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60 Cards in this Set
- Front
- Back
PRE-LOAD
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AMOUNT OF BLOOD AVAILABLE TO FILL THE VENTRICLES. END DIASTOLIC VOLUME, END DIASTOLIC PRESSURE
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HOW MUCH BLOOD VOLUME IS HELD IN THE VENOUS SYSTEM
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64%
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FRANK-STARLING-MECHANISM
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GREATER THE PRE-LOAD=GREATER THE STRETCH=GREATER THE FORCE OF CONTRACTION
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AFTER-LOAD
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RESISTANCE OR PRESSURE THE VENTRICLES CONTRACT OR PUMP AGAINST
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CARDIAC OUTPUT
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AMT OF BLOOD PUMPED IN ONE MINUITE, C.O.=S.V. X RATE
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STROKE VOLUME
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BLOOD EJECTED IN ONE CONTRACTION
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BLOOD PRESSURE
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PERIPGERAL VASCULAR RESISTANCE (AFTERLOAD) B/P=C.O. X P.V.R.
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HOW DOES THE BODY COMPENSATE FOR BLOOD LOSS
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BARORCEPTORS-SNS NERVES-ADRENAL MEDULA-NE AND EPINEPHRINE RELEASED-VASOCONSTRICTION-SVR AND PRELOAD INCREASE
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HOW MUCH BLOOD VOLUME DO ARTERIES CONTAIN
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13%
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HOW MUCH BLOOD VOLUME DO CAPILLARIES CONTAIN
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7%
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HOW MUCH BLOOD CAN THE VENULES COMPENSATE FOR
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500-1000 ML BLOOD LOSS, 15-20% OF VOLUME
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AEROBIC METABOLISM
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1.GLUCOSE BREAKDOWN YIELDS PYRUVIC ACID, 2.PYRUVIC ACID ENTERS THE KREB OR CITRIC ACID CYCLE, 3.PYRUVIC ACID IS DEGRATED TO CO2,H2O,ENERGY
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ANAEROBIC METABOLISM
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1.GLYCOLYSIS OCCURS AND PYRUVIC ACID IS PRODUCED, 2.PYRUVIC ACID DOES NOT ENTER KREB OR CITRIC ACID CYCLE, 3.PYRUVIC ACID DEGRADES INTO LACTIC ACID AND SMALL AMOUNT OF ENERGY
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INADEQUATE PERFUSION LEADS TO:
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BARORECEPTORS NOT BEING STRETCHED-STROKE VOLUME DECREASED-CNS ALERTED
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RENIN
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RELEASED FROM KIDNEYS DUE TO LOW PRESSURE. RENINACTS AS AN ENZYME TO CONVERT PLASMA PROTIEN ANGIOTENSIN TO ANGIOTENSIN 1 WICH IS CONVERTED TO ANGIOTENSIN 2 BY ANGIOTENSIN-CONVERTING ENZYME
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ANGIOTENSIN 2
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STIMULATES VASOCONSTRICTION THAT LAST ABOUT ONE HOUR, AND PRODUCES ALDOSTERONE
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ALDOSTERONE
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CAUSES KIDNEYS TO REABSORB Na+, REDUCES Na+/H2O LOSS FROM SWEATING AND GI TRACT=INTRAVASCULAR VOLUME MAINTAINED
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POSTERIOR PITUITARY GLAND
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STIMULATED BY HYPOTHALAMUS WHEN BP IS LOW, THE GLAND RELEASES ADH WICH CAUSES KIDNEYS TO REABSORBE Na=FLUID VOLUME MAINTAINED
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SPLEEN
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STORES 300 ML OF BLOOD IN VENOUS SINUS, DROP IN PRESSURE=SNS STIMULATES CONSTRICTION OF SINUS=UP TO 200ML ADDED TO CIRCULATION
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WHAT % BODY FLUID IS IN INTERSTITIAL SPACE
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88%
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EYRTHROPOIETIN
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RELEASED BY KIDNEYS IN RESPONSE TO HYPOXIA, ANEMIA ECT. CAUSES INCREASE PRODUCTION AND MATURATION OF RBC. CAN INCREASE BY 10 OVERTIME
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COMPENSATED SHOCK HEART-
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INCREASES RATE AND FORCE OF CONTRACTIONS
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COMPENSATED SHOCK BLOOD VESSELS-
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CONSTRICT=BP MAINTAINED
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COMPENSATED SHOCK SKIN-
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GETS COOL, CLAMY, PALE
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COMPENSATED SHOCK RESPIRATIONS-
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INCREASE TO GET RID OF CO2 AND INCREASE O2
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COMPENSATED SHOCK URINARY SYSTEM-
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PITUITARY RELEASES ADH/ADRENAL CORTEX RELEASES ALDESTRONE=DECREASED URINATION=MAINTAIN FLUID VOLUME
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COMPENSATED SHOCK GI SYSTEM-
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DIGESTION SLOWES DUE TO DECREASES BLOOD FLOW AND DECREASED GUT MOBILITY
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DECOMPENSATED SHOCK
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AKA:PROGRESSIVE SHOCK, MEDICAL INTERVENTION MAY STILL HELP, BODT CAN NO LONGER COMPENSATE, HEART NO LONGER PERFUSED VESSELS DIALATE=BP DROBS
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IRREVERSABLE SHOCK
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SELF NOR MEDS CAN CORRECT CONDITIONMULTIPLE ORGAN DISFUNCTION SYNDROME DUE TO MICRO EMBOLI, MASSIVE RELEASE OF NEURTROPHILS
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HEART, LUNGS, BRAIN CAN LIVE
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4-6 MIN WITH OUT O2
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LIVER, KIDNEYS, GI TRACT CAN LIVE
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45-60 MIN WITH OUT O2
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MUSCLE, SKIN, BONE CAN LIVE
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2-3 HOURS WITH OUT O2
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HYPOVOLEMIC SHOCK
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FLUID LOSS CAUSED BY HEMORRHAGE, BURNS, DEHYDRATION
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IF FLUID LOSS IS NONTRAUMATIC OR PT IS NOT SHOWING SIGNS OF SHOCK YOU SHOULD
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TAKE ORTHOSTATIC VITALS, POS. IF PULSE INCREASE OR BP DECREASES 10-20 = 500-1000 CC LOST
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CAPILLARY BLEEDING=
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OOZES, CLOTS QUICKLY,BRIGHT RED
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VENOUS BLEEDING=
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FLOWS STEADY, DARK RED
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ARTERIAL BLEEDING=
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RAPID, SPURTING, BRIGHT RED
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HEMOSTASIS VASCULAR PHASE
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VESSSEL CUT-SMOOTH MUSCLES AROUND VESSEL CONTRACT-REDUCING LUMEN SIZE AND BLOOD FLOW, SUSTAINED FOR UP TO 10 MIN. MAY NOT WORK IF CUT NOT CLEAN
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HEMOSTASIS PLATLET PHASE
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1-5 SEC. POST INJURY, PLATLETS STICK TO COLLAGEN-PLATLETS STICK TO PLATLETS-RAPID CONTROL BUT CLOTS ARE UNSTABLE
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HEMOSTASIS COAGULATION PHASE
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DISRUPTION OF INTIMA EXPOSES COLLAGEN AND OTHER PROTEINS- THIS LEADS TO COAGULATION, IN 3-6 MIN. VESSES IS FILLED
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WHAT MEDS. LOWER COAGULATION PHASE
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COUMADIN, HEPARIN, FIBRONOLYTICS
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STAGE 1 BLEEDING
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NO RESPONSE, LOSS OF <15% VOLUME, 500-700 ML,
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STAGE 2 BLEEDING
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COMPENSATED, 15-25% LOSS OF VOLUME, 750-1,250 ML, TACHYCARDIC, NARROWING BP, COOL&CLAMMY, RESTLESS, THIRST
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STAGE 3 BLEEDING
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DECOMPENSATED, 25-35% LOSS, 1,250-1,750 ML, TACHYCARDIC, BP DROPSPULSE BARELY PALPABLE, ANXIETY, LOC DECREASE, COOL, PALE, LOW URIN OUTPUT
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STAGE 4 BLEEDING
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>35% LOSS, 2,000 ML, PULSE BARLEY PALPABLE, RR SHALLOW, UNRESPONSIVE, SKIN COLD-MOTTLED, URIN CEASES, SURVIVLE UNLIKELY
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PREGNANT WOMEN HAVE
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50% MORE VOLUME, MAY NOT HAVE EARLY SIGNS
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ATHLETES HAVE
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MORE VOLUME AND CARDIAC NERVES, MAY MOVE SLOWER THROUGH STAGES
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OBESE PATIENTS HAVE
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LESS VOLUME, SMALL LOSS MAY BE SERIOUS
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INFANTS AND CHILDREN HAVE
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20% MORE VOLUME THAN ADULTS, CAN COMPENSATE WELL-CRASH QUICKLEY
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ELDERLY HAVE
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LOWER VOLUME RESERVES, COMPENSATORY SYSTEMS LESS RESPONSIVE, LOWER PAIN PERCEPTIONS/MENTAL ACUITY
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NEUROGENIC SHOCK
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OCCURS AFTER SPINAL INJURY, CORD CUT BELLOW C-5= PHRENIC NERV INTACT=DIAPHRAGMATIC BREATHING
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ANAPHYLACTIC REACTION
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EXTREME SYSTEMIC REACTION, MASSIVE DUMPUNG OF HISTAMINE, PT HAVE SENSE OF IMPENDING DOOM
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ANAPHYLACTIC SHOCK
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COMPRISED OF HYPOVOLEMIC, CARDIOGENIC, NEUROGENIC, RESPIRATORY SHOCK, PT DIES FROM CIRCULATORY, RESPIRATORY FAILURE
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SEPTIC SHOCK
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PT HAVE HISTORY OF ILNESS/INFECTION, PT HAS HIGH FEVERS, PALE, INFECTS LUNGS, BRAIN
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CARDIOGENIC SHOCK
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DUE TO POOR CONTRACTILITY, AMI, USUALY RESULTS WHEN 40% OR MORE OF LEFT VENTRICLE IS DAMAGED, MORTALITY RATE OF 80-90%
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MULTIPLE ORGAN DYSFUNCTION SYNDROME
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due to irreversable shock,ischemia and infection of organs
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WHAT IS TACHY PULSE RATE DUE TO HYPOVOLEMIA
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>100-ADULTS, >120-SCHOOL AGE, >140-PRESCHOOLER, >160-INFANTS
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WHAT BP IS USUALY SUFFICIENT TO MAINTAIN LOC
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88-100 mmHg
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CONTRAINDICATIONS OF PASG
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ABSOLUTE-PULMONARY EDEMA, CARDIOGENIC SHOCK, RELATIVE-PREGNANCY, EVISCERATION, IMPALED OBJECT IN ABD, SUSPECTED DIAPHRAGMATIC RUPTURE, DO NOT INFLATE UNLESS BP <90 OR LOSS OF PULSES
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IV COMPLICATIONS
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PYROGENIC REACTION, CATHETER SHEAR, ARTERIAL PUNCTURE, CIRCULATORY OVERLOAD, THROMBOPHLEBITIS, AIR EMBOLISM, PAIN, HEMATOMA, INFILTRATION, LOCAL INFECTION
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