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Complex Care Concepts > Shock > Flashcards

Shock Flashcards

1
Q

Shock

A

Inability to perfuse the tissues for any reason with a MAP of less than 60

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2
Q

Hypovolemic shock

A 
Total body fluids decreased 
Hemorrhage
Dehydration 
Diabetes insipidus 
Vomiting
Diarrhea
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3
Q

Cardiogenic shock

A

Direct pump failure

Fluid volume not affected

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4
Q

Distributive shock

A

Fluid shift
Neural-induced
Chemical induced

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5
Q

Neural induced

A 
Pain
Anesthesia 
Stress
Spinal Cory injury 
Head trauma
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6
Q

Chemical induced

A

Anaphalyxsis
Sepsis
Capillary leak

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7
Q

Obstructive shock

A 
Cardiac function by noncardiac factor 
Cardiac tamponade
Arterial stenosis
PE
Pulmonary HTN
Tumor 
Tension pneumothorax 
Constructive pericarditis
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8
Q

Cardio manifestations

A 
Decrease output 
Increase pulse 
Threats pulse
Decreased BP
Narrowed pulse pressure 
Postural hypotension 
Low central venous pressure 
Flat hand and neck veins 
Slow cap refill 
Diminished peripheral pulses
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9
Q

Respiratory manifestations

A 
Increased respirations 
Shallow respirations 
Increased CO2
Decreased O2
Cyanosis
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10
Q

GI manifestations

A

Decreased motility
Diminished or absent bowel sounds
N&V
Constipation

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11
Q

Neuromuscular manifestations

Early

A

Anxiety
Restlessness
Increased thirst

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12
Q

Neuromuscular manifestations

Late

A 
Lethargy
Coma
Muscle weakness
No DTR
Sluggish pupils
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13
Q

Kidney manifestations

A

Decreased output
Increased gravity
Sugar and acetone present in urine

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14
Q

Skin manifestations

A

Cold
Pale, mottled, cyanotic
Moist, clammy
Mouth dry, paste like coating present

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15
Q

Anaphylaxis

A

Widespread loss of muscle tone

Chemical induced distributive

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16
Q

Initial stage

A 
MAP 5-10 below baseline 
Metabolism is still aerobic 
Increase HR, BP, RR
Difficult to detect 
Some lactic acid
17
Q

Non-progressive

Compensatory stage

A 
MAP 10-15 below baseline 
Kidney and hormonal activation 
Decrease urine 
Fluid shift to vital organs 
Acidosis and lactic acid start 
Hyperkalemia 
Reversible if caught early
18
Q

Signs and symptoms of non-progressive stage

A 
Anxiety 
Thirst
Tachycardia
Tachypnea 
O2 90-95%
Low urine 
Cool and clammy
19
Q

Labs for non-compensatory

A 
Acidosis
Hyperkalemia 
Hypernatremia 
Hyperglycemia 
Lactic acid
20
Q

Progressive stage

A

MAP 20 over baseline
Vital organs hypoxic
Ischemia of non-vital organs
Can recover if reverse within one hour

21
Q

Signs and symptoms of progressive stage

A 
Severe thirst
Impending doom 
Confusion 
Thready, tachy
O2 75-80
Hypotension 
Cyanosis
Cool and clammy
Anuria
22
Q

Refractory stage

A

Irreversible
Ischemia
Body cannot respond
Rapid progression to MODs

23
Q

MODS

A

Rapid loss of consciousness
Non-palpable pulse
Unmeasurable O2
Shallow, slow respirations

24
Q

Multiple organ dysfunction syndrome

A

Loss of vital organ due to microemboli
Occurs first in liver, heart, kidney
Irreversible even if MAP restored

25
Q

Early neuromuscular assessment

A

Anxious
Restlessness
Increased thirst

26
Q

Late neuromuscular assessment

A 
Lethargy
Coma
Muscle weakness
Pain
Absent DTR
Sluggish pupils
27
Q

GU assessment

A

Oliguria or anuria
Sugar and acetone present
Increased SP gravity

28
Q

Integumentary assessment

A 
Cool and clammy 
Pale
Cyanotic
Mottled
Dry mouth
29
Q

GI assessment

A

N&V
Decreased or absent bowel sounds
Constipation

30
Q

Nursing actions for hypovolemic shock

A 
Oxygen!!!
Trendelenburg
Look for bleeding 
IV 
Vasopressors 
Monitor urine
31
Q

Cardiogenic shock signs symptoms

A 
Cold, clammy
Poor pulses. 
Agitation
Pulmonary congestion 
Tachypnea 
Continuing chest discomfort!!!!
32
Q

Cardiogenic shock

A 
Heart muscle or valve damage
MI most common 
Tachycardia 
Hypotension
BP systolic <90
MAP 30 less than baseline 
Low urine output
33
Q

Medical management of cardiogenic shock

A 
Pain relief 
Preload and after load reduction 
Nitro
Intra-aortic balloon pump 
Heart cath
CABG
34
Q

Distributive shock

A

Fluid in interstitial spaces
Loss of sympathetic tone
Blood vessel dilation
Capillary leak

35
Q

Obstructive shock

A 
Outside the heart 
Pericarditis 
Tamponade 
PE
Pneumothorax 
Aortic dissection 
Surgical emergency!!!
36
Q

Vasoconstrictors

A

Dopamine
Epinephrine
Norepinephrine
Phenylephrine

37
Q

Heart contractility

A

Doubutamine

Milrinone

38
Q

Myocardial perfusion

A

Nitro

Complex Care Concepts (25 decks)

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