Shock and Dysrhythmias Flashcards
What are the 5 main types of shock?
Cardiogenic Neurogenic (vasogenic) Anaphylactic Septic Hypovolemic
In shock what happens to BP?
Decreases
Does cardiac output increase or decrease with shock?
Decrease
What are some common symptoms of shock?
Dyspnea, diaphoresis, altered sensorium
What are N/V caused by in shock?
Constriction of the splanchnic nerves
What are the two main impairments of cellular metabolism associated with shock?
Impairment of oxygen use Impairment of glucose use
What are some compensatory mechanisms for decreased glucose?
Cells switch to glycogen, protein, fat
What are some causes of hypovolemic shock?
Loss of whole blood
Loss of plasma
Loss of interstitial fluid
When does hypovolemic shock begin?
When the intravascular volume has decreased by 15%
What is neurogenic shock due to?
Massive vasodilation due to imbalance b/w parasympathetic and sympathetic stimulation of vascular smooth muscle parasympathetic overstimulation of sympathetic under stimulation
What type of shock has the highest mortality rate?
Septic
What is a dysrhythmia?
An abnormality of heart rhythm including altered rates or sites of impulse initiation and abnormal conduction pathways
What are the three types of dysrhythmia?
Abnormal rates of sinus rhythm
Abnormal sites of impulse initiation
Disturbances in conduction pathways
What is the normal conduction pathway?
SA Node –> AV node –> Bundle of HIs –> bundle branches (R and L) –> purkinje fibers
What is a triggered activity?
Impulse generated during or after repolarizing
What is sinus arrhythmia?
Degree of variability in heart rate (normal)
What is Sick Sinus syndrome?
Altering tachy and brady not normal
What is electrical asystole?
Sinus arrest- absence of pulse initiation
What are two factors in abnormal site of impulse initiation?
SA node failure
Enchanced excitability, triggered activity or reentrant circuits
What are escape rhythms?
Originate in AV node or ventricular Purkinje fibers
Absences of P waves and PR intervals
If P wave is present- may be inverted or during QRS
What are atrial dysrhythmias?
Premature atrial complexes and tachycardia (PACs)
Originate in atria- not at SA node
What is atrial flutter?
Type of atrial dysrhythmia
Rapid atrial rate
What is atrial fibrillation?
Types of atrial dysrhythmia
Completely disorganized and irregular atrial rhythm with irregular ventricular rhythm
What is a junctional dysrhythmia?
Initiated proximal to AV node or distal to AV node
Impulse to atria and ventricles simultaneously
P waves preceds, follows, or is buried in QRS
