Shock

Question 1

What are the 3 compensatory mechanisms of shock?

Answer 1

Tachycardia
Peripheral vasoconstriction
Inreased respiratory rate

Question 2

What are the 3 elements of adequate perfusion?

Answer 2

PUMP-functioning heart
PIPES-intact vessels and containers
FLUID-adequate volume

Question 3

What is the trauma triad of death?

Answer 3

Hypothermia
Coagulopathy
Acidosis

Question 4

How do you keep a shock patient’s blood patient sufficient enough to get to the vital organs?

Answer 4

Lay them down

Question 5

What is compensated shock?

Answer 5

15-30% decrease in BV

BP elevated or normal, RR elevated, normal or slight change in LOC

Question 6

What is decompensated shock?

Answer 6

30-40% decrease in BV

BP begins to fall, RR elevated, HR elevated, altered LOC

Question 7

What is irreversible shock?

Answer 7

40% and greater decrease in BV

BP is low, RR decrease, HR decrease, ALOC/Unresponsive

Question 8

Class 1 of hemorrhage?

Answer 8

<750 ml

Question 9

Class 2 of hemorrhage?

Answer 9

750-1500 ml

Question 10

Class 3 of hemorrhage?

Answer 10

1500-2000 ml

Question 11

Class 4 of hemorrhage?

Answer 11

> 2000 ml

Question 12

What is normal BV in men and women?

Answer 12

male: 5-5.5 L
female:4.5-5 L

Question 13

What is cardiogenic shock? What is it caused by? What are the signs/symptoms?

Answer 13

Damage/failure of myocardium leads to ineffective pumping

Caused by AMI (acute myocardial infarction), HF, trauma

Tachycardia, tachypnea, hypotension, chest pain, SOB, pulmonary edema, ALOC, probable cardiac history

Question 14

What is cardiac tamponade? What causes it? What are signs/symptoms?

Answer 14

Fluid collects in pericardial sac squeezing the heart

Tachycardia and Beck’s triad (JVD, narrowing pulse pressure (hypotension), muffled heart sounds

Question 15

What does Beck’s triad imply? What is it?

Answer 15

Cardiac tamponade

JVD, narrowing pulse pressure (hypotension), muffled heart sounds

Question 16

What is tension pneumothorax? What are sounds and symptoms?

Answer 16

Air collects in the plural space of the chest cavity compressing lungs, heart, and vessels

Respiratory distress, tachycardia, diminished or absent lung sounds, hypotension, JVD

Question 17

What are the two causes of obstructive shock?

Answer 17

Cardiac tamponade and tension pneumothorax

Question 18

What is narrowing pulse pressure?

Answer 18

The gap between the systolic and diastolic pressures continually decreases. The diastolic may remain mostly constant while the systolic decreases

Question 19

What organs does distributive shock affect?

Answer 19

the pipes (vessels)

Question 20

What is anaphylactic shock? What are signs and symptoms?

Answer 20

Multisystem allergic reaction causes massive vasodilation, increased vascular permeability, bronchoconstriction

hypotension, hives, stridor, dyspnea, andiodema, wheezing, weak pulses, skin flushed, cyanotic, GI upset

Question 21

What is neurogenic shock? What are signs and symptoms?

Answer 21

Spinal cord damage causes systemic vasodilation below the injury

MOI indicating spinal injury, hypotension, bradycardia, skin flushed below the injury, parlysis, priapism

Question 22

What is a priapism?

Answer 22

Erection caused by neurologic injury

Question 23

What is septic shock? Causes? What are signs and symptoms?

Answer 23

Severe systemic infection damages blood vessels increasing permeability and decreasing ability to vasoconstrict

Recent surgery, UTI, decubitus ulcers

Tachycardia, tachypnea, fever, hypotension, chills, weakness, AMS (altered mental state)

Question 24

What is the main cause of sepsis in the older population?

Answer 24

UTI from old catheters

Question 25

What indicates neurogenic shock more than other shock?

Answer 25

Bradycardia

Question 26

What is psychogenic shock? Causes? What are the signs and symptoms?

Answer 26

Sudden temporary vasodilation leading to syncope (passing out)

Seeing, hearing, smelling something that sends them outta here

Syncope, tachycardia, lightheadedness, hypotension, chills, clammy skin

Question 26

What does AMS mean?

Answer 26

Altered mental state

Question 27

What is hypovolemic shock? Causes? Signs and symptoms?

Answer 27

Fluid loss (through dehydration, not bleeding)

vomiting, diarrhea, burns, sepsis (3rd spacing)

tachycardia, pale/cool skin, weak peripheral pulses, hypotension, AMS

Question 27

What is meant by 3rd spacing?

Answer 27

Fluid leaving the vessels into the surrounding tissues

Question 28

What is hemorrhagic shock? Causes? Signs and symptoms?

Answer 28

Trauma, bleeding, GI bleeds

loss of volume of whole blood

tachycardia, tachypnea, cool/pale/diaphoretic, bleeding, AMS, hypotension

Question 29

What are the two primary symptoms of shock in pediatrics?

Answer 29

Increased HR and RR

Question 30

What is the formula for the minimum SBP for a pediatric age 1-10?

Answer 30

70 + (2x their age)

Question 31

What are the two largest causes of shock for adults and geriatric patients?

Answer 31

Infection and fluid loss

Question 32

What is the primary cause of shock in pediatrics?

Answer 32

Dehydration

Question 33

What does NPO mean?

Answer 33

nil per os

Nothing in mouth

Question 34

What vital sign is not an adequate indication of shock in pediatrics?

Answer 34

BP

Question 35

Compensated shock lasts longer or shorter in pediatrics?

Answer 35

Longer

They seem fine for much longer and will suddenly drop off the cliff and die much faster