SHOCK

Question 1

HEMODYNAMIC SHOCK-

causes

Answer 1

• hemorrhage
• dehydration
• burns

Question 2

HEMODYNAMIC SHOCK-

hemodynamic changes

Answer 2

decreased CO/CI
decreased CVP
decreased PCWP
increased SVR

Question 3

HEMODYNAMIC SHOCK-

Pt presentation

Answer 3

decreased BP
increased HR
increased RR
decreased urine output
cool, pale, moist skin
weak, thready pulse

Question 4

HYPOVOLEMIC SHOCK

Answer 4

loss of intravascular fluid volume –> decreased MAP due to volume loss

Question 5

CARDIOGENIC SHOCK

Answer 5

cardiac pump failure –> reduced contractility of heart

Question 6

CARDIOGENIC SHOCK-

causes

Answer 6

MI
blunt chest trauma
dysrhythmias
structural defect
endocarditis
myocarditis
cardiomyopathy

Question 7

CARDIOGENIC SHOCK-

hemodynamic changes

Answer 7

decreased CO/CI
increased CVP
increased PCWP
increased SVR

Question 8

CARDIOGENIC SHOCK-

Pt presentation

Answer 8

decreased BP
increased HR
increased RR
(+) JVD
decreased urine output
decreased LOC
cool, pale, moist skin

Question 9

OBSTRUCTIVE SHOCK

Answer 9

circulatory collapse –> physical obstruction of circulatory intravascular blood volume –> poor tissue perfusion

Question 10

OBSTRUCTIVE SHOCK-

causes

Answer 10

massive PE
tension pneumothorax
cardiac tamponade

Question 11

OBSTRUCTIVE SHOCK-

hemodynamic changes

Answer 11

depends on etiology

Question 12

OBSTRUCTIVE SHOCK-

Pt presentation

Answer 12

decreased BP
increased RR
chest pain/pressure
other symptoms depending on etiology

Question 13

NEUROGENIC SHOCK

Answer 13

loss of sympathetic nervous system tone –> loss of spinal cord transmission –> loss of vascular tone

Question 14

NEUROGENIC SHOCK-

causes

Answer 14

injury to spinal cord (common at C6 & above)

Question 15

NEUROGENIC SHOCK-

hemodynamic changes

Answer 15

decreased/normal CO/CI
decreased/normal CVP
decreased/normal PCWP
decreased SVR
decreased HR

Question 16

NEUROGENIC SHOCK-

Pt presentation

Answer 16

decreased BP
decreased HR
cool, moist above
warm, dry above
diminished/absent motor/sensory function below injury

Question 17

SEPTIC SHOCK

Answer 17

decreased vascular tone –> toxins & endotoxins enter system activating SIRS response

Question 18

SEPTIC SHOCK-

causes

Answer 18

infection

Question 19

SEPTIC SHOCK-

hemodynamic changes

Answer 19

early: 
increased CO/CI
decreased/normal CVP
decreased/normal PCWP
decreased SVR

Late:
decreased CO/CI
decreased CVP
decreased PCWP
increased SVR

Question 20

SEPTIC SHOCK-

Pt presentation

Answer 20

decreased BP
increased HR
increased RR
increased temperature
decreased urine output
decreased LOC
bounding pulses
warm, flushed skin
petechiae
purpura

Question 21

ANAPHYLACTIC SHOCK

Answer 21

IgE mediated decrease in vascular tone &/or volume –> chemical mediators released in response to allergy –> systemic vasodilation & capillary leaking

Question 22

ANAPHYLACTIC SHOCK-

causes

Answer 22

medications
insect bites/stings
envenomation
blood transfusion
imaging contrast
food

Question 23

ANAPHYLACTIC SHOCK-

hemodynamic changes

Answer 23

increased CO/CI
decreased CVP
decreased PCWP
decreased SVR

Question 24

ANAPHYLACTIC SHOCK-

Pt presentation

Answer 24

decreased BP
increased HR
shortness of breath
wheezing/stridor
pruritis/urticaria
anxiety
flushed, red skin