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Stages of Shock
Final Exam
| Question | Answer |
|---|---|
| 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
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