Shock Flashcards

1
Q

What is circulatory shock?

A

rapid hypoperfusion that is life threatening

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2
Q

What are the different classifications of circulatory shock?

A

1) cardiogenic - failure of heart to pump adequately
2) hypovolemic - problem with blood volume
3) obstructive - inability of heart to fill properly, obstruction to outflow of blood from heart
4) distributive - problem with tone of blood vessels

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3
Q

What classification of shock is anaphylactic shock?

A

distributive

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4
Q

What happens in anaphylactic shock?

A
  • severe allergic reaction, reaction is systemic
  • IgE antibody on mast cell and antigen bind, form immune complex
  • mast cell degranulates, releases inflammatory mediators
  • mediators trigger excessive vasodilation, increase capillary permeability systemically
  • widespread vasodilation = inadequate vascular resistance = decrease in blood pressure
  • low blood pressure = hypoperfusion
  • edema from increased capillary permeability is fluid loss, also decreases blood pressure
  • circulatory failure
  • in this case, problem is compounded because the mediators that cause vasodilation also cause bronchospasm… causing person’s airway to constrict
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5
Q

What classification of shock is septic shock?

A

distributive

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6
Q

What happens in septic shock?

A
  • severe infection
  • systemic inflammatory response
  • vasodilation and fluid loss from increased capillary dilation
  • decreased blood pressure
  • hypoperfusion
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7
Q

What happens in hypovolemic shock?

A
  • rapid decrease in blood volume by ~20%
  • sympathetic nervous system increases heart rate (to increase CO) and causes vasoconstriction to non-vital organs (to increase peripheral resistance)
  • because of this, blood pressure will initially remain unchanged
  • endocrine and renal systems also try to compensate:
  • —- hypothalamus stimulates thirst center, triggers secretion of ADH (vasoconstriction, increase water reabsorption)
  • —- RAAS activated by decrease BP at glomerulus (vasocontriction, increase sodium reabsorption… followed by water)
  • compensations no longer adequate
  • blood pressure decreases
  • inadequate perfusion
  • hypoxia… eventually cell death
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8
Q

What are three main causes of hypovolemic shock?

A

1) blood loss
2) plasma loss (can occur with severe burns)
3) extracellular fluid loss (dehydration)

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9
Q

What factors affect blood pressure?

A

1) blood volume
2) cardiac output
3) perfipheral resistance

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10
Q

What is the formula for cardiac output?

A

CO = SV x HR

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11
Q

What are main signs of hypovolemic shock?

A

early:

  • increased heart rate
  • increased respiratory rate
  • cool, clammy skin
  • decreased urine output

later:

  • weak, thready pulse
  • decreased BP
  • altered mentation/LOC
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12
Q

How is hypovolemic shock treated?

A
  • stop the cause of decreased blood volume
  • administer oxygen
  • administer IV fluids
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