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11 Cards in this Set

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Cardiogenic Shock
Shock caused by insufficient cardiac output; inability of the heart to pump enough blood to perfuse all parts of the body.
Causes of Cardiogenic Shock
Most commonly caused by severe left ventricle failure secondary to AMI or CHF. Reduced bp decreased coronary artery perfusion, heart muscle becomes more damaged thus establishing a viscious cycle resulting in complete pump failure.
Ejection Fraction
The percentage of blood in the ventricle that is ejected with each beat
Why would a pt. in Cardiogenic Shock be hypovolemic?
Some pt. may become hypovolemic from the vasodilatory effects of nitroglycerin, and or the severe diaphoresis that accompanies some acute cardiac events.
Treatment of Cardiogenic Shock
Assure open airway, administer O2 and assist ventillations if necessary.

Keep pt. warm. Elevate pt. head and shoulders so that gravity can isolate fluid to assist in O2 exchange in the alveoli.
IV with NaCl TKO established.
HR monitor.
Administer Atropine (bradycardia), AED (V-Fib).
Dopamine to elevate bp.
Hypovolemic Shock
Shock caused by a loss of intravascular fluid volume.
Causes of Hypovolemic Shock
Internal-External Hemmorhage
Traumatic Injury
Long Bone/ Open Fx.
Severe dehydration (Vomiting/Diarrhea)
Burns
Diaphoresis
DKA with resultant osmotic diuresis
3rd Space loss
Osmotic Diuresis
Greatly increased urination and dehydration due to high levels of glucose that cannot be reabsorbed into the blood from the kidney tubules, causing a loss of water into the urine. (Polyuric)
3rd Space Loss
Loss from intracellular or, more commonly, from intravascular spaces into the interstitial spaces. Can occur with bowel obstruction, peritonitis, pancreatitis, liver failure resulting from ascites.
Signs of Hypovolemic Shock
Altered Mental Status: progressing from anxiety to lethargy or combativeness to unresponsiveness.
Pale, Cool Clammy (sweaty). Bp may be normal but then begins to fall. Puls normal, then rapid, finally slow to absent. Unination decreases. Cardiac dysrhythmia to finally asystole.
Treatment of Hypovolemic Shock
Administer fluid only enough to maintaina systolic bp between 70 and 85 mmHg. "permissive Hypotension". Lactated Ringers or NaCl. <40mmHg should still receive aggressive fluid resuscitation.