Shock Flashcards
Define hypovolemic shock and its causes.
A dramatic decrease in blood volume secondary to things such as hemorrhage, third spacing, or dehydration.
Define cardiogenic shock
A decrease in effective circulating blood volume while the blood volume is normal or even increased. It’s essentially a decrease in cardiac output.
What are causes of cardiogenic shock?
Cardiac disease and arrhythmias are the main causes.
Define distributive shock
Inadequate distribution of blood flow even if blood volume is normal.
What are causes of distributive shock?
Sepsis (septic shock), anaphylaxis (anaphylactic shock), or disease states like GDV (obstructive shock.)
What are presenting symptoms of hypovolemic shock?
Pale MM, prolonged CRT, weak pulses, low-normal or low BP, and tachycardia.
What are presenting symptoms of cardiogenic shock and do you differentiate those from other types of shock?
Similar to those of hypovolemic shock ( low BP, pale MM, prolongd CRT, tachycardia) however they will be accompanied by symptoms that are present with severe heart disease or heart failure (Respiratory distress, cyanosis, crackles) which will enable you to differentiate the two.
What are presenting symptoms of early distributive shock?
Brick red (hyperemic) MM, short CRT(<1 sec), tachycardia, and bounding pulses.
What are presenting symptoms in late distributive shock?
Similar to those of hypovolemic shock. Tachycardia, pale MM, prolonged CRT, hypotension.
Define hypoxic/hypoxemic shock
Inadequate oxygen within the arterial blood.
What are causes of hypoxic shock?
Respiratory diseases, anemia.
What are presenting symptoms of hypoxic shock?
Respiratory distress, cyanotic or pale mucous membranes.
Define metabolic shock
The inability of cells to utilize oxygen and other nutrients being delivered to them.
What are causes of metabolic shock?
Hypoglycemia, cyanide poisoning, and dysfunction of mitochondria.
True or false: Shock is a clinical diagnosis.
True
True or false: A normal BP rules out the presence of shock.
False
True or false: GDV can be categorized as distributive and hypovolemic shock.
True.
True or false: Patients who have SIRS, sepsis, or trauma are at risk of developing DIC.
True
True or false: Fluid therapy can contribute to the development of DIC.
True. Fluid therapy leads to dilution which can exacerbate the depletion of the coagulation and fibrinolytic systems.
Which organ(s) does SIRS affect the earliest and why?
The kidneys. They have high oxygen demand and will initiate RAAS and oliguria in an attempt to maintain blood volume.
True or false: The hepatic system is prioritized over other body systems and is therefore one of the last systems to be affected by sepsis.
False. The cerebral system is prioritized so it’s one of the last systems affected by sepsis.
