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174 Cards in this Set
- Front
- Back
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afterload
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The force or resistance against which the heart pumps.
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anaphylactic shock
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Severe shock caused by an allergic reaction.
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anaphylaxis
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An unusual or exaggerated allergic reaction to foreign protein or other substances.
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aneurysm
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A swelling or enlargement of a part of an artery, resulting from weakening of the arterial wall.
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autonomic nervous system
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The part of the nervous system that regulates involuntary functions, such as heart rate, blood pressure, digestion, and sweating.
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cardiogenic shock
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Shock caused by inadequate function the heart, or pump failure.
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compensated shock
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The early stage of shock, in which the body can still compensate for blood loss.
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cyanosis
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Bluish color of the skin resulting from poor oxygenation of the circulating blood.
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decompensated shock
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The late stage of shock when blood pressure is falling.
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dehydration
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Loss of water from the tissues of the body.
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distributive shock
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A condition that occurs when there is widespread dilation of the small arterioles, small venules, or both.
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edema
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The presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.
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homeostasis
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A balance of all systems of the body.
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hypothermia
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A condition in which the internal body temperature falls below 95 degrees Fahrenheit (35 degrees Celsius), usually as a result of prolonged exposure to cool or freezing temperatures.
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hypovolemic shock
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Shock caused by fluid or blood loss.
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irreversible shock
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The final stage of shock, resulting in death.
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myocardial contractility
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The ability of the heart to contract.
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neurogenic shock
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Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.
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obstructive shock
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Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues.
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perfusion
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Circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs.
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preload
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The precontraction pressure in the heart as the volume of blood builds up.
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psychogenic shock
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Shock caused by a sudden temporary reduction in blood supply to the brain that causes fainting (syncope).
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sensitization
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Developing a sensitivity to a substance that initially caused no allergic reaction.
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septic shock
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Shock caused by severe infection, usually a bacterial infection.
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shock
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A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypoperfusion.
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sphincters
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Circular muscles that encircle and, by contracting, constrict a duct, tube, or opening.
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syncope
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Fainting.
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Cardiogenic shock may result from all of the following, EXCEPT:
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Increaded preload
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Patients develop septic shock secondary to
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poor vessel function and severe volume loss
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Distributive shock occurs when:
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widespread dilation of the blood vessels causes blood to pool in the vascular beds.
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Pulmonary edema and impaired ventilation occur during:
A) neurogenic shock. B) anaphylactic shock. C) septic shock. D) cardiogenic shock. |
cardiogenic shock |
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Capillary sphincters are:
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circular muscular walls that regulate blood flow through the capillaries.
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Shock is the result of:
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hypoperfusion to the cells of the body.
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When assessing a patient with signs and symptoms of shock, it is MOST important to remember that:
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blood pressure may be the last measurable factor to change in shock.
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Which of the following injuries would MOST likely cause obstructive shock?
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cardiac tamponade
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Which of the following would MOST likely result in hemorrhagic shock?
A) liver laceration B) excessive sweating C) severe vomiting D) repeated diarrhea |
liver laceration |
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In infants and children, a capillary refill time (CRT) that is greater than ______ second(s) is a sign of poor peripheral perfusion.
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2
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Neurogenic shock occurs when:
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failure of the nervous system causes widespread vasodilation.
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Hypovolemic shock caused by severe burns is the result of a loss of:
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plasma
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All of the following conditions would make you suspect shock, EXCEPT:
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tachycardia
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One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:
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carbon dioxide
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When the body senses a state of hypoperfusion, the sympathetic nervous system releases epinephrine, the effects of which include:
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tachycardia
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You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
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apply pressure directly to wound
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Clinical signs of compensated shock include all of the following, EXCEPT:
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absent peripheral pulse
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Which of the following patients is in decompensated shock?
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a 20-year-old female with absent radial pulses and dilated pupils
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Which of the following MOST accurately describes septic shock?
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bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
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When treating an 80-year-old patient who is in shock, it is important to remember that:
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changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.
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Which of the following statements regarding anaphylactic shock is MOST correct?
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Each subsequent exposure following sensitization often produces a more severe reaction.
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Which of the following clinical signs is unique to anaphylactic shock?
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wheezing
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Hypotension in a child with blunt or penetrating trauma is particularly significant because:
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it often indicates the loss of half of his or her blood volume
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In an acute injury setting, neurogenic shock is commonly accompanied by:
A) hypovolemia. B) diaphoresis. C) tachycardia. D) hypothermia. |
D) hypothermia. |
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Regulation of blood flow is determined by?
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cellular need
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Basic causes of shock:
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a)pump failure b)blood or fluid loss c)blood vessel dialation
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Noncardiovascular causes of shock are respiratory failure and?
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anaphylaxis
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Nuerogenic shock usually develops from damage to spinal cord at the:
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cervical level
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Neurogenic shock is caused by
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radical change in size of blood vessels
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Hypovolemic shock is result of
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low blood volume
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In anaphylatic shock poor oxygenation and poor perfusion is a result of
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widespread vasodilation
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when treating shock patient frequently check vitals every
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5 minutes
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The Golden Period is the first 60 minutes after
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the injury occurs
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What is a sudden reaction of nervous system causing temporary vasodilation and fainting?
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psychogenic shock
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At what systolic blood pressure should you recognize that an adult patient is in decompensated shock?
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90 mm Hg
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In compensated shock, the pulse of the patient usually:
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increases
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When assessing breathing for a patient in shock, an increased respiratory rate can be a sign of:
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compensated shock
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When treating a patient who exhibits signs and symptoms of shock, which of the following actions would not be appropriate?
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Splint all suspected extremity fractures.
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Signs and Symptoms of Cardiogenic Shock
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chest pain
irregular weak pulse/low BP cyanosis cool clammy skin anxiety rales in breathing pulmonary edema/possibly short of breath |
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Causes of Obstructive Shock
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mechanical obstruction of cardiac muscle leading to pump failure
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A collection of fluid between pericardial sac and myocardium caused by blunt force trauma to chest/ type of obstructive shock
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cardiac tamponade/pericardial tamponade
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type of obstructive shock caused by damage to lungs allowing air to escape into chest cavity and apply pressure to structures in mediastinum such as the heart
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tension pneumothorax
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Signs and Symptoms of Septic Shock
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WARM SKIN
tachycardia low BP |
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Signs and Symptoms of Neurogenic Shock
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BRADYCARDIA
Low BP SIGNS OF NECK INJURY |
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Signs and Symptoms of Anaphylactic Shock
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QUICK ONSET
mild itching rash burning skin vascular dilation generalized edema especially around face and lips pallor/cyanosis dizziness/fainting sneezing/tightness in chest/cough WHEEZING |
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Causes of Hypovolemic Shock
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Hemorrhagic fluid/blood loss burns can cause plasma loss |
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Signs and Symptoms of Hypovolemic Shock
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Rapid weak pulse
low BP Cyanosis lips & nail beds cool clammy skin dehydration/thirsty INCREASED RESPIRATORY RATE |
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A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?
A) full immobilization of her spine B) application of the pneumatic antishock garment (PASG) C) 100% oxygen administration D) rapid transport to a trauma center |
D) rapid transport to a trauma center |
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When perfusion to the core of the body decreases:
A) blood is shunted away from the skin. B) the voluntary nervous system releases hormones. C) decreased cardiac contractility occurs. D) blood is diverted to the gastrointestinal tract. |
A) blood is shunted away from the skin. |
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A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing:
A) pump failure. B) a local infection. C) decompensated shock. D) septic shock. |
D) septic shock. |
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Intrapulmonary shunting occurs when:
A) blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the leftside of the heart in an unoxygenated state. B) a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and anoverall decrease in blood oxygen levels. C) any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide todiffuse across the alveolar-capillary membrane. D) the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing theexchange of gases in the lungs. |
A) blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the leftside of the heart in an unoxygenated state. |
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A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should:
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follow appropriate standard precautions.
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Shock
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Widespread inadequate tissue perfusion
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Perfusion
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Transfer of oxygenated blood
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Diffusion
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Gas Exchange
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Perfusion Triangle
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Heart, Blood Vessels, and Blood
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Hypovolemic Shock
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Hemorragic(Hypovolemic shock) and non-hemorragic(Metabolic). Loss of fluids and Electrolytes due to vomitting and or diahrreah.
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Neurogenic Shock
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Affects vasomotor center. Damage to cervical spine may affect the size and muscular tone. 2 tone skin.
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Treatment for Neurogenic Shock
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Oxygen, Blanket, Supine position to let body fight it out.
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Septic shock
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Toxins damage the vessel walls, causing leaking and impairing contraction. Usually ALOC due to head trauma.
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Symptoms for Septic Shock
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Hot, flush and diaphoretic.
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Treatment for Septic Shock
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Oxygen, semi-fowlers or fowlers, can use blankets.
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Anaphylactic Shock
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Occurs when a person reacts violently to a substance.
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What happens in Anaphylactic Shock?
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Foreign body invaders attach to the Mast Cells and explode releasing Leukotrenes and Histamines.
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Signs and Symptoms of Anaphylactic Shock
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Hot, Flush, Diaphoretic
1 -Wheezing, due to constricted bronchioles. 2- Itchy, Body is telling you to get rid of it. 3- Blood pressure drops- Hypotensive. 4- Eutokarya - Red skin bumps. |
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What does the acronym D.I.C.E stand for?
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Drug dose, Integrity of container, color and clarity, expiration date.
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What are the steps to administer an EPI-Pen?
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1- Locate mid-lateral thigh.
2- Rub alcohol from big circle to small circles. 3- Administer epi for 10 seconds. 4- Place in sharps box. 5- Massage administered area. |
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Epinephrine dosages for adults and pediatrics
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.3mg for adults and .15mg for pediatrics.
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Effects of Epinephrine on the body
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1- Vaso-constrictor
2- dialates bronchioles 3- Increased heart rate |
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Treatment for Anaphylactic Shock
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Fowlers position, Oxygen, and blanket
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Psychogenic Shock
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Occurs after a patient faints and has no blood return to head.
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Syncople Episode
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Patient faints and blood returns to the head.
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What special precaution should you look out for when dealing with patients who went through Psychogenic shock or a Syncople episode?
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If a patient falls check for injuries and take spinal precautions.
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Cardiogenic shock
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Is a pump failure due to tissue becoming esquemic on the coronary arteries.
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Angina Pectoris
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If the heart becomes esquemic or oxygen deprived.
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Myocardial Infarction
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Heart Attack
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Pulmonary Edema
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develops when the Right ventricles pump blood back down to the feet
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Pedal Edema also known as Pitting Edema
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Swelling of the feet
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Treatment for Cardiogenic Shock
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Fowlers or semi-fowlers, Blanket and Oxygen. Only go Code 3 if there is Myocardial Infarction.
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Obstructive shock
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blockage of blood flow to the lungs. Producing a Pulmonary embolism
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Thrombosis
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Clot in the lung
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Obstructive shock is usually seen in?
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Diving accidents
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Pericardial tamponade/ Myocardial Tamponade
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Jugular Vein Distention (JVD), Muffled heart sounds, heart filled with fluids, hypotensive.
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Hypotensive
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Low blood pressure
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Tension pneumothorax
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Pressure in the Pleura
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Subcutaneous Emphysema
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Blood rising to top of skin. (Rice Crispies)
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respiratory Insufficiency
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Not enough Oxygen flow to the blood can produce shock
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examples of respiratory insufficiency
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1- Carbon monoxide poisoning
2- Cyanide Poisoning 3- Anemia |
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When does Anemia occur?
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When there is an abnormally low number of red blood cells
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What are the three stages of Shock?
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Compensated, decompensated and Irreversible
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What happens in the Compensated stage of shock?
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Body fights, goes into fight or flight mode.
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What happens in the Decompensated stage of shock?
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Blood Pressure is below 90 Systolic
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What happens in the Irreversible stage of shock?
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The patien is pretty much dead
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Symptoms of Classic Compensated Shock
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weak rapid pulse, More than 2 seconds on Cap. Refill, rapid breathing, Pale Skin, Marked Thirst,**** Blood pressure maintained at adequate level***
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What does Aspirin do?
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It is a platelet inhibitor.
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Severe Fractures are assos. w/ what type of shock?
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Hypovolemic shock
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Abdominal and/or Chest injuries Assos. w/ what shock?
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Hypovolemic shock
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Spinal injury assos. w/ what shock?
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Neurogenic Shock
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Infections are assos. w/ what type of shock?
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Septic Shock
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Major Heart attack are assos. with what shock?
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Cardiogenic Shock
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Injections, Stings, ingestion and inhalation of a substance or substances are assos. w/ what type of shock?
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Anaphylactic Shock
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A sick patient who is vomitting and has diahrreah is assos. w/ which shock?
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Metabolic/Hypovolemic Shock.
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Fainting is assos. with which shock?
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Psychogenic shock?
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What is cavitation
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When pressure waves exert force on an object as it passes through its trajectory.(e.g.: exit wound on a bullet)
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What is Cu-Contra-Cu?
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Sloshing of the brain/internal organs
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What is the Ventury effect?
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Sucking in of air
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What does the Ventury effect cause in the human body?
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Causes an embolysm also known as Thrombosys in the lungs.
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How do you treat a patient with a Jugular Vein Laceration?
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You get an acclusive dressing and tape all 4 sides.
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What is an acclusive dressing?
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An air tight dressing.
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What kind of movement does a flail chest depict?
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Paradoxical movement?
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HOw do you treat a patient with a Flail Chest?
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Big bulky trauma dressing and tapedown.
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How do you tapedown a big bulky trauma dressing on a patient?
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Hashtag or cross.
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What are the control centers?
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Respiratory, Cardiac, Vasomotor and R.A.S(Reticular Activating System)
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What is the Reflex arc?
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When a sensor in the arc detects an irritating stimulus, instead of going to the brain the message is sent to a motor nerve. (e.g.: Detecting Heat, sharps ect.)
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What is Cushings Triad?
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Tachypnea- High BP, Bradycardia - Low Heart Rate, Hypertension.
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What is anascoria?
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disorder of unequal pupils. Accounts for 3% of population.
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Name one good thing about scalp lacerations?
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If there is fair ammount of bleeding it is good because there is not much room for ICP to present itself.
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What is paraorbital achimosis?
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Racoon eyes.
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What skull fractions account for 80% of skull fractions?
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Linear fractions.
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What is a linear fraction?
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A fraction where the skull seals itself when fully developed.
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What is a concussion?
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It is a brain injury with no permanent damage.
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What is a contusion?
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Permanent damage(Bruise to the head)
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What are symptoms of a brain contusion? |
ICP, widening pulse pressure, watch for Cushings triad symptoms. |
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What kills brain tissue?
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Blood on brain tissue.
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Speed of Intercranial bleeding of the Epidur
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it is super fast
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Speed of intercranial bleeding of the subdural
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slow
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speed of intercranial bleeding of the intracerebral
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fast
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Head injury indicators
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ALOC, Acute iindicator of neurological damage and should be looked at close.
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Non-traumatic brain injuries are?
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CVA- Cerebral vascular Accident or a Stroke.
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What is a fracture?
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Broken bone
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What is a dislocation?
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Disruption of a joint
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What is a Sprain?
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Tearing of ligaments
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What is a Strain?
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Stretching or tearing of a muscle.
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What is a closed fracture?
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A fracture that does not break the skin
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What is an open fracture?
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Also known as a Compound fracture is an external wound associated with fracture.
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what is a nondisplaced fracture?
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Crack of bone
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What is a displaced fracture?
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fracture where there is deformity
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What is a greenstick fracture?
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It is a bend that is common with children
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What is an epiphyseal fracture?
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A fracture near the growth plate
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What is a transverse fraction?
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a break straight through bone
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what is Rule #1 for splinting?
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CMS before an dafter splinting
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What is rule #2 for splinting?
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Splint in position found, unless there is no distal cms, then move it.
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What is rule #3 for splinting?
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don't tape or strap over injuries or uninjured joints( you don't want to cut off distal CMS.)
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What is rule #4 for splinting?
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the splint should extend past 2 nearest uninjured joints distal and proximal to injury.
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What position is used to splint for the wrist or hand?
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The position of function.
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What is a fracture of the the proximal femur?
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Isolated midshaft femur fracture.
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What is compartment syndrome?
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Elevated pressure within a fascial compartment.
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