shock Flashcards
what are the 3 types of shock?
- hypovolemic
2 cardiogenic - distributive
what is hypovolemic shock
decrease preload secondary to intravascular volume loss, resulting in decreased cardiac output and a compensatory increase in SVR
what is “third spacing”
fluid loss due to fluid going into places it should not be
what is cardiogenic shock
decrease cardiac output due to pump failure; SVR increases to maintain perfusion
what are the 4 categories of cardiogenic shock
- cardiomyopathy
- arrhythmia
- mechanical abnormality
- extracardiac abnormality
what is the hallmark feature of distributive (vasodilatory shock)
decreased SVR
what happens as a result of distributive shock
increased CO; usually with tachycardia
what are the cardinal findings of shock
- hypotension
- oliguria (decreased urine output)
- mental status changes
- cool, clammy skin
- metabolic acidosis
what are the two types of vascular failure
- failure of cardiac output
2. failure of peripheral resistance
what are the two types of failure of cardiac output
- inappropriate or inadequate heart rate
2. failure to receive or eject proper stroke volume
what causes failure of peripheral resistance
vasodilation and microvascular injury
what is SIRS? what criteria define it
systemic inflammatory response syndrome- inflammatory response to 2 of the following:
- temperature
- heart rate greater than 90
- RR greater than 20
- WBC greater than 12,000 or less than 4000
- greater than 10% bands (immature WBCs)
what is the presence of viable bacteria in the bloodstream called?
bacteremia
what is sepsis?
SIRS secondary to infection (must have known source of infection)
what is the definition of severe sepsis
spepsis associated with organ dysfunction, hypoperfusion, or hypotension
