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21 Cards in this Set
- Front
- Back
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What is definition of shock?
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inadequate tissue perfusion
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5 different types of shock?
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hypovolemic
septic cardiogenic neurogenic anaphylactic |
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Signs of shock?
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pale, diaphoretic, cool skin
hypotension, tachycardia, tachypnea decreased mental status and pulse pressure poor capillary refill poor urine output |
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What are the best indicators of tissue perfusion?
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urine output and mental status
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What labs help assess tissue perfusion?
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pH from ABG
lactic acid levels base deficit |
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What is definition of hypovolemic shock?
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decreased intravascular volume
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Common causes of hypovolemic shock?
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hemorrhage
burns bowel obstruction crush injury pancreatitis |
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What are the signs of hypovolemic shock?
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Early: orthostatic hypotension, mild tachycardia, anxiety, diaphoresis, vasoconstriction (lower pulse pressure)
Late: changed mental status, decreased BP, marked tachycardia |
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What is the treatment for hypovolemic shock?
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1. stop bleeding
2. IV fluids (isotonic lactate ringer) 3. blood if needed |
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How do you check effectiveness of treatment?
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urine output
BP heart rate mental status extremity warmth capillary refill |
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What labs do you check to evaluate treatment?
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pH
base deficit lactate level |
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Most common vital sign associated with hypovolemic shock?
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tachycardia
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What patients do not mount a normal tachycardic response to hypovolemic shock?
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pts on beta blockers, spinal shock (no sympathetic tone), endurance athletes
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Use vasopressors for hypovolemic shock?
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NO
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How do you treat septic shock?
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1. volume
2. antibiotics 3. drain infection 4. pressors PRN |
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What are lab findings in septic shock?
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early: hyperglycemia/glycosuria, respiratory alkalosis, hemoconcentration, leukopenia
late: leukocytosis, acidosis, elevated lactic acid |
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Is it important to indentify the organism in septic shock?
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YES
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Signs and sx of septic shock?
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initial: vasodilation (warm skin and full pulses), normal urine output
delayed: vasoconstriction and poor urine output, mental status changes, hypotension |
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What is the definition of cardiogenic shock?
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cardiac insufficiency
left ventricular failure (usually) both lead to inadequate tissue perfusion |
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Causes of cardiogenic shock?
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MI, papillary muscle dysfunction, massive cardiac contusion, cardiac tamponade, tension pneumothorax, cardiac valve failure
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How do you treat cardiogenic shock?
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1. CHF: diuretics and vasodilators, with or without pressors
2. LV failure (MI): pressors, afterload reduction |
