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22 Cards in this Set

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circulatory shock:
-failure of the heart to pump blood adequately
-imbalance btn O2 supply and O2 demand at the cellular level
-causes cellular hypoxia resulting in impairment of cells, tissues, organs and systems
What determines CO?
stroke volume, preload, afterload, contractility
What happens to CO during shock?
-CO decreases and metabolic rate increases
3 Stages of shock:
1. compensatory
2. progressive
3. irreversible
compensatory shock:
-SNS stimulated
-vasoconstriction causing increase in BP
-increase in rate and depth of breathing (chemoreceptors)
-prevents cell damage
progressive shock:
-unable to compensate
-cellular metabolism decreases causing a decrease in oxygen consumption
-edema as result of increase in capillary hydrostatic pressures
-arrhythmias as result of decrease of ATP
-glycolysis increases lactic acid causing metabolic acidosis
3 classifications of shock:
1. cardiogenic
2. hypovolemic
3. vasogenic (not cardiovascular)
3 types of vasogenic shock:
1. septic (causes severe vasodilation)
2. anaphylactic
3. neurogenic
List 4 major complications of shock:
1. ARDS
2. ARF
3. DIC
4. multiple organ failure
Causes of cardiogenic shock:
-most commonly due to MI
-compensatory mechanisms cause a decrease in CO and increase in myocardial oxygen demand
Clinical effects of cardiogenic shock:
-narrowing of pulse pressure
-peripheral vasoconstriction
-respirations become rapid and deep
-decrease in urinary output
Tx of cardiogenic shock:
1. thrombolytic agent (early)
2. + inotropic drugs
3. vasodilator
4. diuretics
5. IABP
hypovolemic shock:
-blood volume deficiency of 15-25% due to hemorrhaging or extensive 3rd degree burns
-blood volume lowers CO, body vasoconstricts, increases ADH
hemorrhagic shock:
-crystalloid and blood replacement as needed
-test with cap refill
aka for cap refill:
capillary blanch test
Tx for hypovolemic shock
1. control source of blood loss
2. fluid therapy-colloids, crystalloids, blood products
3. dopamine to restore BP
types of septic shock:
-bacteriemia, septicemia, septic shock
-mortality is 40-85%
Who are mostly at risk for septic shock?
infants, aged, immunosuppressed
sources of sepsis:
invasive procedures, surgery, invasive lines and catheters
anaphylactic shock:
overaction of the immune system
neurogenic shock:
depression of vasomotor center of the medulla
Ex. drug overdose
Tx of anaphylactic/neurogenic shock:
1. airway management-bronchodilators, intubation
2. fluid therapy
3. steroids
4. antihistamines