EXAM 2 Shock

Question 1

Shock is a __ characterized by decreased or impaired __ __. This leads to inadequate delivery of __ and __ to support vital organs. The cause and initial presentation of various types of shock may differ but they have the same physiological responses of cells to ___. The treatment strategies are different for each type of shock.

Answer 1

syndrome; tissue perfusion
oxygen; nutrients

hypoperfusion

Question 2

Shock can be classified as __ __ __ or __ __

Answer 2

low flow shock ; distributive shock

Question 3

Low flow shock has a __ __ __.

List the types of shock that are low flow shock.

Answer 3

decreased cardiac output

hypovolemic shock
cardiogenic shock

Question 4

Distributive shock is normal __ of __ __, but the __ __ is __ to other areas
List the types of shock that are distributive shock.

Answer 4

increase; cardiac output; cardiac output; distributed

anaphylactic shock
septic shock
neurogenic shock

Question 5

Hypovolemic Shock
Mechanism:
Specific Causes:

Answer 5

Loss of blood or plasma

Hemorrhage 
Burns 
Dehydration
Peritonitis
Pancreatitis

Question 6

Cardiogenic Shock
Mechanisms:
Specific Causes:

Answer 6

decreased pumping capability of the heart

myocardial infarction of left ventricle
cardiac arrhythmia
pulmonary embolus
cardiac tamponade

Question 7

Vasogenic or Neurogenic or Distributive Shock
Mechanisms:
Specific Causes:

Answer 7

Vasodilation owing to loss of sympathetic and vasomotor tone

Pain and fear
Spinal cord injury
Hypoglycemia (insulin shock)

Question 8

Anaphylactic Shock
Mechanisms;
Specific Causes:

Answer 8

Systemic vasodilation and increased permeability owing to severe allergic reaction

Inset stings
Drugs
Nuts
Shellfish

Question 9

Septic (endotoxic) Shock
Mechanisms:
Specific Causes:

Answer 9

Vasodilation owing to severe infection, often with gram-negative bacteria

Virulent microorganisms (gram-negative bacteria) or multiple infections

Question 10

Most manifestations of shock are __ regardless of what starts the process or which tissues are affected

Answer 10

similar

Question 11

These common manifestations result from physiologic adjustments or compensatory mechanisms in the attempt to ensure continued __ of vital organs
These adjustment actions are performed by:
1.
2.

Answer 11

oxygenation

Sympathetic Nervous system
RAAS

Question 12

RAAS - increased __ __ in response to lower blood pressure

Answer 12

ADH secretion

Question 13

B/c vital organs are not being perfused, you can have __ and __

Answer 13

lethargy; weakness

Question 14

The cells do not have enough O2 to perform aerobic respiration therefore they perform __ __ which leads to a buildup of __ __ and can cause __ __

Answer 14

anaerobic respiration
lactic acid
metabolic acidosis

Question 15

Early clinical manifestations of shock include (1)

- b/c ___ stimulates sympathetic nervous system to stimulate the body’s __ or __ __

Answer 15

1. anxiety and restlessness
   hypotension
   fight/flight response

Question 16

Compensatory mechanisms include: 
1. 
2.
3.
4.
5.

Answer 16

1. Tachycardia which is a sympathetic nervous system’s response to stimulate the heart to work a little harder to increase cardiac output
2. Cool, pale moist skin
3. Oliguria- b/c of renal vasoconstriction and renin mechanism
4. Thirst
5. Rapid respirations due to anaerobic metabolism that leads to metabolic acidosis

Question 17

Some progressive manifestations include: 
1.
2.
3.
4.

Answer 17

lethargy
weakness
faintness (b/c of decreased blood flow and cardiac output)
metabolic acidosis b/c of anaerobic metabolism

Question 18

Hypovolemic shock: 
You have a loss of \_\_ \_\_ \_\_. This can come from: 
1.
2.
3.
4.

Answer 18

intravascular fluid volume

1. Hermorrhage
2. GI loss from n/v
3. Drainage from a fistula or wound
4. Diuresis (increased or excessive production of urine )

Question 19

With hypovolemic shock, blood volume is insufficient to meet ____ demand of tissues

Answer 19

metabolic