t want to put head down, do modified trendelenburg does NOT work
cardiogenic
MONA for cardiogenic shock
morphine (opioids)
oxygen
nitroglycerin
aspirin
Stimulates beta-receptors for myocardial strength
dobutamine
Vasodilator to reduce preload.
nitroglycerin
improves tissue perfusion, increases co.
low-dose dopamine
causes vasoconstriction, increases workload.
high-dose dopamine
dilates blood vessels
morphine
most shock pt’s have serious dysrhythmias =
antiarrhythmic meds
describe antibiotic treatment for septic shock
first = broad spectrum then = narrow spectrum
What do you do very FIRST for septic shock
get culture & sensitivity!
What is VERY important for all types of shock
FLUIDS!!!
thermoregulation is treatment for what shock
neurogenic shock
vasoactive meds are treatment for what shock
neurogenic & all types
what types of fluids do you use for fluid replacement in treatment of shock
crystalloids
colloids
