Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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?
|
thickness
|
|
|
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? B2? |
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
widespread or impaired which means? |
sudden
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?
|
initial
compensatory progresive refractory |
|
|
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?
|
SNS
inc HR and contractability artery and venous vasoconstriciton shunt to vital organs RAA 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
hypoxemia 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 vasoconstriction 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 hyperventilation acidosis dec renal output |
|
|
right S and S of cardiogenic shock?
|
edema in LE
JVD ascites hepatomegaly inc central venous pressure |
|
|
cardiogenic management?
|
intraaortic balloon
+ inotropes (digoxin) vasodilators (nitro) diuretics antidysrhythmics 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?
|
closed
|
|
|
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
|
