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36 Cards in this Set
- Front
- Back
- 3rd side (hint)
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The 4 main categories of shock are |
-cardiogenic -hypovolemic -distributive -obstructive |
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Cardiogenic Shock |
Occurs when either systolic or diastolic dysfunction of the hearts pumping action results in reduced cardiac output, stroke volume, and BP |
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Causes of cardiogenic shock |
-diastolic dysfunction (inability of the heart to fill) cardiac tamponade, ventricular hypertrophy, cardiomyopathy -dysrhythmias (bradydysrhythmias, tachydysrhythmias) -Structural factors (valvular stenosis,regurgitation, pneumothorax) -systolic dysfunction (MI, cardiomyopathy) |
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Hypovolemic shock types |
Absolute hypovolemia Relative hypovolemia |
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Absolute hypovolemia |
-external loss of whole blood (hemorrhage, surgery, GI, Bleeding ) -loss of other body fluids (vomiting, diarrhea, excessive diuresis, diabetes insipidus, diabetes ) |
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Relative hypovolemia |
-fluid shifts (burn injuries, scores) -internal bleeding (fracture of long bones, rupture spleen, hemothorax, severe pancreatitis) -massive vasodilation (sepsis) -pooling of blood or fluids (bowel obstruction) |
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Distributive shock |
-Anaphylactic -Neurogenic -Septic shock -Obstructive shock |
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Anaphylactic Shock |
Hypersensitivity (allergic) reaction to a sensitizing substance (contrast media, blood or blood products, inspect bites, anesthetic agents, food or food additives, vaccines, environmental agents, latex |
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Neurogenic shock |
-hemodynamic consequence of spinal cord injury and/or disease at or above T5 -spinal anesthesia -Vasomotor center depression |
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Septic shock |
-Infection (pneumonia, peritonitis, UTI, invasive procedures, in dwelling lines and catheters) -at-risk patients (older adults, patients with chronic diseases, patients receiving immunosuppressive therapy or who are malnourished or debilitated. |
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Obstructive shock |
-physical instruction impeding the filling or outflow of blood resulting in reduced CO (Cardiac tamponade, tension pneumothorax, superior vena cava syndrome, abdominal compartment syndrome, pulmonary embolism) |
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Relationship of shock SIRS ABD MOD |
Shock causes >SIRS causes > MOD |
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Cardiogenic shock |
Unable to keep up with physiological demands of the heart. Caused by pump failure |
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Distributive shock |
Loss vascular tone that leads to odd distribution of blood into the body. |
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HYPOVOLEMIC |
-the reduced intravascular pressure volume results in decreased venous return to the heart, decreased preload, decreased stroke volume, and decreased cardiac output. |
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Loss of 15-30% of volume leads to what? |
Increased HR, CO, and respiratory rate and depth. The patient will appear anxious, urine output will decrease |
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If fluid volume is greater than 30% loss in hypovolemia shock what should you do ? |
Replace with blood products immediately |
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DISTRIBUTIVE SHOCK : Neurogenic |
hemodynamic phenomenon that occurs within 30 minutes of a spinal cord injury and can last up to 6 weeks |
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DISTRIBUTIVE SHOCK : Neurogenic caused by what? |
Spinal cord injury associated with cervical and high thoracic injury. |
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DISTRIBUTIVE SHOCK : Neurogenic |
Vasodilation leads to pooling of blood in the blood vessels, tissues hypoperfusion, and impaired cellular metabolism |
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DISTRIBUTIVE SHOCK : Neurogenic (clinical manifestations) |
Hypotension and bradycardia. Patient will not be able to regulate temperature |
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DISTRIBUTIVE SHOCK : Anaphylactic shock |
Hypertensive allergic reaction that causes massive vasodilation, release of vasoactive mediators and an increase in capillary permeability. As capillarity permeability increases fluid leaks from the vascular space into the interstitial space |
What happens with anaphylactic shock |
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DISTRIBUTIVE SHOCK : Anaphylactic shock (signs/symptoms) |
The patient has a sudden onset of symptoms including dizziness, chest pain, incotinence, swelling of the lips and tongue, wheezing and stridor. Skin changes include flushing, purititus, urticaria and angioedema. |
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A feeling of impeding sense of doom, confusion and anxiousness are associated with which distributive shock ? |
Anaphylactic |
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DISTRIBUTIVE SHOCK : Septic shock |
Life-threatening syndrome in response to an infection. It is characterized by dysregulated patient response along with new organ dysfunction related to infection |
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What is septic shock characterized by ? |
Septic shock is characterized by persistent hypotension, despite adequate fluid resuscitation abs inadequate tissue percussion that results in tissue hypoxia. |
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What are the main organisms that cause septic shock ? |
Gram positive and gram negative bacteria |
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Which organism caused more complications in septic shock ? |
Gram positive |
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What is common with septic shock |
Respiratory failure |
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Common signs of septic shock |
-change in mental status -decreased urine output -gi dysfunction gi bleeding and paralytic ileus
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DISTRIBUTIVE SHOCK : Obstructive shock |
Developed when a physical obstruction to blood flow occurs with a decreased CO |
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Causes of Obstructive Shock |
Cardiac tamponade, pneumothorax, superior vena cabs syndrome, abdominal compartment syndrome pulmonary embolism |
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Signs/symptoms of obstructive shock |
-tachycardia -decreased bp -decreased preload -decreased CO -tacypnea -SOB -decreased urine output -cool, clammy skin -anxiety, confusion, agitation -decreased or absent bowel sounds |
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Stages of shock: initial |
Metabolism changes at the cellular level from aerobic to anaerobic causing lactic acid build up |
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STAGES OF SHOCK : compensatory stage |
The body tries to overcome the increasing consequences of anaerobic metabolism and maintain homeostasis |
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Signs/symptoms of the compensatory stage |
-Restlessness -SNS response release of epinephrine/norepinephrine -INCREASED HR -decreased blood flow to the lungs -decreased blood flow to all other organs except the heart |
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