shock Flashcards
anaphylactic shock
from severe alergic rx
cardiogenic shock
heart fails to pump normally
s/s hypotenison, crackles, tachypnea
hypovolemic shock
reduced circulating blood volume
neurogenic shock
severe damage to CNS
obstructive shock
heart or greater blood vessel blocked by obstruction
from PE, pneumothorax, sternosis
septic shock
severe immune response to infections
cardiogenic shock patho
MI causes necrotic tissue that impaires CO, ischemia from decreased O2, decreased CO and BP, decreased BP leads to pulmonary congestion, pulmonary edema, SIRS, lactic acidosis
goal of cardiogenic shock
optimize CO
cardiogenic shock interventions
optimize O2 delivery, decrease O2 consumption, administer related drug therapy (dobutamine)
neurogenic shock is most often associated with ____ and ______
acute spinal cord injury and nontraumatic causes (tumor, disc degeneration, inflammation/infection)
neurogenic shock above T6
SNS impulses are reaching arterioles, no vasoconstriction, only vasodilation, hypovolemia, further damage to spinal cord
manifestations of neurogenic shock
hypotenison, bradycardia, hypothermia
treatment for neurogenic shock
stabilize spinal cord, optimize O2 delivery, give fluids
assessment findings in shock
hypotension, hyperventilation, weak rapid pulse, clammy skin, oliguria, changes in LOC
vitals in shock
SBP <90, MAP <60, HR tachycardia, RR rapid
chemical burn is from
acids and alkalines
thermal burns from
steam, scalds, heat, fire
electrical burns
from lightning, electricity
radiation burns
from exposure to industrial equipment, sunburn
superficial burns
sunburn, minor steam burn
superficial partial thickness
wet and weepy, painful
epidermis and top portion of dermis
deep partial thickness burn
no blisters, minimal fluid leakage, pale
epidermis and deep dermis
full thickness burn
down to subcutaneous tissue
pale white or charred and leathery
painless and insensitive to palpation
zone of coagulation on burn
innermost
irreversible skin death
zone of stasis
potentially salvageable
inflammatory rx
zone of hyperemia
outermost layer
where early spontaneous recovery occurs
major burns rule of 9 %
20% can produce a systemic response and are considered major
body’s response to burns
inflammatory response, SNS (vasoconstrict), decreased CO, hypovolemic shock, decreased UO, GI stress ulcer, hyperkalemia, hyponatremia
circulatory mgmt for burns
LR (parkland formula)
renal mgmt for burns
keep UO > 0.5 mL/kg/hr
compartment syndrome
pressure builds up around muscles from fluid in extravascular space
compartment syndrome treatment
escharotomy
increased labs in shock
glucose, lactate, creatinine, WBC
decreased labs in shock
serum proteins, bicarbonate, Hbg, platelets
