Shock 1

Question 1

SIRS criteria

Answer 1

Temp > 38 or < 36
HR > 90
RR > 20
WBC > 12 or < 4

Question 2

MAP formulation

Answer 2

MAP = CO x SVR
MAP = (2xDBP) + SBP / 3

Question 3

Examples of the 4 types of shock

Answer 3

Hypovolemic: hemorrhagic, GI losses, capillary leak, burns
Cardiogenic: MI, dysrhythmia, HF, valve disease
Distributive: sepsis, neurogenic, anaphylaxis
Obstructive: PE, tension pneumo, pericardial tamponade

Question 4

How are vital signs altered in shock

Answer 4

Tachycardia
Tachypnea
Hypotension
Increased or decreased temp
Low O2 sat

Question 5

General appearance in shock

Answer 5

Initially may appear normal
Later restless
Later pale, dusky, cyanotic, mottled skin
Cool moist skin, diaphoretic
Dry mouth
Dilated pupils
Cap refill delayed

Question 6

CNS changes in shock

Answer 6

Restless
Disorientation
Acute delirium
Confusion
Coma

Question 7

CVS changes in shock

Answer 7

SBP may initially be increased to compensate, then drops
Pulse pressure early increase, then decrease
Neck vein flattening or distension
Rapid weak pulse
Decreased cap refill
Demand ischemia
Cardiomyopathy

Question 8

Respiratory changes in shock

Answer 8

Tachypnea
Hyper or hypocapnea
Bronchospasm
Progression to respiratory failure
Acute lung injury

Question 9

Renal changes in shock

Answer 9

Decreased GFR
Renal blood flow redistributes from renal cortex causing oliguria
Renal failure

Question 10

GI changes in shock

Answer 10

Ileus
Mesenteric ischemia can result from decreased perfusion
Increased lactate

Question 11

Typical ABG in shock

Answer 11

Metabolic acidosis with respiratory compensation

Can vary