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perfusion: shock
pathophysiology NUR 304
| Question | Answer |
|---|---|
| What can shock be classified as? | circulatory or cardiogenic |
| What happens with circulatory shock? | when the vascular space becomes empty (volume depleted), too large (vasodilated), for available volume, or obstructed |
| Define circulatory shock? | the heart ceases to effectively pump blood forward |
| What is the most common cause of cardiogenic shock? | sudden, acute pump failure following MI |
| How do you combat shock? | you must quickly and efficiently increase the oxygen supply & decrease the oxygen demand while reducing the workload on the heart. |
| What are the three types of shock? | hypovolemic, obstructive, and distributive |
| What is shock? | circulation through the vascular network is impaired, the CO bottoms out, & compensatory mechanisms immediately begin trying to restore circulation. |
| What can cause hypovolemic shock? | hemorrhagic/loss of whole blood from the vascular space. intravascular dehydration due to loss of fluid from the vascular space. intravascular volume loss due to massive fluid shifts & third spacing of fluid |
| What are some examples of conditions that can lead to hypovolemic shock? | trauma, disseminated intravascular coagulation (DIC), aortic aneurysm, intraoperative & postoperative complications, polyuria, diarrhea, diabetes insipidus, addisonian crisis, burns, ascites, removal of fluid accumulation, loss of volume dehydration |
| What can cause obstructive shock? | blood cannot be ejected from the LV into systemic circulation because the heart is displaced or compressed |
| What are some examples of conditions that can lead to obstructive shock? | cardiac tamponade, cardiac myxoma, mediastinal shift, diaphragmatic hernia, pneumothorax, if the blood can't physically get out of the heart to the rest of the body, the vascular space will be depleted. therefore, the body thinks that its in shock. |
| What can cause distributive shock? | loss of vasomotor tone due to interference with sympathetic nervous system function leads to neurogenic shock. when vasodilation occurs the vessels become larger, making the volume seem less to the body so the body thinks its in shock |
| What are some examples of conditions that can lead to distributive shock? | injury to spinal cord, severe acute pain, brain injury, hypoxemia, insulin reaction, release of histamine in blood, presence of systemic inflammatory mediators that releases endotoxins which produces vasodilation |
| What are some CM of shock? | tachycardia, hypotension, cool ashen skin, diaphoresis, cyanosis of lips and nail beds |
| What are the initial symptoms of shock? | weakness, fast breathing, fast HR, diaphoresis, anxiety, increased thirst, can be followed by confusion, unconsciousness, and cardiac arrest |
| How can we treat hypovolemic shock? | fluid replacement with balanced crystalloids or restoration with blood products |
| How can we treat distributive shock? | combination of vasoconstrictors and fluid replacement |
| How can we treat cardiogenic shock? | depending on the situation; drugs, surgery, or other interventional procedures |
| How can we treat obstructive shock? | immediate life saving interventions |
| Define anaphylactic shock | type of distributive shock that involve the immune system. occurs when a person has a hypersensitive reaction to an antigen |
| What are some CM of anaphylactic shock? | sudden nasal congestion, flushed skin, anxiety, feeling of impending doom, urticaria, tachypnea, generalized edema, and hypotension |
| How can we treat anaphylactic shock? | epinephrine, corticosteroids, diphenhydramine, vasopressors, dopamine, aminophylline |
| Define septic shock | caused by widespread infection |
| What is the most common type of circulatory shock? | septic shock |
| Who is at the greatest risk for septic shock? | the very young and very old, and people with weakened immune systems |
| What are some CM of septic shock? | alteration in temperature, warm flushed skin, hypotension, confusion, hyper and hypoventilation |
| How can we treat septic shock? | antibiotic therapy, inotropic and vasopressor drugs |
| Define neurogenic shock | the sympathetic nervous system stops sending signals to the vessel walls, causing the vessels throughout the body to vasodilate & the BP TO DROP |
| When does neurogenic shock usually occur? | when there is severe damage to the CNS; mostly after an acute spinal cord injury |
| What is the most commonly injured area with neurogenic shock? | the cervical spine |
| What are some CM of neurogenic shock? | bradycardia, dry warm skin, orthostatic hypotension, fainting, no sweating below the level of injury, flaccid paralysis below the level of injury, poikilothermia, priapism |
| Define poikilothermia | when the body adopts the temperature of the local environment because the hypothalamus does not function properly in an injured brain |
| Define priapism | abnormal and prolonged erection of the penis due to lesions in the CNS |
Created by:
keiondraharden
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