Lecture 9 -shock

Question 1

Class I Hemorrhage (minimal blood loss)

Answer 1

Blood volume loss < 15%
Adult blood loss < 750 ml 
Cardiovascular: heart rate normal or mild increase
Pulse normal 
Blood pressure normal 
PH normal 
Respiratory: rate normal (14-20)
Neurologic: slightly anxious 
Urine output >30
Mental status: normal 
Heart rate <100bp

Question 2

Class II

Answer 2

Mild blood loss 
Blood volume loss: 15-30% 
Adult blood loss: 750-1500 ml of blood loss
Cardiovascular
Tachycardia 
Diminished peripheral pulses
Blood pressure decreased
Normal PH
Respiratory rate 20-30
Urine output (ml/hr): 20-30
Mental status: anxious 
Heart rate >100

Question 3

Class III (moderate blood loss)

Answer 3

Blood volume loss: 30-40%
Adult blood loss: 1500-2000ml
Cardiovascular 
Significant tachycardia 
Thready peripheral pulses
Hypotension
Metabolic acidosis 
Blood pressure (mmHg) decreased 
Respiratory rate: 30-40 (breaths/min)
Urine output: 5-15 (ml/hour)
Mental status confused 
Heart rate >120

Question 4

Class IV (severe blood loss)

Answer 4

Blood volume loss >40%
Blood loss (ml) > 2000
Cardiovascular:
Severe tachycardia
Thready central pulses 
Significant hypotension
Significant acidosis 
Respiratory: >35
Blood pressure: decreased 
Urine output: negligible 
Mental status: lethargic 
Heart rate >140

Question 5

Pericardium

Answer 5

Membranous sac, surrounding heart

Function: lubricates heart, reduce friction

Question 6

What is pericarditis?

Answer 6

Inflammation of the pericardium

Question 7

What is pericarditis caused by?

Answer 7

Painful friction/ rub between pericardial layers 
Viral infections of pericardium
Idiopathic 
Uremic pericarditis 
Bacterial infection of pericardium 
Post-infarct
Dresslers

Question 8

What can pericarditis be classified according f to,

Answer 8

Composition of fluid that accumulates around heart ❣
Types:
Serous
Purulent
Fibrinous
Caseous
Haemorrhagic 
Post infarction

Question 9

What can acute pericarditis occur as?

Answer 9

Complications of infection
Immunologic conditions
Heart attack

Question 10

What are the signs and symptoms of Anaphylactic?

Answer 10

Anxiety
Dyspnoea
Hypotension

Question 11

What are the signs and symptoms of neurogenic shock?

Answer 11

Paralysis 
Absence of reflexes
Hypotension
Bradycardia 
Loss of temperature regulation

Question 12

What are the treatment of neurogenic shock?

Answer 12

Treat underlying cause
May last days/months
Vasoconstrictors (dopamine)

Question 13

What can be comprised to maintain BF to vital organs?

Answer 13

Blood supply to kidneys, skin, GIT

Question 14

What are the stages of shock?

Answer 14

Positive feedback
MAP reduced
Coronary blood flow reduced
Heart performance impaired

Question 15

What are the consequences of compensatory mechanisms impaired?

Answer 15

Inadequate tissue perfusion 
Decreased oxygen supply
Anaerobic metabolism 
Accumulation metabolic waste
Cellular waste