Part 6 - Recognition of Shock

Question 1

A critical condition that results from inadequate tissue delivery of O2 and nutrients to meet tissue metabolic demand

Answer 1

Shock

Question 2

T/F Shock is always characterized by inadequate peripheral end-organ perfusion

Answer 2

F; not always

Question 3

T/F The definition of shock depends on BP measurement

Answer 3

F; it can occur with a normal, increased, or decreased SBP

Question 4

T/F In children, most shock is characterized by low cardiac output

Answer 4

T

Question 5

T/F All types of shock can result in impaired function of vital organs

Answer 5

T

Question 6

Fever, infection, injury, respiratory distress, and pain may contribute to shock by

Answer 6

Increasing tissue demand for O2 and nutrients

Question 7

The goal in the treatment of shock

Answer 7

Improve O2 delivery

Question 8

Acid-base derangement in shock

Answer 8

Metabolic acidosis

Question 9

O2 content of the blood is determined primarily by

Answer 9

1) Hgb concentration 2) Percent hemoglobin saturated with O2 (SaO2)

Question 10

Volume of blood pumped by heart per minute

Answer 10

Cardiac output

Question 11

Volume of blood pumped by the heart with each beat

Answer 11

Stroke volume

Question 12

Cardiac output is a product of

Answer 12

HR and SV

Question 13

Infants are dependent on ___ to maintain cardiac output

Answer 13

Heart rate; stroke volume cannot increase very much

Question 14

T/F The arterial blood contains more O2 than what the tissue needs

Answer 14

T

Question 15

Refers to low blood O2 sat

Answer 15

Hypoxemia

Question 16

Refers to oxygen deprivation of a region of a body or organ

Answer 16

Hypoxia

Question 17

T/F Hypoxemia alone can result in hypoxia

Answer 17

F

Question 18

Tissue oxygenation and O2 delivery are determined by

Answer 18

1) CO 2) Blood’s arterial O2 content

Question 19

T/F O2 delivery may be normal despite hypoxemia

Answer 19

T; if increase in CO is commensurate with decrease in O2 content

Question 20

Stroke volume is determined by

Answer 20

1) Preload 2) 1/Afterload 3) Contractility

Question 21

MCC of low stroke volume and, therefore, low CO

Answer 21

Inadequate preload

Question 22

Inadequate preload can cause what type of shock

Answer 22

Hypovolemic shock

Question 23

Hypoglycemia can cause what type of shock

Answer 23

Cardiogenic

Question 24

Toxic ingestion of CCB can cause what type of shock

Answer 24

Cardiogenic

Question 25

Increase after load can cause what type of shock

Answer 25

Cardiogenic shock

Question 26

Preload is best measured by

Answer 26

Central venous pressure

Question 27

Central venous pressure is measured in the

Answer 27

SVC or right atrium

Question 28

Situations that can cause decreased end-diastolic volume despite increased CVP

Answer 28

Increased pressure around the atrium such as tension pneumothorax or pericardial tamponade (venous return to the heart is obstructed)

Question 29

Physiology of septic shock

Answer 29

Inappropriate vasodilation and maldistribution of blood flow > decreased preload