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Peds- Exam2 > Shock > Flashcards

Shock Flashcards

1
Q

what is shock?

A

inadequate tissue perfusion
leads to cellular dysfunction
then organ failure

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2
Q

possible identifiable consequences of shock:

A 
hypotension
tachycardia
decreased urine output
adventitious breath sounds
tissue hypoxia
metabolic acidosis
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3
Q

4 types of shock

A
  1. hypovolemic
  2. cardiogenic
  3. distributive
  4. obstructive
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4
Q

3 types of distributive shock

A

neurogenic
anaphylactic
septic

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5
Q

type of shock due to blood/plasma loss due to burns or peritonitis

(extracellular fluid losses–> diarrhea, dehydration)

A

hypovolemic shock

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6
Q

what happens to the vitals during hypovolemic shock

A
  • decreased BP
  • increased HR
  • decreased CVP (central venous pressure)
  • poor capillary refill
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7
Q

type of shock that is due to decreased cardiac output

A

cardiogenic shock

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8
Q

what are the causes of cardiogenic shock?

A
  • cardiac surgery
  • dysrhythmias
  • primary pump failure
  • myocarditis
  • cardiomyopathy
  • heart failure
  • AV block (dysrhythmia)
  • SVT (supraventricular tachycardia = type of dysrhythmia)
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9
Q

cardiac output formula

A

cardiac output = stroke volume X HR

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10
Q

type of shock that is a vascular problem that prevents the blood from being distributed properly

A

distributive shock (vasogenic shock)

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11
Q

type of shock that is a massive vasodilation (loss of sympathetic nervous system tone)

  • happens in spinal cord injuries
  • full bladder
A

neurogenic shock

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12
Q

what happens to the BP during neurogenic shock>

A

decreases;

bc of vasodilation

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13
Q

type of shock where there is a massive vasodilation and capillary leakage

(hypersensitivity reaction)

A

anaphylactic shock

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14
Q

RESPIRATORY symptoms during anaphylactic shock

A
  • stridor
  • cough/wheeze
  • rhinitis
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15
Q

CUTANEOUS symptoms during anaphylactic shock

A
  • flushing
  • urticarial/hives
  • angioedema
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16
Q

CARDIOVASCULAR symptoms during anaphylactic shock

A
  • tachycardia
  • arrhythmia
  • hypotension
  • hypovolemia
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17
Q

GASTROINTESTINAL symptoms during anaphylactic shock

A
  • nausea/vomiting
  • diarrhea
  • abdominal pain
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18
Q

CNS symptoms during anaphylactic shock

A
  • impending doom
  • LOC changes
  • seizures
  • headache
19
Q

amount of epinephrine to give for children 8-25kg

A

0.15mg (EpiPen Jr.)

20
Q

amount of epinephrine to give for children > 25kg

A

0.3mg (EpiPen)

21
Q

amount of epinephrine to give (first like rescue med)

A

0.01 mg/kg to 0.3 mg/kg

22
Q

type of shock that causes massive vasodilation and capillary leakage
(maldistribution of blood)

A

septic shock

23
Q

signs of septic shock

A

fever, high WBCs

24
Q

type of shock that may appear like hypovolemic shock, but the cause is different (mechanical)
–there is a road block

A

obstructive shock

25
Q

4 types of obstructive shock

A
  1. tension pneumothorax
  2. cardiac tamponade
  3. pulmonary embolism
  4. congenital heart lesion
26
Q

tension pneumothorax

A

(type of obstructive shock)

-build up of air/fluid/blood and causes compression of lungs

27
Q

cardiac tamponade

A

(type of obstructive shock)

  • buildup and causes compression of lungs, but it is PULLING around the heart
  • result of trauma, cardiac surgeries
28
Q

pulmonary embolism

A

(type of obstructive shock)

-blockage (restricting blood’s ability to go to the lungs)

29
Q

congenital heart lesion

A

(type of obstructive shock)

  • the heart is restructured (looks very different)
  • actual blockages and things are not running correctly
30
Q

s/s of compensated shock

A
  • apprehension
  • irritability
  • normal BP
  • narrowing pulse pressure
  • thirsty
  • pale
  • decreased urine output
  • mild tachycardia
  • decreasing peripheral perfusion
31
Q

s/s of uncompensated shock

hypotensive

A
  • chills/fever
  • increased vasodilation
  • may have warm extremities initially
  • tachypnea
  • oliguria
  • cool, pale extremities
  • change in LOC
  • tissue hypoxia leading to organ death
  • metabolic acidosis
  • DIC (disseminated intravascular coagulation)
32
Q

treatment/intervention to improve oxygenation and ventilation

A
  • administer O2 as ordered
  • intubation (lung rest)
  • check blood gasses (oxygenation status)
  • oxygen saturation
  • PH monitoring
33
Q

treatment/intervention to improve heart function

A
  • vasopressors–> produces vasoconstriction

- inotropes–> helps heart stimulate and strengthen heart contractions (Epinephrine, calcium, etc.)

34
Q

treatment/interventions for fluid administration:

A
  • isotonic crystalloid (NS or LR)
  • bolus at 20ml/kg over 5-20 min
  • blood products
  • colloids (albumin)
  • FFP to correct coagulopathies
35
Q

what is toxic shock sydrome caused by?

A

staphylococcus bacteria

36
Q

what product has a well-known association with TSS?

A

tampons

37
Q

ways to get toxic shock syndrome

A
  • sinusitis
  • pneumonia
  • catheter infections
  • skin infections
  • wound infections
  • nasal packing
  • contraceptive diaphragms
  • IUDs
38
Q

what will TSS look like?

A
  • sudden temp of 38.9 (102 F) or higher
  • vomiting and diarrhea
  • macular erythroderma (red rash)
  • hypotension
  • late sign is desquamation of palms
39
Q

identify the shock:

a patient presents with hypotension, rapid pulse and respirations, and x-ray shows a large pulmonary embolism

A

obstructive

40
Q

identify the shock:

a child has suffered a tragic amputation and rescue personnel are having a difficult time stopping the bleeding

A

hypovolemic

41
Q

identify the shock:

margo was in a house fire and was burned over 70% of her body

A

hypovolemic

42
Q

identify the shock:

jeremy took a bite of his friend’s PB&J. his lips immediately began to swell and his breathing became labored

A

anaphylactic

43
Q

identify the shock:

kate is post-op from a AVSD surgery. she was doing fine, but started to look pale and the ECG monitor showed SVT

A

cardiogenic

Peds- Exam2 (3 decks)

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