NCMB 418 (CU 13)

Question 1

Heart does not adequately pump enough blood to the body’s tissues

Answer 1

Cardiogenic Shock

Question 2

Clinical Manifestations of Cardiogenic Shock”

Answer 2

low systolic BP (< 90 mmHg)
tachycardia
Chest pain or tightness
Capillary refill – sluggish
Severe hypoxia
Anxiety and confusion
Nausea
decreased urine output

Question 3

Most common cause of cardiogenic shock

Answer 3

heart attack
(myocardial infarction)

Question 4

most common form of shock

Answer 4

Hypovolemic shock

Question 5

inadequate circulating blood volume in the intravascular bed

Answer 5

Hypovolemic shock

Question 6

Occurs as a result of fluid loss from the intravascular space

Answer 6

Absolute hypovolemia

Question 7

occurs as a result of
vasodilation and an increase
in vascular capacitance

Answer 7

Relative hypovolemia

Question 8

Clinical Manifestations of hypovolemic shock: The reversible

Answer 8

• Narrowed pulse pressure
• Tachycardia, tachypnea
• Hypoxia
• Decreased urinary output
• Thirst
• Pale and cool skin, delayed capillary refill
• Changes in the LOC

Question 9

compensatory stage occurs with a fluid loss of 15% to 30% or up to 1500mL

Answer 9

The reversible

Question 10

begins with a fluid loss of 30% to 40% or up to 2000 mL. Compensatory mechanisms begin to fail and tissue perfusion becomes ineffective

Answer 10

The progressive stage

Question 11

Clinical Manifestations of hypovolemic shock: The progressive stage

Answer 11

• Increased heart rate
• Cardiac dysrhythmias
• CO, cardiac index, right atrial pressure, and PAWP decrease
• Increased SVR – due to continued vasoconstriction of the arterial system
• Hypotension with a narrowed pulse pressure
• LOC changes:

Question 12

is an allergy emergency that
can cause death in less than 15 minutes.

Answer 12

Anaphylaxis

Question 13

Pharmacological management of anaphylactic shock

Answer 13

Epinephrine

Question 14

Signs and Symptoms of anaphylactic shock:

Answer 14

• itching, redness,
• swelling of lips, itchy throat, tongue
• nausea, vomiting
• SOB, wheezing,
  chest tightness
• hypotension, weak
  pulse

Question 15

an inflammatory response initiated by the launch of immune mediators that are part of the inflammatory reaction.

Answer 15

Septic Shock

Question 16

Clinical Manifestations: Early sepsis

Answer 16

• Temperature > 38.3° or < 36° C
• Tachypnea
• Tachycardia
• Hypotension
• Altered mental status
• Positive fluid balance (>20 mL/kg
  over 24 hours)
• Hyperglycemia
• SvO2 > 70%
• Cardiac index > 3.5 L/min/m2
• WBC > 12,000 cells/mm
• WBC < 4000 cells/mm
• Elevated C-reactive protein
• Elevated procalcitonin

Question 17

can produce a profound septic shock
and has a very distinctive cutaneous component

Answer 17

Toxic shock syndrome

Question 18

The body’s response to an
infectious or noninfectious insult affecting the whole body

Although the definition refers to it as an “inflammatory” response, it
actually has pro- and antiinflammatory components

Answer 18

Systemic Inflammatory
Response Syndrome (SIRS)

Question 19

Criteria of SIRS: at least two of the following:

Answer 19

Temperature : hypo/hyperthermia
Heart Rate : tachycardia
Respiratory Rate : tachypnea
White Blood Cells: leukocytosis

Question 20

A progressive dysfunction of more than one organ in patients who are critically ill or injured

Answer 20

Multiorgan Dysfunction Syndrome