icu 4

Question 1

Shock

Answer 1

A complex syndrome characterised by decreased tissue perfusion and impaired
cellular metabolism
with accompanying cellular dysfunction and
eventual organ failure
▪ Altered physiological state that affects the function of every cell and system in the
body

Question 2

shock is a secondary physiological response

Answer 2

cellular injury of any kind, resulting in an
imbalance between the supply and demand of
oxygen to the cells, precipitating cellular hypoxia
and anaerobic respiration, and irreversible
cellular injury

Question 3

Cellular injury may take many forms, such as

Answer 3

trauma, blood loss, heart disease, burns,
poisoning and infection

Question 4

What does the
cardiovascular system
need in order to function
appropriately in getting
oxygen to tissues?
Picture a hose and
tap…. With a nozzle and
a hose on the end…
Water
Handle
Tap =
Hose =

Answer 4

Water = blood volume
Handle = pump
(strength of contractions
of heart)
Tap = vascular tone
Hose = vessels ( free of
blockage or obstruction)

Question 5

Classification of Shock States

Answer 5

Distributive(neurogenic, Septic, anaphylactic)
Hypovolaemic
Cardiogenic
Obstructive

Question 6

Resuscitation
The Deteriorating Patient – shock

Answer 6

Cardiogenic shock
Hypovolaemic shock
Obstructive shock
Distributive shock

Question 7

Cardiogenic shock

Answer 7

▪ Associated with cellular injury of the heart and its related structures, and results in a
failure of cardiac function
▪ Common causes include myocardial infarction, cardiomyopathy, valve disease or
trauma of anatomical rupture

Question 8

▪ Hypovolaemic shock

Answer 8

▪ Results from a loss of blood or extracellular fluid
▪ Caused by haemorrhage, burns or, in extreme cases, vomiting and diarrhoea

Question 9

} Obstructive shock

Answer 9

◦ Occurs when blockages or disruptions of systemic, pulmonary or coronary circulation
interfere with cardiac output
◦ Caused by cardiac tamponade, pulmonary embolism or dissecting aortic aneurysm

Question 10

Distributive shock

Answer 10

◦ Shift of fluid into the peripheral vasculature, resulting in pooling of fluid, hypotension
and poor tissue perfusion
◦ May be anaphylactic, septic or neurogenic in nature

Question 11

signs of shock

Answer 11

early signs, compensatory signs
progessive signs, refractory signs

Question 12

early signs

Answer 12

map lower than 10mm hg
effective comensation
o2 - vital organs
high heart rate

Question 13

compensatory signs

Answer 13

map lower an 10-15 mmhg from baseline
increases renin, adh, hr. lowers pulse pressure, ph

Question 14

progressive signs

Answer 14

map lower than 20mmhg from baseline
tissue organ hypoxia, weak rapid pulse, sensory neural changes

Question 14

refractory signs

Answer 14

excessive cell damage/ organ damage, mulit system organ failure, lowers ph