Part 6 - Recognition of Shock Flashcards
A critical condition that results from inadequate tissue delivery of O2 and nutrients to meet tissue metabolic demand
Shock
T/F Shock is always characterized by inadequate peripheral end-organ perfusion
F; not always
T/F The definition of shock depends on BP measurement
F; it can occur with a normal, increased, or decreased SBP
T/F In children, most shock is characterized by low cardiac output
T
T/F All types of shock can result in impaired function of vital organs
T
Fever, infection, injury, respiratory distress, and pain may contribute to shock by
Increasing tissue demand for O2 and nutrients
The goal in the treatment of shock
Improve O2 delivery
Acid-base derangement in shock
Metabolic acidosis
O2 content of the blood is determined primarily by
1) Hgb concentration 2) Percent hemoglobin saturated with O2 (SaO2)
Volume of blood pumped by heart per minute
Cardiac output
Volume of blood pumped by the heart with each beat
Stroke volume
Cardiac output is a product of
HR and SV
Infants are dependent on ___ to maintain cardiac output
Heart rate; stroke volume cannot increase very much
T/F The arterial blood contains more O2 than what the tissue needs
T
Refers to low blood O2 sat
Hypoxemia
Refers to oxygen deprivation of a region of a body or organ
Hypoxia
T/F Hypoxemia alone can result in hypoxia
F
Tissue oxygenation and O2 delivery are determined by
1) CO 2) Blood’s arterial O2 content
T/F O2 delivery may be normal despite hypoxemia
T; if increase in CO is commensurate with decrease in O2 content
Stroke volume is determined by
1) Preload 2) 1/Afterload 3) Contractility
MCC of low stroke volume and, therefore, low CO
Inadequate preload
Inadequate preload can cause what type of shock
Hypovolemic shock
Hypoglycemia can cause what type of shock
Cardiogenic
Toxic ingestion of CCB can cause what type of shock
Cardiogenic
Increase after load can cause what type of shock
Cardiogenic shock
Preload is best measured by
Central venous pressure
Central venous pressure is measured in the
SVC or right atrium
Situations that can cause decreased end-diastolic volume despite increased CVP
Increased pressure around the atrium such as tension pneumothorax or pericardial tamponade (venous return to the heart is obstructed)
Physiology of septic shock
Inappropriate vasodilation and maldistribution of blood flow > decreased preload
