shock Flashcards
slight increases in HR, RR, BP could indicate?
shock
what happens to blood sugar in shock?
elevated
Preventing _______ in older adults helps prevent shock
dehydration
Normal Lactate Level?
0.5-1 mmOl
Type of shock?
too little blood volume decreases MAP
Main Causes: hemorrhage and dehydration
hypovolemic
Type of shock?
Direct pump failure (fluid volume not affected)
cardiogenic
Type of shock?
MI, Cardiac arrest, Cardiomyopathies, myocardial degeneration
cardiogenic
Type of shock?
the actual volume of blood isn’t lost but where the blood is going is. Total body fluid vol is normal or increases
distributive
Type of shock ?
Neural Induced - pain, anesthesia, stress, spinal cord injury, head trauma
distributive
Type of shock?
Chemical induced -
anaphylaxis, sepsis, capillary leak (burns, trauma, liver impairment, hypoproteinemia)
distributive
Type of shock?
INDIRECT pump failure - total body fluid not affected but CENTRAL Volume is decreased
obstructive
type of shock?
Cardiac tamponade, arterial stenosis, pulmonary embolism, thoracic tumors, tension pneumo
obstructive
Progressive stage of shock = life-threatening. The body can only tolerate it for a little while before MODS.
obstructive
type of shock?
falling systolic, rising diastolic, narrowing pulse pressure
obstructive
how long do you have with life threatening obstructive shock?
The patient’s life can be saved if the cause is corrected within 1 hour or less.
things that cause obstructive shock?
Cardiac tamponade, arterial stenosis, pulmonary embolism, thoracic tumors, tension pneumo
Can an AP assess shock?
no, Only RN’s can assess and get vitals on pt with suspected shock
Changes in systolic ____are not always present in the ______stage of shock so use changes in _______ and _______as main indicator of shock presence.
BP , initial stage, pulse rate and quality
Too little blood volume decreases MAP
Main Causes: hemorrhage and dehydration
Hypovolemic shock
what type of fluid to treat shock?
Isotonic crystalloids or colloids (including blood products)
0.9 sodium chloride or lactated ringer’s
what is SIRS?
systemic inflammatory response syndrome = generalized systemic infection in organs remote from the initial injury.
what commonly causes SIRS?
infection AKA sepsis
non infectious sources of SIRS?
thromboembolism, autoimmune and pancreatitis
most important vitals nd labs for SIRS
- Temp >38 c or <36 (even numbers)
- HR > 90
- RR > 20 or PaCO2 < 32
- WBC > 12000 or <4000
Or >10% immature bands
SVO2 > 70%
Cl > 3.5 L/m
Serum lactate > 1 mmol / L
may be indicative of?
sepsis
What do you have to do within 3 hours of suspecting severe sepsis?
Draw lactate levels
Give Antibiotics
Obtain blood cultures
signs of poor perfusion
Lactic acidosis
Oliguria
Mental status alteration
abnormal clumps of thickened blood (clots) form inside blood vessels. These abnormal clots use up the blood’s clotting factors, which can lead to massive bleeding in other place
DIC- complication of shock
