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16 Cards in this Set
- Front
- Back
What is shock?
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when not enough O2 and nutrients meet tissue metabolic demand; sometimes, but not always when there is inadequate peripheral and end-organ perfusion
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What blood pressure and cardiac output is associated with shock?
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all can be, normal, increased, decreased; cardiac output is usually low, but can be high
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Define the four types of shock, hypovolemic, cardiogenic, distributive, and obstructive
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1.) hypovolemic: not enough blood volume or oxygen-
carrying capacity 3.) inappropriate distribution of blood volume and flow 2.) impaired cardiac contractility 4.) obstructed blood flow |
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What is the pathophysiology of shock?
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When O2 delivery is not enough to meet tissue demand, cells will use anaerobic metabolism for energy, making lactic acid as a by-product, which can only keep a cell going for so long, so if O2 delivery is not reinstilled organ failure occurs
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What is the formula for cardiac output?
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stroke vol(volume of blood pumped per beat) X HR(beats/min)
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Why are infants dependent on an adequate HR?
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because they're stroke volume is so small that HR must be higher to maintain the necessary CO; as the child develops, the heart is more able to increase stroke volume
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What is adequate distribution dependent on?
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size of blood vessels since each determines the vascular resistance
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What is the most common cause of low cardiac output?
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low stroke volume, or inadequate preload which can lead to hypovolemic shock
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What is the cause of cardiogenic shock?
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"of the heart" meaning that muscle of the heart is the issue...so most commonly, poor contractility, less commonly, increased afterload
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What is the main method of treating cardiogenic shock?
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reducing afterload because it essentially reduces CO, which then causes blood vessels to vasoconstrict to maintain adequate blood flow to organs, all the while causing resistance to output
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What are the four compensatory mechanisms of shock that occur in order and what is the physiology behind them?
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1.) tachycardia- initially HR increases to maintain CO, but eventually SV cant keep up, so perfusion of tissues is compromised
2.) increase SVR- selective vasoconstriction happens to divert blood to vital organs causing a decrease in peripheral perfusion and to the gut and kidneys so as to decrease urine output 3/4.) Contractility increases so ventricles completely empty, also venous blood return increases to increase preload and improving venous return to the heart |
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What is the formula for blood pressure?
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Cardiac Output(CO) x SVR
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How is blood pressure effected in children?
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SVR increases when CO decreases so BP actually stays normal, initially
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What is pulse pressure and what happens during shock in kids?
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difference between systolic and diastolic BP that is usually narrowed because SVR increases diastolic blood pressure; if SVR is low, then pulse pressure widens
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What is the most common tachyarrythmia that causes cardiovascular compromise during pregnancy?
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SVT, because it starts and stops randomly
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What are effects that SVT has on ABCDE?
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A.) nothing
B.) Tachypnea, increased work of breathing, crackles and grunting if CHF C.) Tachy, delayed cap refill, weak peripheral pulses, cool ext, , diaphortic, hypotension, JVD D.) AMS, lethargy, irratibility E.) check temp last |