HLTH 2501: shock

Question 1

what is shock?

Answer 1

hypotension due to decreased circulating blood volume that leads to decreased tissue perfusion and general hypoxia

Question 2

hypovolemic shock

Answer 2

is a loss of blood or plasma and is caused by hemorrhage, burns, dehydration, peritonitis, and pancreatitis

Question 3

cardiogenic shock

Answer 3

is a result of decreased pumping capability of the heart and is caused by MI of the left ventricle, cardiac arrhythmia, pulmonary embolism, and cardiac tamponade

Question 4

2 types of vasogenic shock

Answer 4

neurogenic and distributive

Question 5

vasogenic shock

Answer 5

is vasodilation owing to a loss of sympathetic and vasomotor tone and is caused by pain and fear, spinal cord injury, and hypoglycemia (insulin shock)

Question 6

anaphylatic

Answer 6

systemic vasodilation and increased permeability owing to severe allergic reactions caused by insect stings, drugs, nuts, and shellfish

Question 7

septic shock

Answer 7

vasodilation owning to severe infection, often of gram-negative bacteria and is caused by virulent microorganisms or multiple infections

Question 8

types of shock (5)

Answer 8

hypovolemic, cardiogenic, vasogenic, anaphylactic, and septic

Question 9

what is BP determined by?

Answer 9

blood volume, heart contraction, and peripheral resistance; when one of these factors fail, BP drops

Question 10

result of shock

Answer 10

less CO and blood flow through the microcirculation, leading to reduced O2 for cells; less O2 also cause anaerobic metabolism and increased lactic acid production

Question 11

compensation mechanisms for shock

Answer 11

SNS activated, adrenal medulla activation, RAAS system, ADH release, glucocorticoids are secreted, and acidosis stimulates respirations

Question 12

what occurs if shock is prolonged?

Answer 12

cell metabolism is diminished and cell wastes are not removed; this leads to lower pH or acidosis, and this causes vasodilation, making the problem worse

Question 13

why is shock hard to reverse is not treated on the onset?

Answer 13

because the compensations by the body aggravate the problem; ex. vasoconstriction`, thrombus formation, and edema

Question 14

first signs of shock

Answer 14

thirst, agitation, anxiety, and restlessness due to the SNS stimulation

Question 15

compensation signs of shock

Answer 15

cool, moist, pale skin, tachycardia, and oliguria

Question 16

oliguria

Answer 16

vasoconstriction shunts blood from the viscera and skin to vital areas

Question 17

septic shock signs

Answer 17

“warm shock”; fever, warm, dry flushed face, rapid strong pulse, hyperventilation, and evidence of an infection

Question 18

signs of a decrease in BP

Answer 18

lethargy, weakness, dizziness, weak pulse, initially respiratory alkalosis followed by acidosis

Question 19

what does acidosis lead to

Answer 19

CNS depression, reduced cell metabolism, and diminished effectiveness of medications

Question 20

emergency treatment for shock

Answer 20

place patient in a supine position, cover and keep warm, call for assistance, and administer O2 if possible

Question 21

treating patients with hypovolemic shock

Answer 21

reduce whole blood, plasma, and fluid with electrolytes and HCO3

Question 22

treatment for anaphylaxis shock

Answer 22

antihistamines, corticosteroids, and epipen

Question 23

treatment for septic shock

Answer 23

glucocorticoids and antimicrobials