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9 Cards in this Set
- Front
- Back
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Describe the following type of shock...
a. Compensated Shock or nonprogressive |
Compensated or nonprogressive
»If BP or CO remains at this level, tissue damage will occur. However, natural compensatory mechanisms will bring BP back up to a reasonable level. |
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What are the three general states that shock is catagorized
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1. Compensated or nonprogressive
2. Decompensated or progressive 3. Irreversible or refractory |
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Describe the following type of shock...
a. Decompensated or progressive b. irreversible/refractory shock |
Natural mechanisms will not achieve
adequate tissue perfusion and tissue death will ensue without clinical intervention. b. Irreversible (Refractory) »Nothing can be done to save the system. |
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What occurs in shock?
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1. Vasoconstriction
2. Decreased flow and decreased BP 3. Decrease delivery of nutrients and O2 4. Increase in accumulation of waste products and toxins 5. Activation of clotting cascade (DIC) 6. Vasoactive agents causing dilation 7. Production of free radicals from multiple sources including macrophages, neutrophils, endothelium etc. • Further deterioration of vascular integrity |
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Differentiate between compensated and decompensated cardiac failure
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Generally cardiac failure has two categories adequate response (compensated) and inadequate response (decompensated)
Compensated- In this case, all the reflex mechanisms gradually increase BP until an equilibrium is reached. There is no further increase in fluid retention and preload stabilizes at a new higher level. Decompensated- increase preload, increase or decrease CO, if CO increased BP decreased |
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Differentiate between systolic and diastolic dysfunction
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diastolic- due to hypertrophy of the hear it is unable to fill all the way
systolic- when the ventricle gets too big and flabby it is unable to pump blood |
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Which of the following reflexes would most
likely be working 2 minutes after an MI to stabilize BP? 1. Stimulation of Beta-one receptors of SA node 2. Aldosterone causing Na+ retention 3. ADH causing incresed TPR 4. Stimulation of Beta-2 receptors of vasculature 5. Stimulation of alpha receptors of the vasculature |
Answers is 1 and 5
1. 2. (would occur in long term) 3. (not impact in 2 minutes) 4. (cause vasodilation) |
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Pediatric patient presents in shock following 2 days of vomiting and diarrhea. Which of the following is the primary cause of the shock?
• Elevated TPR • Elevated blood volume • Decreased renin • Elevated ADH • Decreased preload |
Decreased preload causes decreased in blood volume and elevated TPR and ADH would occur
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Patient is diagnosed with decompensated cardiac failure. Which of the following is most likely present
• Overstretched actin/myosin overlap • Decreased levels of natriuretic peptide B • Decreased preload • Elevated arteriolar radius of gut • Elevated end diastolic ventricular volume |
Elevated end diastolic ventricular
volume, increased Preload (always with cardiac failure), elevated natriuretic peptide B, arteriolar radius of gut decreased |
