Shock

Question 1

What are potential causes of cardiogenic shock?

Answer 1

Inadequate heart function
Disease of muscle tissue
Impaired electrical system
Disease or injury

Question 2

S/S of cardiogenic shock

Answer 2

chest pain
irregular, weak pulse
low BP
cyanosis
cold, clammy skin
anxiety
crackles
pulmonary edema

Question 3

What are potential causes of obstructive shock?

Answer 3

Mechanical obstruction of the cardiac muscle causing a decrease in CO
tension pneumothorax
cardiac tamponade
pulmonary embolism

Question 4

S/S of obstructive shock

Answer 4

dyspnea
rapid, weak pulse
rapid, shallow breaths
decreased lung compliance
unilateral, decreased, or absent breath sounds
decreased BP
JVD
subcutaneous emphysema
cyanosis
tracheal deviation toward affected side
Beck triad (tamponade)

Question 5

Beck Triad

Answer 5

JVD
narrowing pulse pressure
muffled heart tones

Question 6

What is the cause and s/s of septic shock?

Answer 6

Severe bacterial infection

warm skin or fever
tachycardia
low BP
weak, thready pulse
shallow, rapid respirations
AMS

Question 7

What is the cause and s/s of neurogenic shock?

Answer 7

Damage to c-spine causing widespread blood vessel dilation

bradycardia or nl pulse
low BP
signs of c-spine injury

Question 8

S/S of anaphylactic shock

Answer 8

urticaria
widespread vasodilation
hypovolemia
swelling

Question 9

What causes psychogenic shock?

Answer 9

Temporary, generalized vascular dilation causing syncopal episode

Question 10

What is hypovolemic shock and s/s?

Answer 10

loss of blood or fluid

rapid, weak pulse
low BP
AMS
cyanosis
cool, clammy skin

Question 11

What does a pediatric pt’s body rely on to help with compensation?

Answer 11

Increasing pulse and SVR

Question 12

What are the common cause of severe allergic reactions?

Answer 12

Injections : tetanus, antitoxin, penicillin
Stings : wasps bees, hornets, ants
Ingestion : fish, shellfish, nuts, eggs, medication
Inhalation : dust, pollen, mold

Question 13

What is the progression of shock?

Answer 13

compensated shock
decompensated shock
irreversible shock

Question 14

S/S of compensated shock

Answer 14

agitation, anxiety, restlessness
sense of impending doom
weak, rapid (thready) pulse
moist, clammy skin
pallor, cyanotic lips
SOB
n/v
delayed cap refill
thirst narrowing pulse pressure

Question 15

S/S of decompensated shock

Answer 15

AMS
hypotension
narrowing pulse
labored or irregular breathing
thready or absent peripheral pulses
ashen, mottled, or cyanotic skin
dull eyes, dilated pupils
diminished urine output
diaphoresis
thirst
decreased cap refil
dry mucosa
n/v

Question 16

What happens during the compensated shock stage?

Answer 16

Chemical release by ANS causes arterial BP to remain nl or slightly elevated
Increase in rate and depth of respirations to bring in more oxygen and C02.
Narrowing pulse

Question 17

Why does the body increase rate and depth of respirations during compensated shock?

Answer 17

Attempt to maintain acid-base balance by creating respiratory alkalosis to offset metabolic acidosis.

Question 18

What occurs during decompensated shock?

Answer 18

Blood volume decrease more than 30%.
Compensatory mechanisms begin to fail.
CO falls dramatically reductions BP and cardiac function.
Vasoconstriction in order to shunt blood to brain, heart, lungs, and kidneys.

Question 19

Initial management of shock

Answer 19

Control obvious bleeding
Manage airway
Amdminister supplemental oxygen
PLace in position of comfort
Obtain vital sign including SpO2 and glucose
Obtain IV/IO access
Maintain body heat