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Complex > Shock 1 > Flashcards

Shock 1 Flashcards

1
Q

shock is a ______

A

condition

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2
Q

shock is a lack of ______ and _______

A

perfusion and oxygenation

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3
Q

describe hypoxia

A

no perfusion of organs

inability to oxygenate the rest of the body

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4
Q

describe perfusion

A

how good blood is flowing to the body
identified by BP, color, warmth
if MAP is maintained then good perfusion is ensured

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5
Q

what is oxedated phosporylation

A

normally, 36-38 molecules of ATP is produced
if no oxygen, anaerobic cycle produces only 2 molecules of ATP
*cannot survive on this

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6
Q

what is the oxygenation cycle

A 
lungs
coronary arteries
carotid artery
kidneys (get 1/4 of blood supply)
liver (get 2/3 blood supply)
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7
Q

why do you go into shock??

A

no oxygen is going to the organs and eventually no oxygen goes to the heart and lungs

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8
Q

what is the MAP and formula

A

mean arterial pressure

MAP=systolic + diastolic (2) / 3

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9
Q

what is the minimum the MAP can be

A

> 70

means perfusing to extremities, kidneys, liver, lungs

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10
Q

if workload is increased, you need a ______ MAP

A

higher

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11
Q

what is the stroke volume(SV) formula

A

systolic BP - diastolic BP

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12
Q

what is a normal SV

A

50-60 mL/beat

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13
Q

what does stroke volume mean

A

amount of blood per beat that you push out

can be manipulated by vasoconstriction

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14
Q

what happens when you first go into shock

A
  • gets cold
  • blood starts SHUNTING UP trunk (no longer in extremities)
  • vasoconstriction pushes blood to important liver, heart, lungs (eventually only pumps to heart)
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15
Q

what are the factors that influence MAP

A

1) total blood volume
2) cardiac output
3) size of vascular bed

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16
Q

what is the cardiac output formula

A

SV x HR

17
Q

what is a normal C.O.

A

4-6 L

18
Q

describe afterload

A

SYSTOLIC

force heart has to push to get blood out (push of blood from left ventricle to aorta)

19
Q

describe preload

A

DIASTOLIC
left ventricle and diastolic volume
how much blood left after heart pushes out blood
*never pushes ALL out (leftover blood)

20
Q

describe the ejection fraction

A

the percent of blood you push out of the heart

21
Q

what is a normal ejection fraction

A

70s (65-75)

aka if heart is working well you will push this amount out

22
Q

pt w/ CHF or MI will have a ______ ejection fraction

A

decreased

no good cardiac output (may be as low as 20)

23
Q

describe the vascular bed

A

where does the blood have to go?
in septic shock: dilation of vessels
not enough blood flow

24
Q

what are the 4 types of shock

A

hypovolemic
cardiogenic
distributive
obstructive

25
Q

describe hypovolemic shock

A

*total body fluid is decreased
hemorrhage and dehydration
loss of fluid… cannot maintain C.O.

26
Q

how do you fix hypovolemic shock

A

easy

give more fluid and blood

27
Q

describe obstructive shock

A

*clot
cardiac function decreased by non cardiac functions
fluid is NOT affected
pulmonary HTN, pneumothorax, pericarditis, tamponade

28
Q

describe cardiogenic shock

A 
**pump failure
fluid volume is NOT affected
no strength to push blood out of heart
r/t HF (something has hurt the heart)
cannot pump well d/t MI, valvular problems, dysrthymias, cardiac arrest, myopathies
29
Q

describe distributive shock

A

**fluid SHIFTED from central vascular space
body fluid is either normal or increased
two kinds: neural or chemical

30
Q

describe distributive shock (neural)

A

loss of vascular tone
cut in spinal cord, cannot maintain C.O. or vascular tone
cannot get epi or sympathetic to work well

31
Q

what causes shock

A
  • anaerobic environment

* decrease in MAP: d/t decrease in C.O, blood volume, or expansion of vascular bed

32
Q

what is the chemical process for the start of shock

A

drop of just 5-10 mmHg is detected by baroreceptors in the aortic arch and carotid sinus which causes shock process

33
Q

how does the pt appear in shock??

A
  • cold (d/t shunting of blood, elevate legs!!)
  • gut/GI doesnt work
  • liver doesnt work (no outward sign)
  • kidneys stop working (outward sign is decreased renal output, put in foley to monitor)
  • head/brain stop working (dizziness, lightheaded, pass out)
  • heart and lungs stop working
34
Q

what is normal urine output

A

30 mL/ hr (if less than this it is a problem)

35
Q

full chemical process of shock

A

1) baroreceptos send info to brain, which starts to shunt blood to vital areas (heart lungs, brain)
2) leads to increased lactic acid, protein destroying enzymes and oxygen radicals

36
Q

if shock is corrected in ______ it may be reversible, if not can lead to ______

A

1-2 hrs

MODS

37
Q

describe baroreceptors

A

sit on glomerulus
triggered to conserve blood flow, no output
oxygen free radicals attack the heart

38
Q

what is MODS

A

multiple organ dysfunction system

d/t lack of oxygenation

Complex (38 decks)

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