shock Flashcards
distributive shock includes…
septic, anaphylactic, and neurogenic
vasodilatory/normovolemic shock
“distributive shock”
- loss in blood vessel tone leading to loss of vascular volume into the extravascular space
allergy to blood products
whole blood is the highest and albumin is the lowest
1st exposure to an allergen
Ige synthesis by B cells
2nd exposure to an allergen
Ige modulated within 15 min
Histamine
mediates allergic inflammatory response by binding to H1 on endothelial and smooth muscle cells to cause vasodilation and bronchoconstriction
increase in vascular permeability
change in osmotic pressure causing fluid to shift out of circulation leading to edema
bronchoconstriction
low pressure due to vasodilation which activates platelets releasing from mast cells
anaphylactic shock
hypoperfusion of organs and fluid shift leading towards circulatory collapse
anaphylaxis treatment
adrenergic agonist, glucocorticoids
epinephrine and dexamethasone
treatment for anaphylaxis
anaphylactic shock treatment
A- beta 2 agonist
B- oxygen
C- NS, IV adrenergics
shock
hypoperfusion of organs leading to lack of nutrients and O2 to meet demands and can result in metabolic acidosis
hypovolemic shock
low blood volume leading to decreased cardiac output due to trauma or severe dehydration
- 20% loss
cardiogenic shock
low cardiac output due to ineffective pumping of heart; causes myocardial infarction
- will present as low SBP, hypoxia, cyanosis, high JVP
obstructive shock
heart is not able to fill properly leading to an obstruction
- examples are pulmonary embolism or cardiac tamponade (heart does not stretch between contractions)
hypovolemic shock treatment
-ADH to increase water presence
-NS or LR
-Albumin to increase proteins and expand plasma volume
-Whole blood
lung injury (ARDS) due to hypovolemic shock
hypoperfusion causes inflammation leading to pulmonary edema causing membrane thickening which leads to low gas exchange
- will present as low O2 and tachypnea
MODS
multiple organ dysfunction due to hypovolemic shock
low cardiac output
causes high preload and afterload and low coronary artery perfusion
right sided heart failure
liver congestion, GI congestion, weight gain, edema
left sided heart failure
pulmonary issues, decreased cardiac output, impaired gas exchange, pulmonary edema, extreme fatigue
adrenalin to increase cardiac output and HR, noradrenaline to maintain CPP, dopamine to decrease vascular resistance, and intra-aortic balloon pump to create suction effect to increase blood flow
cardiogenic shock treatment
diuretics (spironolactone and lasix), direct acting vasodilators (nitroprusside, nitroglycerine ACE inhibitor, calcium channel antagonist), phosphodiesterase inhibitors (milrinone), beta blockers
HF treatment
