Patho - Exam 3 Shock

Front 1

circulatory shock:

Back 1

-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

Front 2

What determines CO?

Back 2

stroke volume, preload, afterload, contractility

Front 3

What happens to CO during shock?

Back 3

-CO decreases and metabolic rate increases

Front 4

3 Stages of shock:

Back 4

1. compensatory
2. progressive
3. irreversible

Front 5

compensatory shock:

Back 5

-SNS stimulated
-vasoconstriction causing increase in BP
-increase in rate and depth of breathing (chemoreceptors)
-prevents cell damage

Front 6

progressive shock:

Back 6

-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

Front 7

3 classifications of shock:

Back 7

1. cardiogenic
2. hypovolemic
3. vasogenic (not cardiovascular)

Front 8

3 types of vasogenic shock:

Back 8

1. septic (causes severe vasodilation)
2. anaphylactic
3. neurogenic

Front 9

List 4 major complications of shock:

Back 9

1. ARDS
2. ARF
3. DIC
4. multiple organ failure

Front 10

Causes of cardiogenic shock:

Back 10

-most commonly due to MI
-compensatory mechanisms cause a decrease in CO and increase in myocardial oxygen demand

Front 11

Clinical effects of cardiogenic shock:

Back 11

-narrowing of pulse pressure
-peripheral vasoconstriction
-respirations become rapid and deep
-decrease in urinary output

Front 12

Tx of cardiogenic shock:

Back 12

1. thrombolytic agent (early)
2. + inotropic drugs
3. vasodilator
4. diuretics
5. IABP

Front 13

hypovolemic shock:

Back 13

-blood volume deficiency of 15-25% due to hemorrhaging or extensive 3rd degree burns
-blood volume lowers CO, body vasoconstricts, increases ADH

Front 14

hemorrhagic shock:

Back 14

-crystalloid and blood replacement as needed
-test with cap refill

Front 15

aka for cap refill:

Back 15

capillary blanch test

Front 16

Tx for hypovolemic shock

Back 16

1. control source of blood loss
2. fluid therapy-colloids, crystalloids, blood products
3. dopamine to restore BP

Front 17

types of septic shock:

Back 17

-bacteriemia, septicemia, septic shock
-mortality is 40-85%

Front 18

Who are mostly at risk for septic shock?

Back 18

infants, aged, immunosuppressed

Front 19

sources of sepsis:

Back 19

invasive procedures, surgery, invasive lines and catheters

Front 20

anaphylactic shock:

Back 20

overaction of the immune system

Front 21

neurogenic shock:

Back 21

depression of vasomotor center of the medulla
Ex. drug overdose

Front 22

Tx of anaphylactic/neurogenic shock:

Back 22

1. airway management-bronchodilators, intubation
2. fluid therapy
3. steroids
4. antihistamines