shock

Question 1

what does cardiogenic shock result from?

Answer 1

decreased myocardial contractility

Question 2

symptoms of cardiogenic shock?

Answer 2

cool/pale skin
altered mental status
thready pulse
crackles/dyspnea
dec. output!

Question 3

heart rate in cardiogenic shock

Answer 3

high

Question 4

BP/MAP in cardiogenic shock

Answer 4

low

Question 5

CVP in in cardiogenic shock

Answer 5

high

Question 6

wedge in cardiogenic shock

Answer 6

high

Question 7

SVR in cardiogenic shock

Answer 7

high

Question 8

CO in cardiogenic shock

Answer 8

low

Question 9

reason for hemodynamic change in cardiogenic shock

Answer 9

sympathetic/RAAS response

Question 10

medical management in cardiogenic shock

Answer 10

+ inotropes (dobutamine, dopamine, digoxin, milrinone)
diuretics
nitrates
opioids
vasopressors

Question 11

nursing interventions in cardiogenic shock

Answer 11

afterload reducer
preload reducer
HOB elevated
intraaortic balloon pump

Question 12

surgical intervention for cardiogenic shock

Answer 12

intraaortic balloon pump

Question 13

complications in cardiogenic shock

Answer 13

dysrhythmias
med dependence (dobutamine)
acute tubular necrosis (kidney failure)

Question 14

what is important to remmebr about intraaortic balloon pump for cardiogenic shock

Answer 14

goes through fem
bleeding/pulse concern
increases O2 supply and decreases demand

Question 15

in terms of shock, which kinds of shock are “pool” “pump” and “pipe” problems

Answer 15

cardiogenic = pump problem
hypovolemic = pool
early septic = pipe

Question 16

what does hypovolemic shock result from?

Answer 16

-dec. blood/intravascular volume
-internal & external fluid shifts

Question 17

symptoms in hypovolemic shock

Answer 17

cool/pale! & diaphoretic!
dec. LOC!
tachycardia
hypoTN
postural vs
tachypnea
oliguria

Question 18

heart rate in hypovolemic shock

Answer 18

high

Question 19

BP/MAP in hypovolemic shock

Answer 19

low (no volume to pump)

Question 20

CVP in hypovolemic shock

Answer 20

low

Question 21

wedge in hypovolemic shock

Answer 21

low

Question 22

SVR in hypovolemic shock

Answer 22

high (compensation)

Question 23

CO in hypovolemic shock

Answer 23

low (no volume)

Question 24

why are there hempdynamic changes in hypovolemic shock

Answer 24

vasoconstriction and compensation from sympathetic/RAAS

Question 25

med treatment in hypovolemic shock

Answer 25

IV FLUID OR BLOOD TO REPLACE VOLUME vasopressors??

Question 26

nursing interventions in hypovolemic shock

Answer 26

modified trendelenburg

Question 27

complications in hypovolemic shock

Answer 27

tubular necrosis shock liver from dec. perfusion

Question 28

what is early septic shock from?

Answer 28

release of toxins from bacteria -> damage to vascular endothelium -> water leak -altered vascular permeability

Question 29

s/sx of early septic shock

Answer 29

warm/dry/flushed skin! fever increased WBCs

Question 30

HR in early septic shock

Answer 30

high

Question 31

BP/MAP in early septic shock

Answer 31

slightly low

Question 32

CVP in early septic shock

Answer 32

low

Question 33

wedge in early septic shock

Answer 33

low

Question 34

SVR in early septic shock

Answer 34

low (bacteria causes vasodilation)

Question 35

CO in early septic shock

Answer 35

normal (or high)

Question 36

reasons for hemodynamic changes in early septic shock

Answer 36

altered vascular permeability, bacteria causes vasodilation (protein leakage -> fluid follows)

Question 37

medical management of early septic shock

Answer 37

**fluids/antimicrobials **vasopressors and low dose steroids after fluids

Question 38

nursing interventions for early septic shock

Answer 38

**cooling blanket/antipyretic ventilation

Question 39

which forms of shock look similar symptomatically?

Answer 39

cardiogenic and late septic

Question 40

what does late septic shock come from?

Answer 40

progression of early shock, irreversible vascular issues **contractility worsens

Question 41

s/sx of late spetic shock

Answer 41

**cold/clamy diaphoretic dec. LOC dec. urine signs of increased preload

Question 42

HR in late spetic shock

Answer 42

high

Question 43

BP/MAP in late spetic shock

Answer 43

severely low

Question 44

CVP in late spetic shock

Answer 44

high

Question 45

wedge in late spetic shock

Answer 45

high

Question 46

SVR in late spetic shock

Answer 46

high (from vasopressors and compensation)

Question 47

CO in late spetic shock

Answer 47

very low

Question 48

med management of late spetic shock

Answer 48

+ inotropes (dobutamine dopamine) vasopressors corticosteroids antibiotics

Question 49

nursing interventions for late spetic shock

Answer 49

supportive care like DNR/CC

Question 50

complications of late septic shock

Answer 50

MODS death

Question 51

which lab value is high in sepsis

Answer 51

lactate

Question 52

what are the 3 kinds of distributive shock?

Answer 52

septic, anaphylactic, neurogenic

Question 53

indicatord of shock

Answer 53

MAP < 60 high lactate high bicarb (ABGs)

Question 54

what are the 3 stages of shock? (progression order)

Answer 54

compensatory, progressive, refractory

Question 55

what is a rare form of shock from massive dilation of blood vessels as a result of loss of sympathetic tone

Answer 55

neurogenic shock

Question 56

which form of shock has signs of hypotension, bradycardia, and hypothermia?

Answer 56

neurogenic

Question 57

treatment of neurogenic shock

Answer 57

treat cause volume replacement vasopressors

Question 58

pathways used to recognize sepsis

Answer 58

SIRS and qSOFA

Question 59

what are the 3 aspects of qSOFA

Answer 59

low bp altered mentation high resp rate

Question 60

what 4 aspects make up the SIRS criteria

Answer 60

temp >38 HR >90 RR >20 OR PaCO2 <32 WBC >12000

Question 61

when are blood products administered?

Answer 61

when hgb is 7.0-9.0 or lower