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37 Cards in this Set

  • Front
  • Back
where is interstitial fluids located?
between cells and vessels
what is the formula for (pressure) aka blood pressure?
flow x resistance
what does blood viscosity mean?
what makes resistance?
small constricted blood vessels make high pressure
big dilated blood vessels makes low pressure
sympathetic nervous system
what catacholamines are produced?
epi and norepi
what does alpha do?
vasoconstrict arms and legs
what does beta do?
B1- increases heart rate (receptor in the heart)
B2- bronchodilates (receptor in lungs)
what does the RAA system do in fight or flight?
angiotensin 1 converted to angio II which is a potent vasoconstrictor
aldosterone- secreted which is an antidiuretic hormone therefore retains sodium and water
urine becomes more concentrated therefore thicker
less sodium in urine and more potassium in urine
Shock can be acute
or impaired
which means?
whole body
tissue perfusion (blood can't get there)
cell metabolism (cells have no energy)
or hemodynamics
S and S for all shocks?
SBP <90
Hr is either brady or tachy
altered mental status
narrow blood pressures- ex. 70/50
what is the formula for pulse pressure?
systolic - diastolic = pulse pressure

normal *40* d/t
120 - 80 = 40
what are the four stages of shock?
what happens in initial stage of shock?
decreased Cardiac output
impaired tissue perfusion (check 02 sats)
lactic acidosis (can be determined by blood test)
what happens in compensatory stage of shock?
inc HR and contractability
artery and venous vasoconstriciton
shunt to vital organs
stim ant pit- ADTH
adrenal medulla- release epi and norepi
Chemical- hyperventilate
what happens in progressive shock?
Na-K pump fails
cell energy production fails
digestive organelles swell
what happens in refractory shock?
unresponsive to therapy
MODS (multi organ dysfunction syndrome)
ultimately death regardless of cause d/t ineffective tissue perfusion
cardiovascular patho to all shocks?
mycardial depressant factor (MDF) excreted from the pancreas d/t lack of blood flow to the pancreas and other organs (wants to slow the heart to conserve energy)

lactic acidosis
neurologic patho to all shocks?
can't regulate temp, HR, Resp, etc. d/t the SNS failing
Brain not getting enough blood
Vessels dilate leads to pooling of blood into the lower extremities
increased cap. permeability therefore 3rd spacing
small blood clots
Hematologic patho to all shocks?
decreased BP
acidosis (retaining Co2)
stasis of cap blood
DIC (disseminated intravascular coagulation)- clot then bleed out
pulmonary patho to all shocks?
increased pulmonary cap permeability
micro emboli
resp. failure and acture resp. distress (ARDS)
renal patho to all shocks?
vasoconstriction and hypofusion
acute tubular necrosis
(need to monitor kidney function)
gastrointestinal patho to all shocks?
vasoconstriction- gut starts leaking out therefore gram negative bacteria in the GI tract
what is cardiogenic shock?
failure of heart to pump
what causes cardiogenic shock?
most commonly caused by MI
**high mortality**
patho of cardiogenic shock?
decreased cardiac output
injured ventricles can't push blood so stroke volume is decreased
poor emptying d/t not being able to push everythin gout
increased pulmonary pressure d/t things backing up
pulmonary edema
dec oxygenation (can't transfer Co2 and O2 through fluids in the lungs)
left S and S of cardiogenic shock?
crackles in lungs
dec peripheral pulses
dec O2 sats
altered mental status
dec renal output
right S and S of cardiogenic shock?
edema in LE
inc central venous pressure
cardiogenic management?
intraaortic balloon
+ inotropes (digoxin)
vasodilators (nitro)
ventricular assist device
when is ventricular assist device used?
when waiting for a heart transplant
what are complications of intraaortic balloon?
if slips too low it will cut off renal flow
if too high it will cut off blood flow through the subclavian and carotid arteries
when intraaortic balloon is inflated, the aortic valve is?
hypovolemic shock?
too low blood volume
causes of hypovolemic shock?
absolute loss
relative loss
absolute loss?
bleeding out on the floor, can see the blood
relative loss
intravascular to extravascular
3rd spacing
can't see the blood loss from the blood vessels
patho of hypovolemic shock?
everything decresed
intravascular volume
venous return
stroke volume
cardiac output
tissue perfusion
cellular metabolism
what is the intial sign of hypovolemic shock?
resp. alkalosis, because of hyperventilation and blowing off too much CO2