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68wm6 p2 Shock

Shock

QuestionAnswer
Define shock: A life-threatening response to alterations in circulation that results in inadequate delivery of oxygen to tissues and cells, and their subsequent dysfunction and death.
When does shock begin? Shock begins when cardiovascular system fails
Identify the three events that lead to the development of shock: *Blood volume decreases (volume problem) *Heart failure as an effective pump (pump problem) *Peripheral vessel dilation (tank problem)
What are the four main types of shock? *Hypovolemic. *Distributive. *Obstructive. *Cardiogenic.
What types of shock fall under 'distributive shock'? *Neurogenic. *Septic. *Anaphylactic.
Define shock: A life-threatening response to alterations in circulation that results in inadequate delivery of oxygen to tissues and cells, and their subsequent dysfunction and death.
When does shock begin? Shock begins when cardiovascular system fails
Identify the three events that lead to the development of shock: *Blood volume decreases (volume problem) *Heart failure as an effective pump (pump problem) *Peripheral vessel dilation (tank problem)
What are the four main types of shock? *Hypovolemic. *Distributive. *Obstructive. *Cardiogenic.
What causes septic shock? *Systemic inflammatory response syndrome to toxins *Multiple organ dysfunction syndrome *Simular vascular response as in anaphylactic shock
What types of shock fall under 'distributive shock'? *Neurogenic. *Septic. *Anaphylactic.
What does septic shock lead to? *Fluid shift *Hypotension *COAGULATION
What are the characteristics of distributive shock? *Volume is adequate, but perfusion is inadequate. *Vascular beds are dilated. *Blood flow is not sufficient.
What is the characteristic cardiogenic shock *Compression of the heart or great vessels. *Compression reduces blood that can enter and leave the heart. *Heart is unable to fill. *Cardiac output is reduced
What is the characteristic cardiogenic shock
What are causes of Neurogenic (distributive) shock? *Injury or disease to upper spinal cord *Spinal anesthesia *Drugs that vasodilate
What does anaphylactic shock lead to? *Capillary hyperpermeability – causes the release of plasma through the capillary walls. *Hypovolemia
What causes septic shock? *Systemic inflammatory response syndrome to toxins *Multiple organ dysfunction syndrome *Simular vascular response as in anaphylactic shock
What does septic shock lead to? *Fluid shift *Hypotension *COAGULATION
What are the characteristics of obstructive shock? *Compression of the heart or great vessels. *Compression reduces blood that can enter and leave the heart. *Heart is unable to fill. *Cardiac output is reduced
What is the characteristic cardiogenic shock Heart failure
What are the causes of cardiogenic shock? *Myocardial infarction *Dysrhythmias *Cardiomyopathy *Myocarditis *Valvular disease and structural disorders
What is the mortality rate of cardiogenic shock? 50% - 80%
What are the four stages of shock? *Initiation *Compensatory *Progressive *Refractory (Irreversible)
What characterizes stage 1 of shock? Subclinical hypoperfusion
What characterizes stage 2 of shock? Activation of compensatory mechanisms to maintain homeostasis
What are the three specific compensatory mechanisms that begin to work indipendently in phase 2 shock? *Neural *Endocrine *Chemical
What are Baroreceptors sensitive to? Pressure changes
What does shock stimulate the pituitary gland to produce? adrenocorticotropic hormone (ACTH)
During shock, ACTH acts on the adrenal cortex to release what? Aldosterone (antidiuretic hormone) to stimulate the retention of Na+ *Glucocorticoids for Glyco/Glucogenesis *Mineralcorticoids (renin-angiotensin response)
What is the Renin-Angiotensin-Aldosterone Response (RAAS) process? Kidney releases renin in response to poor perfusion to the kidneys --> Renin stimulates the conversion of angiotensinogen to angiotensin I. --> Angiotensin I is converted to angiotensin II in the lungs. --> Angiotensin II is a potent vasoconstrictor
A drop of how many mmHg below PTs normal systolic BP indicates impending or actual shock? >20mmHg
What is the normal difference between systolic and diastolic pressure? 30mmHg to 50mmHg
What happens to the difference in systolic/diastolic pressure in the PT with impending shock? The pulse pressure narrows (systolic pressure nears diastolic pressure)
A systolic change of what during an orthostatic (tilt) test indicates hypoperfusion? 10+ drop in systolic
Distended neck veins is indicative of what kind of shock? cardiogenic/obstructive
Flat neck veins is indicative of what kind of shock? hypovolemic/distributive
Hypothermia is characteristic of all shock except which? septic shock
What is a sensitive indicator of systemic perfusion? Urine output: >30ml/hr
What is an indicator that blood needs to be transfused for shock? Hct is less than 30%
What pharmacologic therapy affects preload and afterload? *Vasopressors: epinephrine and norepinephrine *Reduces preload: nitroprusside
What are the actions of an intra-aortic balloon pump? *Reduces afterload *Improves coronary artery perfusion *Improves perfusion to vital organs
What is used to control hemorrhage and hypotension from pelvic fractures? Pneumatic anti-shock garment (PASG) or Military anti-shock trousers (MAST)
What types of fluids are administered to the patient with hypovolemic shock? Crystalloid, colloid, blood
Created by: Shanejqb