Week 6 Shock Flashcards
___ Renin-angiotensin activation, which leads to ___ reabsorption of sodium and water, which leads to ____ preload and ____ urine output
INCREASE Renin-angiotensin activation, which leads to INCREASE reabsorption of sodium and water, which leads to INCREASE preload and DECREASE urine output
Irreversible shock
Prolonged oxygen deprivation leads to generalized cellular hypoxia, cell death & organ failure
MODS very high mortality
Stages of Shock : Compensatory
Normal BP HR >100 RR>20 PaCO2 < 32 mm Hg Cold / clammy Urine output : decreased Confusion / agitation Respiratory alkalosis
Stages of Shock Progressive
Systolic < 90 MAP < 50 Requires fluid resuscitation to support blood pressure HR>150 Rapid shallow respirations PaO2 < 80 PaCO2 > 45 mm Molted / petechia skin Urine Output <0.5ml/kg Lethargy Metabolic acidosis
Irreversible Shock Characteristics
Requires mechanical or pharmacologic support
HR : erratic
Requires intubation and mechanical ventilation and oxygenation
Jaundice
Anuric, requires dialysis
Unconscious
Profound acidosis
What is a late sign/omnious sign in children?
HYPOTENSION
Cardiogenic Shock
PUMP FAILURE
- decreased systolic function and depressed cardiac output
- Uncommon among children who do not have CHD
Causes of cardiogenic shock?
Cardiomyopathies Arrhythmias Surgery for CHD Valvular problems Decreased contractility MI #1 cause of cardiogenic heart
Obstructive Shock
Blood flow is physically obstructed
Causes of Obstructive Shock?
Cardiac Tamponade Tension pneumothorax Massive pulmonary embolism Ductal dependent congenital heart lesions - coarctation of the aorta, hypoplastic left ventricle syndrome Aortic stenosis Constrictive pericarditis
Diabetic Shock
Too much glucose in the body - too much urine output and go into dehydration #1 - push a lot of fluids
Causes of Anaphylaxis shock?
Bee stings
Food allergies
Pollen
Medications
