shock

Question 1

hypovolemic shock description

Answer 1

significant decrease in intravascular volume by 15-30%

Question 2

hypovolemic shock causes

Answer 2

traumatic blood loss
internal fluid shifts: edema, ascites, severe hydration

Question 3

hypovolemic shock pathophysiology

Answer 3

decrease in intravascular volume which results in decreased venous blood return to heart and decreased ventricular filling.

Question 4

hypovolemic shock s/s

Answer 4

impaired perfusion
thready pulses
decreased LOC
pale cool skin

Question 5

hypovolemic shock hemodynamics

Answer 5

BP decreased
HR increased
CO decreased
SVR increased

Question 6

hypovolemic shock treatment

Answer 6

finding causes
replace fluids or blood
vasoactive meds
O2
monitor for adverse effects of treatment

Question 7

cardiogenic shcok description

Answer 7

the heart’s ability to contract and pump blood is impaired, and the supply of O2 is inadequate for heart and tissues

Question 8

cardiogenic shock causes

Answer 8

direct damage to myocardium
hypoxemia or hyperglycemia causes damage
myocardial infarction

Question 9

cardiogenic shock pathophysiology

Answer 9

decrease in SV and CO

Question 10

cardiogenic shock s/s

Answer 10

decreased BP and tissue perfusion
chest pain
fatigue
pulmonary edema
dysrhythmias

Question 11

cardiogenic shock hemodynamics

Answer 11

BP decreased
HR increased
CO decreased
SVR increased

Question 12

cardiogenic shock treatment

Answer 12

treat cause
O2
pain control
lab and hemodynamic monitoring
cardiac meds
positive inotropes, vasopressors, antidysrhythmic meds

Question 13

septic shock description

Answer 13

widespread infection in body. more than 31 million people impacted. more than 6 million people die annually

Question 14

septic shock causes

Answer 14

any agent that causes infection

Question 15

septic shock pathophysiology

Answer 15

inflammatory response is overwhelming. vessels vasodilated and increased capillary permeability. leak into interstitial tissues. cytokines cause clotting

Question 16

septic shock s/s

Answer 16

tachycardia
HTN
increased lactic acid levels
hypoxic
hypo or hyperthermia

Question 17

septic shock hemodynamics

Answer 17

BP decreased
HR increased
CO decreased
SVR decreased

Question 18

septic shock treatment

Answer 18

measure lactate level
obtain blood cx X2 before abx
administer broad spectrum abx
administer 30 ml/kg crystalloid (NS and LR are crystalloids/isotonic fluids)
after 6 hrs apply vasopressors if needed. reassess.
early nutritional support

Question 19

neurogenic shock description

Answer 19

a loss of balance between parasympathetic and sympathetic stimulation causes vasodilation, leading to relative hypovolemic state

Question 20

neurogenic shock causes

Answer 20

spinal cord injury
anesthesia or other damage
meds, hyperglycemia

Question 21

neurogenic shock pathophysiology

Answer 21

overriding parasympathetic nervous system stimulation causes drastic decrease in SVR and bradycardia

Question 22

neurogenic shock s/s

Answer 22

bradycardia
dry warm skin
hypotension

Question 23

neurogenic shock hemodynamics

Answer 23

BP decreased
HR decreased
CO decreased
SVR decreased

Question 24

neurogenic shock treatment

Answer 24

restore sympathetic tone
cant do much to treat cause
support cardiovascular and neurologic function
prevent complications- dvts and internal bleeding (trauma)

Question 25

anaphylactic shock description

Answer 25

caused by a severe allergic reaction when patients who have already produced antibodies to a foreign substance develop a systemic antigen-antibody reaction

Question 26

anaphylactic shock causes

Answer 26

food, insects, meds that cause an allergy

Question 27

anaphylactic shock pathophysiology and s/s

Answer 27

5-30 min after exposure 2 or more of: respiratory compromise reduced BP GI distress skin and mucosal irritation

Question 28

anaphylactic shock hemodynamics

Answer 28

BP decreased HR increased CO decreased SVR decreased

Question 29

anaphylactic shock treatment

Answer 29

remove agent if present first IV fluids epinephrine IM or IV histamine blockers or bronchodilators

Question 30

compensatory stage of shock

Answer 30

normal BP increased HR >100 increased RR >22 cold/clammy skin decreased UOP confusion or agitation respiratory alkalosis

Question 31

progressive stage of shock

Answer 31

low BP increased HR >150 increased RR, rapid and shallow mottled skin decreased UOP <0.5 mL/kg/hr lethargy metabolic acidosis

Question 32

irreversible stage of shock

Answer 32

low BP requires support erratic HR requires intubation jaundice anuric, requires dialysis unconscious profound metabolic and lactic acidosis