Shock

Question 1

What is shock?

Answer 1

Acute circulatory collapse where the circulation is unable to transport
sufficient oxygen to the tissues needs

Question 2

Tissue Perfusion adequate requirements.

Answer 2

right volume at right pressure

Question 3

BP is dependant on

Answer 3

1.The cardiac output
2.The systemic vascular resistance
(Size of blood vessels/leakyness)

Question 4

What happens to cells due to shock

Answer 4

1. Inadequate supply of O2
2. Inadequate supply of nutrients
3. Inadequate removal of metabolic waste -> abnormal cell function

Question 5

4 types of shock

Answer 5

• Hypovolaemic
• Distributive
  -Septic, Toxic, Anaphylactic
• Cardiogenic
• Obstructive

Question 6

Hypovolaemic Shock

Answer 6

Caused by a reduction in the effective circulating intravascular volume

Question 7

Intravascular fluid losses.
(3)

Answer 7

1.Fluid loss affecting the intravascular space only
* Early haemorrhage
2. Fluid and salt loss
* Vomiting or diarrhoea
3. Third space losses
* Loss of fluid into a body cavity

Question 8

Signs of Hypovolaemic shock

Answer 8

• Tachycardia
• Prolonged CRT
• Pale MM
• Poor pulse quality
• Low blood pressure

Question 9

Catecholamines?

Answer 9

Hormones made by your adrenal glands
(adrenaline and noradrenaline)

Question 10

positive inotropy

Answer 10

strengthen the heart’s contractions, so it can pump more blood with fewer heartbeats.

Question 11

positive chronotropy

Answer 11

increases heart rate

Question 12

Distributive Shock

Answer 12

abnormal blood
volume distribution due to a
generalised and excessive
dilatation of the blood vessels

Question 13

Signs of distributive shock

Answer 13

DARK PINK/
RED MM
SLOW CRT

Question 14

3 types of distributive shock

Answer 14

1. Neurogenic shock
   * CNS trauma causing acute vasodilation
2. Anaphylactic shock
   * allergic reaction
3. Endotoxic shock
   * Septic shock

Question 15

Cardiogenic shock

Answer 15

The heart is unable to pump the blood adequately around the body

Question 16

Cardiogenic shock causes

Answer 16

• Cardiomyopathy
• Heart valve disease
• Severe arrhythmias

Question 17

Cardiogenic shock signs

Answer 17

• Heart murmur
• Irregular pulses
• Tachycardia or bradycardia

Question 18

Obstructive Shock

Answer 18

Obstruction of the blood flow through the heart or back to the heart

Question 19

What does obstructive shock look like?

Answer 19

• Heart murmur
• Irregular pulses
• Tachycardia or bradycardia

Question 20

Crystalloids

Answer 20

Electrolyte solutions
-Isotonic, hypertonic and hypotonic

Question 21

what do Isotonic crystalloids do?

Answer 21

Replacement fluids
* OP and electrolytes similar to
ECF

Question 22

What do hypertonic crystalloids do

Answer 22

Expands plasma volume by
drawing fluid out the cells into the
extracellular space

Question 23

Colloids

Answer 23

Contains molecules with a large
molecular weight
* They cannot leave the vascular system

Question 24

Whole Blood transfusions indications

Answer 24

Haemorrhage

Question 25

Types of Arresting Haemorrhage methods

Answer 25

External haemorrhage control
Internal haemorrhage control

Question 26

Internal haemorrhage control methods

Answer 26

Abdominal belly wrap

Question 27

Abdominal belly wrap must be removed after…how long?

Answer 27

12 hours

Question 28

External haemorrhage control

Answer 28

Direct digital pressure
Artery forceps
Pressure dressing
Cold compress

Question 29

Complications of Fluid Therapy

Answer 29

Air embolisms
Cardiac disease
Renal insufficiency
Patients with lung pathology
Increased intracranial pressure
Paediatrics

Question 30

Hyperperfusion signs

Answer 30

• Tissue oedema
• Chemosis – oedema of conjunctiva
• Oedema of distal limbs and face
• Pulmonary oedema
  (Rales, dyspnoea, moist cough,
  tachypnoea)
• Nasal discharge
• Lethargy

Question 31

Hypoperfusion signs

Answer 31

No improvement of the symptoms of shock