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21 Cards in this Set

  • Front
  • Back
What is definition of shock?
inadequate tissue perfusion
5 different types of shock?
Signs of shock?
pale, diaphoretic, cool skin
hypotension, tachycardia, tachypnea
decreased mental status and pulse pressure
poor capillary refill
poor urine output
What are the best indicators of tissue perfusion?
urine output and mental status
What labs help assess tissue perfusion?
pH from ABG
lactic acid levels
base deficit
What is definition of hypovolemic shock?
decreased intravascular volume
Common causes of hypovolemic shock?
bowel obstruction
crush injury
What are the signs of hypovolemic shock?
Early: orthostatic hypotension, mild tachycardia, anxiety, diaphoresis, vasoconstriction (lower pulse pressure)

Late: changed mental status, decreased BP, marked tachycardia
What is the treatment for hypovolemic shock?
1. stop bleeding
2. IV fluids (isotonic lactate ringer)
3. blood if needed
How do you check effectiveness of treatment?
urine output
heart rate
mental status
extremity warmth
capillary refill
What labs do you check to evaluate treatment?
base deficit
lactate level
Most common vital sign associated with hypovolemic shock?
What patients do not mount a normal tachycardic response to hypovolemic shock?
pts on beta blockers, spinal shock (no sympathetic tone), endurance athletes
Use vasopressors for hypovolemic shock?
How do you treat septic shock?
1. volume
2. antibiotics
3. drain infection
4. pressors PRN
What are lab findings in septic shock?
early: hyperglycemia/glycosuria, respiratory alkalosis, hemoconcentration, leukopenia

late: leukocytosis, acidosis, elevated lactic acid
Is it important to indentify the organism in septic shock?
Signs and sx of septic shock?
initial: vasodilation (warm skin and full pulses), normal urine output

delayed: vasoconstriction and poor urine output, mental status changes, hypotension
What is the definition of cardiogenic shock?
cardiac insufficiency
left ventricular failure (usually)

both lead to inadequate tissue perfusion
Causes of cardiogenic shock?
MI, papillary muscle dysfunction, massive cardiac contusion, cardiac tamponade, tension pneumothorax, cardiac valve failure
How do you treat cardiogenic shock?
1. CHF: diuretics and vasodilators, with or without pressors

2. LV failure (MI): pressors, afterload reduction