hypotension over

Question 1

hypotension/ + important question to ask

Answer 1

is the pt in shock or not?

Question 2

how does hypotension & shock diff ?

Answer 2

shock = an exagerrated version of hypotension

Question 3

hypotension + shock/ 3 main reasons

Answer 3

pump fluid: heart= c_ardi_ogen_ic;

conduit=pipe, BV= di_stri^bu_tive/

blood volume= ^hypo_volem^ic

Question 4

hypotension + shock/ cardiogenic shock/

hx

Answer 4

Ca_rdiac ^hx,

CA_{D ri}sk fa^cto_rs

c_hest p^ain.

Question 5

hypotension + shock/cardiogenic shock /

Phys Exam

Answer 5

HEENT : J_VD.

heart: S_{3 g}all^op,
lung: cra^ckles on exam,
skin: co_{ld e}xtre^mities. slo_{w ca}pillary refill

Question 6

hypotension + shock/cardiogenic shock /lab tests findings

Answer 6

E_CG,

Che_{st f}il^{m (}pulmonary edema)

C_K/CK-M_B T_ropoⁿin, B^NP

a_ngio_gr^aphy ( ck if MI, to isolate the bv)?

Question 7

hypotension + shock/distributive shock / hx

Answer 7

I_nfectio_us hx:

Fe^ver, rig_ors,

c_ough, ple_ur^{al n}fec_tions.

U_TI sx

skⁱn i_nfec^tion

Question 8

hypotension + shock/ distributive shock/PE

Answer 8

Signs of high output shock: VS:

b^oundi_{ng p}ulse^{s, bri}sk c_apillary refi_{ll. wid}e pul_{se pr}essu^re/

foc_{al l}ung fin^dings,

ab_{d. T}en^dern^ess/

CV_A Tend_erness/

ski_{n fi}ndings, W_arm ^extre_mities.

Question 9

hypotension + shock/ distributive shock/septic shock/

Phys Exam

Answer 9

Fe_ver Rig^ors/

Urinary frequency/dysuria

Cough

Diarrhea Abdominal pain

Question 10

hypotension + shock/ distributive shock often septic shock

/lab tests findings

Answer 10

Laboratory tests: C_BC, B^MP & l^acta^te, u^rinal_ysis

Chest film (pulmonary edema)/

look for Infectious signs:

Catheter site redness or purulence,

abdominal tenderness =>MRI? ck

hint: BMP: basic metabolic panel => metabolic acidosis

Complete Blood Count Test‎ for WBC

Question 11

hypotension + shock/hypovolemic shock /

hx

Answer 11

hx of

in: de_hydratⁱo_n, decr^{d o}ral i_ntake
out: vo_mitin^g, di^arrhea.

he_mor^rhag_e.

m_eleⁿa. br_igh^{t r}ed blo_od p_{er re}ct^um/

Question 12

hypotension + shock/hypovolemic shock /

Phys Exam

Answer 12

VS: sm_{all pul}s^{e pre}ssu_re pr^essur^{e, p}oor ref^ill

Col_{d e}xre^mïti^es.

Question 13

hypotension + shock/hypovolemic shock /

lab tests findings

Answer 13

all about volume: blood or pee

kidney

U^rinaly^sis

Ele_vate_{d B}U_{N, cr}eatinine

blood

C_BC, Lo^{w F}e,

Gl^ucos^e (glucose osmotic diuresis)

Question 14

hypotension + shock/ ROS evidence of hypoperfusion (5)

Answer 14

VS: Si_gn_ificantl_y de^crd B_P/T^achycard^ia /_incr^d R^R (dec blood=> decr O2) /

MMS: Alt^eration of _men^tal s_tatus(dec blood=> dedr O2) /

liquid:

_dec^{rd u}r_inar^{y o}ut_put (u save fluid) /

_decr^{d ar}teri^al pH (dec blood=> decr O2) from ABG

Question 15

hypotension + shock/ evidence of hypoperfusion/

systolic BP usually….

Answer 15

low