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Complex Midterm > Shock > Flashcards

Shock Flashcards

1
Q

shock is a _____

A

condition

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2
Q

shock is a lack of _____ and ____

A

perfusion and oxygenation

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3
Q

this is no perfusion of organs

inability to oxygenate the rest of the body

A

hypoxic

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4
Q

what is perfusion

A
  • how good the blood flow is to the body
  • *BP, color, warmth
  • MAP (mean arterial pressure)
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5
Q

if this is maintained, there is good perfusion

A

MAP

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6
Q

describe oxedated phosporylation

A
  • usually 36-38 molecules of ATP
  • if NO oxygen, anaerobic cycle produces 2 molecules of ATP
  • cannot survive on this
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7
Q

what is the MAP formula

A

systolic + diastolic (2) / 3

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8
Q

MAP must be what

A

> 70 for good perfusion to extremities, kidneys, liver, and lungs

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9
Q

if workload is increased….

A

need higher MAP

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10
Q

what is the oxygenated cycle

A
  • lungs
  • coronary arteries of heart
  • carotid artery
  • kidneys (1/4 blood supply)
  • liver (2/3 of blood supply)
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11
Q

why do you go into shock

A

d/t no oxygen to organs and eventually heart and lungs

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12
Q

what is the SV

A

stroke volume

  • systolic - diastolic
  • normal SV=50-60
  • amount of blood per beat that you can push out
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13
Q

what can SV be manipulated by

A

vasoconstriction

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14
Q

what occurs when you initially go into shock

A
  • get cold
  • blood starts SHUNTING UP (no longer in extremities)
  • vasoconstriction pushes blood to liver, heart, and lungs (eventually only heart)
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15
Q

what factors influence MAP

A

1) total blood volume
2) cardiac output
3) size of vascular bed

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16
Q

what is the C.O formula

A

SV x HR

17
Q

what is normal C.O

A

4-6 L

18
Q

describe afterload

A

systolic

force heart has to push to get blood out (push of blood from left ventricle to aorta)

19
Q

describe preload

A

diastolic
left ventricle and diastolic volume, how much blood left after heart pushes out blood
-never pushes all out (leftover blood)

20
Q

describe ejection fraction

A

the % you push out
normal is 65-75%
if heart is working well you push this amount of blood out of the heart

21
Q

pt with CHF or MI will have a decreased

A

ejection fraction

no/bad C.O. (may be as low as 20%)

22
Q

describe size of vascular bed

A

where does the blood have to go

in septic shock, dilation of vessels is not enough blood flow

23
Q

what are the 4 types of shock

A
  • hypovolemic
  • cardiogenic
  • distributive
  • obstructive
24
Q

describe hypovolemic shock

A
  • total body fluid is decreased
  • lost blood or fluid (cannot maintain C.O.)
  • hemorrhage and dehydration
  • easy to fix, give more fluid or blood
25
Q

describe cardiogenic shock

A
  • pump failure, fluid volume is okay
  • no strength to push blood out
  • r/t HF (heart not working)
  • cannot pump well
26
Q

describe obstructive shock

A
  • cardiac function is decreased by non cardiac functions
  • fluid NOT affected
  • clot
  • pulmonary HTN, tamponade, pneumothorax, pericarditits
27
Q

describe distributive shock

A
  • fluid shifted from central vascular space
  • body fluid is normal or elevated
  • neural or chemical
28
Q

what is chemical distributive shock

A
  • septic shock
  • loss of vascular tone
  • lose things to fight infection
29
Q

what causes shock

A

-decrease in MAP d/t decrease in C.O, decrease in blood volume or expansion of vascular bed

30
Q

drop of MAP is detected by what

A

baroreceptors in the aortic arch and carotid sinus that cause shock process

31
Q

pt in shock appears

A
  • cold d/t shunting blood (put legs up, elevate)
  • gut GI doesnt work
  • liver doesnt work (no outward sign)
  • kidneys stop working (outward sign is decreased renal output ie/ less than 30 mL/hr)
  • head/brain stop working
  • heart and lungs stop working
32
Q

chemical process of shock

A
  • baroreceptors send infor to brian, starts to shunt blood to vital areas
  • leads to an increase in lactic acid, protein destroying enzymes and oxygen radicals
33
Q

how soon does shock need to be reversed before it progresses

A

in 1 or 2 hrs or may be irreversible and can lead to MODS

34
Q

what is MODS

A

multiple organ dysfunction system

d/t lack of oxygen

35
Q

what do the baroreceptors do

A

sit on glomerulus and trigger conservation of blood flow, no output
oxygen free radicals attack the heart

Complex Midterm (8 decks)

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