122 medical

Question 1

Hemorrhagic hypovolemic shock:

Answer 1

results from the loss of whole blood from the intravascular space→ leads to decrease in profusion from a reduction in pressure/decrease in 02 carrying capabilities of the blood

Question 2

Non Hemorrhagic hypovolemic shock:

Answer 2

caused by the shift of fluid out of the intravascular space but when red blood cells and hemoglobin remain within the vessel. Mainly water, plasma proteins, and electrolytes that are lost→ reduces blood volume/pressure/perfusion of cells

Question 3

Distributive shock:

Answer 3

caused by a decrease in intravascular volume caused by massive systemic vasodilation/increase in capillary permeability
Massive systemic vasodilation: relative reduction in volume -is inadequate to fill increased vessels

Question 4

Cardiogenic shock:

Answer 4

caused by ineffective pump function of the heart
In heart attack/CHF/abnormal heart rhythm, patients heart is unable to make generate enough force to eject sufficient blood from chamber into systemic circulation
Stroke volume and cardiac output are reduced

Question 5

Obstructive shock:

Answer 5

result from a conduction that obstructs forward blood flow→
Large clots in lungs can prevent blood from getting to the left atrium/left ventricle → as well as pulmonary embolism. Tension pneumothorax and tamponade

Question 6

Metabolic/Respiratory Shock:

Answer 6

dysfunction in the availability of O2 to diffuse into the blood- carried by hemoglobin- and off load at the cell, or be used by cell for metabolism
Certain poisons like cyanide interfere with the cells ability to use oxygen

Question 7

Burn shock:

Answer 7

specific form of nonhemorrhagic shock resulting from a burn. Burns interrupt the integrity of capillaries and vessels→ when a vessel is damages, it become permeable and allows the plasma proteins to leak out and collect in the interstitial space→ once out the plasma can not return inside the cell
Loss of fluid and plasma oncotic pressure leads to edema

Question 8

Anaphylactic shock:

Answer 8

distributive shock reaction→ causes massive and systemic vasodilation/capillaries to become permeable and to leak→ decrease of BP and perfusion→ EPINEPHRINE is the medicine used for anaphylactic shock

Question 9

Septic shock:

Answer 9

distributive shock reaction→ results from sepsis which is an inflammatory response to infection that causes the vessels throughout the body to dilate and become permeable→ fluid leaks out into vessels into interstitial space→ shock is caused by massive vasodilation, which reduces systemic vascular resistance/blood pressure/profusion

Question 10

Neurogenic shock:

Answer 10

distributive shock: can be a response to a spinal cord injury→ may damage the sympathetic nerve fibers that control vessel tone below level of injury→ causes vessels to dilate, drop in systemic vascular resistance, blood pressure and perfusion

Question 11

Cardiogenic shock:

Answer 11

due to an acute myocardial infraction/heart attack, CHF, overdose

Question 12

Bodies response to shock:

Answer 12

body attempts to compensate for disturbance/return the perfusion and tissue function to normal state
When there is a reduction in blood volume or pump function, cardiac output decreases→ pressure in aorta/carotid arteries decrease, resulting in reduction in stretch or tension in arterial walls→ baroreceptors sense reduction and tigger compensatory mechanisms

Question 13

The compensatory mechanisms initiated when shock occurs are

Answer 13

1. Direct sympathetic nerve stimulation→ 2. Hormone release
   During shock, sympathetic system stimulates primarily the vessels and heart to restore blood pressure in arteries→ the effects of this are the following
   Increase in heart rate→ increase in force of stroke volume( ventricular contraction)–> vasoconstriction→ stimulation of release of epi/norepinephrine from adrenal gland
   Direct sympathetic nerve stimulation immediately releases hormones, epinephrine and norepinephrine→ alpha 1,2, and beta 1,2 are stimulated→ alpha r

Question 14

During shock, sympathetic system stimulates primarily the vessels and heart to restore blood pressure in arteries→ the effects of this are the following

Answer 14

Increase in heart rate→ increase in force of stroke volume( ventricular contraction)–> vasoconstriction→ stimulation of release of epi/norepinephrine from adrenal gland
Direct sympathetic nerve stimulation immediately releases hormones, epinephrine and norepinephrine→ alpha 1,2, and beta 1,2 are stimulated→alpha release causes vasoconstriction, and beta effects increase of heart rate/forces contractions

Question 15

Compensatory shock:

Answer 15

pressure in aorta/carotid decreases→ arterial wall tension reduces→ triggers baroreceptors to send decreased signals to hypothalamus→ hypothalamus activates organ/gland stimulation which increase blood pressure restore arterial wall tension
Body is able to maintain near-normal blood pressure/perfusion to vital organs
Blood is shunted away from non-vital areas
Pulse pressure may be narrowed

Question 16

Decompensated shock:

Answer 16

in advanced stage of shock where body can no longer maintain blood pressure and perfusion of major organs→ if not managed these compensatory methods become exhausted and lead to failure
Anaerobic metabolism occurs
Vital organs are not being perfused

Question 17

Wheezing:

Answer 17

high pitched whistling sounds→ indication of swelling/constriction of inner lining of the lower airways- specifically the bronchioles

Question 18

Rhonchi:

Answer 18

coarse crackles, snoring or rattling noise→ indication of the larger conducting airways of the respiratory tract- typically fluid/mucous

Question 19

Crackles/rales:

Answer 19

bubbly or crackling sound→ indication of fluid in alveoli or bronchioles

Question 20

Emphysema:

Answer 20

CPAP
decreased surface area of the alveoli→ disrupting gas exchange
Lung tissue loses elasticity

Question 21

Chronic bronchitis: n

Answer 21

cpap
Mucous/ swelling in the bronchi/bronchioles leading to alveoli
Reduced lung ventilation w/ increased lung perfusion

Question 22

Asthma:

Answer 22

increased sensitivity of lower airways leads to narrowing of bronchioles
Bronchospasm
Edema of the airways
Increased mucus production

Question 23

Pneumonia:

Answer 23

CPAP and beta2
Acute infectious disease of the lower respiratory tract
Causes lung inflammation or fluid/pus filled alveoli
Leads to ventilation disturbances or poor gas exchange

Question 24

Pulmonary embolism:

Answer 24

Obstruction of blood flow in pulmonary arteries
Caused by blood clots
Suspect embolism in patients who: have unexplained dyspnea and chest pain to a specific place and signs of hypoxia but w/ normal breath sounds

Question 25

Acute Pulmonary edema:

Answer 25

Often due to cardiac dysfunction Results in hypoxia Occurs when excessive fluid collects between alveoli and pulmonary capillaries Gas exchange is impaired

Question 26

Signs/assessment: Acute pulmonary edema

Answer 26

Crackles are a sign of pulmonary edema Auscultate lower lobes CPAP Keep patient upright

Question 27

Spontaneous pneumothorax: causes

Answer 27

sudden rupture of visceral lining of lung with with partial collapse of lung-- occur w/ no underlying lung disease Gas exchange is impaired caused by: weakened area of lung tissue/ruptured bleb

Question 28

Cystic Fibrosis:

Answer 28

a hereditary disease where there is overabundant mucus lines the respiratory system

Question 29

Atherosclerosis --

Answer 29

Atherosclerosis- Inflammatory disease that affects the arteries- starts in the innermost lining of the blood vessel where endothelial cell become damaged May eventually lead to a development of a thrombus or plaque build up and occlusion of the vessel Atherosclerosis of the coronary vessel is called coronary artery disease (CAD)

Question 30

Arteriosclerosis

Answer 30

Condition that causes the smallest of the arterial structures to become stiff and less elastic→ commonly referred to as “hardening of the arteries”

Question 31

Acute coronary syndrome:

Answer 31

Includes unstable angina and myocardial infarction Narrowed arteries lead to myocardial ischemia Typical response to MI ischemia is chest discomfort

Question 32

Aortic aneurysm:

Answer 32

Weakened area of the aortic wall dilates Rupture may occur Often in abdominal region

Question 33

Aortic Dissection:

Answer 33

Blood enters a tear in the inner lining of the aorta and separates the layers of wall Often occurs in thoracic region\

Question 34

Dystonia-

Answer 34

involuntary contraction of the muscles