shock general Flashcards
What is shock?
inadequate tissue perfusion (oxygenation and hydration)
Lack of oxygen leads to lack of nutrients and support for organs and cells
Any insult to the body can create a cascade of events leading to shock
What happens if shock is left untreated?
cell death → tissue death → organ failure
How do you treat shock (generally)?
Hydration and oxygenation
Hydration →good blood perfusion → oxygen to cells → cells live
Physiologic responses common to all types of shock?
Hypoperfusion of tissues
Hypermetabolism
Activation of the inflammatory response
Cascading event
Why does a patient in shock require being in the ICU?
Ongoing assessment, at least q1 or q2
What is aerobic metabolism?
Metabolism that uses oxygen
More efficient and effective in producing energy
What is anaerobic metabolism?
Metabolism that does not use oxygen
Causes buildup of lactic acid (toxic, burns muscles)
Accumulation increases permeability
What are the cellular changes associated with anaerobic metabolism?
Self perpetuating negative situation
Loss of fluid and electrolyte
Impaired sodium potassium pump → mitochondrial damage and cell death
Inflammatory process activated clotting cascade
What impact does glucose need influence cellular changes?
Hyperglycemia and insulin resistance due to catecholamines, cortisol, glucagon, and inflammatory cytokines → more glucose is needed → gluconeogenesis → hypermetabolic state → fat and protein metabolism for glucose → proteinlysis → organ failure
How do we treat the self perpetuating negative cycle for cellular changes?
Early detection and treatment
What are the major components of the circulatory system to maintain BP and perfusion?
Blood volume
Cardiac pump
Vasculature
What must the MAP be above and why?
Above 65 mmHg in order for cells to receive oxygen and nutrients needed to metabolize energy to sustain life
