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Stages of Shock

Final Exam

What are the four stages of shock? Initial, Compensatory, Progressive, Irreversible (aka Refractory)
During the ________ stage of shock, no s/s are apparent; body is beginning to react to O2 supply/demand imbalance with lactic acid accumulating from change to anaerobic metabolism (aka metabolic acidosis) Initial
During the _______ stage of shock, s/s are vaguely visible; body is trying to compensate. "Fight or flight" response. Narrow window to intervene before acidosis develops. Compensatory
During the _______ stage of shock, there is an increase in abnormal VS Progressive (aka decompensate)
During the ________ stage of shock, the body must have external supports (meds for BP and cardiac, intubation, external pacer, etc.) Irreversible (aka refractory)
Stage of shock: Priority is blood flow management; preventing hypotension or the advancement to other stages. Compensatory
Stage of shock: Clinical signs are normal BP, HR >100, RR >20, cool clammy skin, confusion, lower urine output and RR alkalosis. Prognosis good if treatment begins early. Compensatory
Term for the blood ejected from heart with systole; Systolic BP minus diastolic Pulse Pressure
Normal pulse pressure is _____ to _____ mmHg 30-40
Pulse pressure is r/t what? Decrease/narrowing of pulse pressure is showing change in it. SV
Lab changes in the compensatory stage include increased _____ and ______ r/t catecholamine and aldosterone release. Na and glucose
Report systolic BP <_____ or drop from baseline of ____ 90; 40
Stage of shock: Heart is overworked; cellular perfusion decreased from vasoconstriction and increased capillary permeability Progressive
Stage of shock: Circulating fluid volume decreases, so HR increases beginning a vicious cycle with worsening prognosis Progressive
Stage of shock: Map falls below normal limits, Systolic <80-90, HR >150, rapid shallow RR, crackles, skin mottled, lethargic, decreased urine output, metabolic acidosis. Progressive
Stage of shock: Weak, thready pulse, Increased BUN, creatinine, liver enzymes. May see seizure. Increased r/o GI bleed and infection. Progressive
Stage of shock: Organ damage is so severe it is unable to respond in any way and can only go on with mechanical or pharmacological support. Irreversible (Refractory)
Stage of shock: No BP or RR without support, cardiac rhythm is erratic or asystole, intubated, skin is jaundiced, anuric, unconscious, profound acidosis Irreversible (Refractory)
MODS can happen in what type of shock? Any
What three things increase r/o developing MODS? Age, malnourished, comorbidities
Created by: mreedy