Module 9

Question 1

What is shock?

Answer 1

a complex clinical presentation of circulatory failure– inadequate tissue perfusion to meet the metabolic demands resulting in cellular dysfunction and eventual organ failure

Question 2

What can cause circulation failure in children?

Answer 2

hypovolemia, altered peripheral vascular resistance and pump failure

Question 3

What are the types of shock?

Answer 3

-compensated
-decompensated
-irreversible or terminal

Question 4

What are the signs of compensated shock?

Answer 4

-vital organ function is maintained by compensatory mechanism
-blood flow is normal or increased and fluids may be shifted
-apprehensive
-irritability
-unexplained tachycardia
-normal blood pressure
-thirst
-pale pallor
-diminished urine output
-reduced perfusion to extremities

Question 5

What are the signs of decompensated shock?

Answer 5

-efficiency of the cardiovascular system is diminished
-tissue hypoxia, metabolic acidosis, and eventually dysfunction of all organ systems
-confusion and somnolence
-tachypnea
-moderate metabolic acidosis
-oliguria
-cool pale extremities
-decreased skin turgor
-poor cap refill

Question 6

Describe irreversible/terminal shock

Answer 6

damage to the heart and brain is of such magnitude that intervention does not help
-thready weak pulse
-hypotension
-periodic breathing or apnea
-anuria
-stupor or coma

Question 7

What is the therapeutic management of shock?

Answer 7

-establish airway/intubation
-administer oxygen
-obtain vascular access
-restore fluid volume
-administer vasopressors (epi)
-provide continuous extro cardio monitoring
-monitor pulse oximetry
-keep child flat/legs raised
-keep child calm and warm

Question 8

What are the 4 congenital heart diseases in children?

Answer 8

1) increased pulmonary blood flow
2) decreased pulmonary blood flow
3) obstruction of blood flow out of the heart
4) mixed blood flow