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Foundations 2 exam 2 > Hypotention and Shock > Flashcards

Hypotention and Shock Flashcards

1
Q

Defined as inadequate tissue perfusion from decreased CO

A

Shock

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2
Q

What is the formula for MAP?

A

MAP = HR x SV x SVR

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3
Q

what stage of shock is associated with compensation, Tachy, and increased SVR?

A

pre-shock

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4
Q

what stage of shock is associated with uncompensated organ damage, tachy, dysnpea, metabolic acidosis, oligouria, and cool extremitites?

A

Shock

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5
Q

what stage of shock is associated with end-organ damage from shock?

A

End organ dysfunction

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6
Q

what lines can you use to resuscitate a patient?

A

Arterial lines, Central lines, PICC, and Swan-Ganz Catheter (Pulm)

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7
Q

Can you give meds and monitor ABGs with Arterial lines?

A

No meds, Yes ABGs

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8
Q

What are 2 central lines

A

Swan-ganz, PICC

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9
Q

What line can enter the Brachia-cephalic vein and ends at the SVC-RA junction

A

PICC

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10
Q

What is normal CVP?

A

5-15 mmHg

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11
Q

What does the Swan Ganz catheter measure

A

Pulmonary pressure (5-15 mmHg)

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12
Q

What does all Shock types include?

A

Hypotension, Oligouria, Metabolic acidosis, Cool extremeties, End-organ failure

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13
Q 
Pathophys of hypovolemic shock
HR_
CVP_
PCWP_
CO_
SVR_
A 
HR_Increase
CVP_decrease
PCWP_decrease
CO_decrease
SVR_Increase
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14
Q 
Pathophys of Cardiogenic shock
HR_
CVP_
PCWP_
CO_
SVR_
A 
HR_ increase
CVP_Increase
PCWP_increased
CO_decrease
SVR_increase
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15
Q 
Pathophys of Early Sepsis shock
HR_
CVP_
PCWP_
CO_
SVR_
A 
HR_increase
CVP_decrease
PCWP_increase
CO_increase
SVR_decrease
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16
Q 
Pathophys of Late Sepsis shock
HR_
CVP_
PCWP_
CO_
SVR_
A 
HR_ Increase
CVP_decrease
PCWP_increase
CO_decrease
SVR_increase
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17
Q 
Pathophys of Neurogenic shock
HR_
CVP_
PCWP_
CO_
SVR_
A 
HR_ decrease
CVP_decrease
PCWP_decrease
CO_decrease
SVR_decrease
18
Q

which shock presents with hematemesis, hematochezia, melena, N/V/D, abdominal pain, trauma, post-op?

A

hemorrhagic shock

19
Q

What would a CMP show for shock patients?

A

elevated lactate - anaerobic respiration

20
Q

why do you give a patient crystalloid, colloid, and FFP?

A 
Crystalloid = saline
Colloid = albumin
FFP = frozen fresh blood
21
Q

What 3 things do you monitor in shock patients?

A

Urine output
peripheral perfusion
Mentation

22
Q

When can you give patients Vasopressors

A

SBP<70 mmHg

23
Q

what is the number 1 cause of cardiogenic shocK?

A

Obstructive cardiogenic shock due to Aortic Stenosis, but can also be due to PE, tamponade, or pneumothroax

24
Q

What happens to SVR to compensate for a low CO

A

SVR increases (renal salt and water retention also)

25
Q

PE of cardiogenic shock

A

JVD, edema, tachy, tachypnea, crackles

26
Q 
How do you manage patients with each issue
1 MI
2 V-tach/fib
3 Tension pnemothorax
4 tamponade
A

1 Cath lab
2 ACLS (ken)
3 decompress
4 pericardiocentisis

27
Q

what is a first line Inotrophic drug for shock management?

A

Dobutamine

28
Q

whats beta blocker and antiarrythmic called that we need to know?

A

Sotalol and Amioderone

29
Q

What is last line of tx for shock patients

A

LVAD, RVAD, ECMO, Transplant

30
Q

Etiology of Distributive Shock (think Sepsis Salad)

A

SALAD

Sepsis, adrenal disease, liver disease, anaphylaxis, Drugs

31
Q

What shock is charaterized with an increase in 02 demand to combat an infection?

A

Sepsic shock

32
Q

what kind of infection can lead to septic shock

A

Any (UTI, pneumonia, bacteremia, ect)

33
Q

What stage of septic shock has a decreased SVR, increased CO, and increased Contractility

A

Early septic

34
Q

when can early septic shock become late septic shock

A

when pro-inflammatory cells> anti- inflammatory cells = vasodilation

35
Q

What stage of septic shock is charaterized with and increase HR, SVR, and hypovolemia, with decreased CO

A

Late sepsic shock

36
Q

what populations get septic shock in general

A

elderly and immuncompromised

37
Q

in septic shock, do order a Pan-culture before or after antibiotics are administered?

A

Pan-cultures before antibiotics, but you can tx empirically using coverage based on likely infectious agent.

38
Q

If you are going to give a vasopressor, what the firs line?

A

Norepi along with ventilator support

39
Q

What causes neurogenic shock

A

pt took a blow to the head that severed the SNS of the thoracocolumnar section of the spine (para/quad)

40
Q

Why are all (HR, CO, SVR) decreased in neurogenic shock?

A

suppressed/eliminated SNS response.

41
Q

how do the DTRs respond with neurogenic shock

A

absent or hyperreflexia

Foundations 2 exam 2 (13 decks)

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