Unit 9 - Shock Flashcards
Shock
- A lack of tissue perfusion (oxygenation) that leads to anaerobic metabolism
- ABSOLUTELY DEADLY
Outcome:
High conc of acidic byproducts build up resulting in organ failure! - delayed life threat
Multiple organs
pathophysiology of shock
need 1 of 3:
- heart not function properly (> cardiogenic shock)
- inadequate amount of blood circulate (break vessel, dehydrate, etc)(> hypovolemic shock)
- blood vessels cannot constrict effectively (vessels dilate lead to low BP) (> distributive shock)
Ischemia
Lack of blood supply
- heart, brain, lungs last 4-6 min
- kidney, liver, GI tract last 45-90 min
- muscles, bone, skin last 4-6 hours
-warm temp = faster; cold temp = slower
types of shock
- cardiogenic
- obstructive
- hypovolemic
3a. hemorrhagic
3b. neurogenic
3c. psychogenic
3d. septic
3e. anaphylactic
cardiogenic shock
Shock caused by inadequate function of the heart, or pump failure to circulate blood around the body
- problem due to heart itself
obstructive shock
Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body’s tissues
- something physically prevents heart fill/empty
hypovolemic shock
Shock caused by fluid or blood loss
-insufficient volume of blood circulate body
- subcategories are either true (total blood volume reduced) or relative (dilated vessels cause pooling in extremities and not circ effectively)
hemorrhagic shock
large loss of blood cause shock
(hypovolemic) ( most common of true)
neurogenic shock
nervous system cannot vasoconstrict = vasodilate = decrease BP and efficiency = shock
- usually brain or spinal injury
(hypovolemic; distributive)( relative)
psychogenic shock
vasodilation due to stress = decrease BP = shock
(hypovolemic; distributive)(relative)
septic shock
severe infection cause inefficient circulation of blood due to vasodilation and pooling in lower areas and leading to shock
(hypovolemic; distributive) (relative)
anaphylactic shock
severe allergic reaction increase permeability of blood vessels and fluid leaves system and airways close (lack of O2 come in)
(hypovolemic) (true)
stages of shock
-Compensated
-Decompensated
-Irreversible
compensated stage
body detect low perfusion and attempt to go back to normal via vasoconstriction and focus blood on vital organs, reduce circulation to extremities. Increase breathing rate and heart rate
- pale, cool skin
- tachycardia
- tachypnea
- possible sweating
- pupils will be PEARL
decompensated stage
Body hypoxic and life-threatening. Decreased O2 = confusion/unresponsive/organs fail and work less effective.
- confused, restless, unresponsive
- slow, shallow, irregular respirations
- rapid, weak pulse
- low BP
- low body temp
- dilated pupils (bilaterally equal)
- diaphoresis (rly sweating)
- thirst (no cure - do not give water)
- possible cyanosis
irreversible stage
vascular system unable to maintain internal pressure and blood pool in extremities away from vital organs; require intervention.
- unresponsive
- chaotic pulse leading to cardiac arrest
- respiratory arrest
domino effect
compensated:
- increase HR = increase blood loss = decrease BP = weak pulse
- increase workload = want O2 = increase RR
- no circ in extremities = pale, moist = protect organs
decompensated:
- cells in extremities die = brain want to restore circ btwn organs and extremities
- vital organs w/o O2 = increase HR = increase blood loss
irreversible:
- vital organs fail = restless, drowsy, confused = irregular HR = stop heart = respiratory arrest = cardiac arrest
treating shock
- reassure patient
- Trendelenburg position (feet elevate above head)
- maintain normal body temp
- care for other injuries
- admin O2 as needed
