Shock Intro

Question 1

Hypoperfusion

Answer 1

Inadequate perfusion of body tissues.

Question 2

Shock is NOT defined by…

Answer 2

pulse rate, blood pressure, cardiac function and hypovolemia.

Question 3

3 Components of adequate perfusion

Answer 3

Pump, Tank and Lungs

Question 4

Pump

Answer 4

Heart

Question 5

Tank/Container

Answer 5

Blood vessels and vasculature

Question 6

Lungs

Answer 6

Provide gas exchange

Question 7

Stroke Volume

Answer 7

Amount of blood ejected by the heart in one minute

Question 8

Preload

Answer 8

Amount of blood delivered to the heart during diastole

Question 9

Afterload

Answer 9

The resistance against which the ventricle must contract.

Question 10

Cardiac contractile force

Answer 10

The strength of contraction of the heart. Affected by circulating hormones called catecholamines.

Question 11

Catecholamines

Answer 11

Circulating hormones. Epinephrine and Norepinephrine.

Question 12

Cardiac Output

Answer 12

Stroke volume X Heart rate

Question 13

Blood Pressure

Answer 13

Cardiac output X SVR

Question 14

Formed Elements

Answer 14

Red blood cells, White blood cells and platelets.

Question 15

The functions of Blood

Answer 15

Transports O2, carbon dioxide, nutrients, hormones, metabolic waste products and heat.

Question 16

Small Vessels of Microcirculation

Answer 16

Arterioles, capillaries and venules

Question 17

Pre-Capillary Sphincter

Answer 17

Responds to local tissue demand such as acidosis and hypoxia, and opens as more blood is needed.

Question 18

Post-Capillary Sphincter

Answer 18

Opens when blood needs to be emptied into the venous system.

Question 19

The Fick Principle

Answer 19

The movement and utilization of oxygen in the body is dependent upon adequate concentration of inspired oxygen andappropriate movement of oxygen across the alveolar/capillary membrane into the arterial bloodstream.

Question 20

3 Components the Fick Principle requires.

Answer 20

Adequate number of red blood cells
Proper tissue perfusion
Efficient offloading of oxygen at the tissue level

Question 21

Causes of Hypoperfusion (pump)

Answer 21

Inadequate pump (heart)
Inadequate pre-load
Inadequate cardiac contractile force
Excessive afterload

Question 22

Causes of Hypoperfusion (fluid)

Answer 22

Inadequate blood volume (fluid)

Hypovolemia

Question 23

Causes of Hypoperfusion (container)

Answer 23

Inadequate Vasculature
Dilated vasculature without change in blood volume
Leak in the vasculature

Question 24

Stages of Shock

Answer 24

Compensated, Decompensated and Irreversible.

Question 25

Compensated Shock

Answer 25

Early stage of shock during which the body’s compensatory mechanisms are able to maintain normal perfusion.

Question 26

Decompensated Shock

Answer 26

Advanced stage of shock that occurs when the body’s compensatory mechanisms no longer maintain normal perfusion.

Question 27

Irreversible Shock

Answer 27

Shock that has progressed so far that the body and medical intervention cannot correct it.

Question 28

Types of Shock

Answer 28

Cardiogenic
Hypovolemic
Nuerogenic
Anaphylactic
Septic

Question 29

Cardiogenic Shock

Answer 29

The heart loses its ability to supply body parts with blood. Usually resulting from left ventricular failure secondary to CHF or MI.

Question 30

Cardiogenic Shock Symptoms

Answer 30

Difficulty breathing, wheezes, crackles rales, productive cough, white/pnk foamy sputum, cyanosis, altered mentation and oliguria.

Question 31

Cardiogenic Shock Treatment

Answer 31

Open Airway, administer oxygen, assist ventilations (if necessary), keep pt warm, elevate the pt head and shoulders, establish and IV with minimal fluid administration, monitor heart rate, Dopamine and Dobutamine may be administered.

Question 32

Hypovolemic Shock

Answer 32

Shock due to loss of intravascular fluid. Internal or external hemorrhage, Trauma, open or long bone fractures, dehydration, plasma loss from burns, excessive sweating, diabetic ketoacidosis.

Question 33

Hypovolemic Shock Symptoms

Answer 33

Altered level of consciousness, pale cool clammy skin, blood pressure may initially be normal and then quickly fall, pulse may be normal initially then become rapid and slowly disappearing, decreased urination, and cardiac dysrhythmias.

Question 34

Hypovolemic Shock Treatment

Answer 34

Airway control, control severe bleeding, keep pt warm, administer a bolus of crystalloid solution for fluid replacement and use the PASG (if it is in local protocols)

Question 35

Neurogenic Shock

Answer 35

Results from injury to the brain or spinal cord causing and interruption of nerve impulses to the arteries. Arteries dilate causing hypovolemia, sympathetic impulses to the adrenal glands are lost, preventing the release of catecholamines.

Question 36

Neurogenic Shock Symptoms

Answer 36

Warm dry red skin, low blood pressure and slow pulse rate.

Question 37

Neurogenic Shock Treatment

Answer 37

Airway Control, Maintain body temperature, Immobilization of the pt and IV access and medications that increase peripheral vascular resistance.

Question 38

Anaphylactic Shock

Answer 38

A sever immune response to a foreign substance. Signs and symptoms most often occur within minutes. Most commonly cause by bee stings and penicillin injections.

Question 39

Anaphylactic Shock Symptoms

Answer 39

Increased heart rate, increased blood pressure, nausea, vomiting, abdominal cramping, altered mental status, dizziness, seizures and headache.

Question 40

Anaphylactic Shock Treatment

Answer 40

Airway Protection (may include intubation), Establish an IV of crystalloid solution, administer epinephrine, antihistamines, corticosteroids or vasopressors.

Question 41

Septic Shock

Answer 41

An infection that enter the bloodstream and is carried throughout the body. The toxins released overcome the compensatory mechanisms. Can cause dysfunction of an organ system or result in multiple organ dysfunction syndrome.

Question 42

Septic Shock Symptoms

Answer 42

Increased to low blood pressure, high fever, no fever or hypothermic. Flushed pale or cyanotic skin. Difficulty breathing and altered lung sounds. Altered mental status.

Question 43

Septic Shock Treatment

Answer 43

Airway Control, Establish IV of crystalloid solution, dopamine to support blood pressure and monitor heart rhythm.