Chapter 12- Shock Flashcards

1
Q

What regulates blood flow through the capillary beds?

A

Capillary sphincters

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2
Q

Perfusion

A

Circulation of blood within an organ or tissue in adequate amounts to meet cells current needs for oxygen, nutrients, and waste removal

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3
Q

Pulse pressure

A

The difference between the systolic and diastolic pressures (systolic - diastolic= pulse pressure.

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4
Q

What is in control of the capillary sphincters?

A

Autonomic nervous system

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5
Q

3 causes of shock

A

Pump failure
Poor vessel function
Low fluid volume

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6
Q

Pump failure can lead to what kind of shock?

Give some examples of what can cause this

A

Cardiogenic shock, obstructive shock

  • tension pneumothorax
  • cardiac tamponade
  • pulmonary embolism
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7
Q

What kind of shock does poor vessel function fall under?

What are some causes of poor vessel function?

A

Distributive shock

  • infection
  • drug overdose (narcotic)
  • spinal cord injury
  • anaphylaxis
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8
Q

Edema

A

Presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.

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9
Q

Cardiogenic shock

A

Caused by inadequate function of the heart, or pump failure

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10
Q

The ability for the heart to contract is…

A

Myocardial contractility

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11
Q

Obstructive shock

A

Caused by a mechanical obstruction which prevents an adequate volume of blood to fill the heart chambers.

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12
Q

Pericardial effusion

A

A collection of fluid between the pericardial sac and the myocardium

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13
Q

Impaired ventricular filling from a pericardial effusion causes…

A

Cardiac tamponade

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14
Q

Pulmonary embolism

A

A blood clot that occurs in the pulmonary circulation and blocks the flow of blood through the pulmonary vessels.

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15
Q

Distributive shock

A

Results when there is widespread dilation fo the small arterioles, small venues, or both

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16
Q

Septic shock

A

Occurs as a result of severe infections, usually bacterial, in which toxins (poisons) are generated by the bacteria or by infected body tissues.

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17
Q

Neurogenic shock

A

Usually a result of high spinal cord injury. When there is injury to the nervous system which results in the loss of control size of the muscular tone of the blood vessels.

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18
Q

Anaphylactic shock (Anaphylaxis)

A

Occurs when a person reacts violently to a substance to which he or she has bee sensitized

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19
Q

What does sensitization mean?

A

Becoming sensitive to a substance that did not initially cause a reaction.

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20
Q

Cyanosis

A

Blue discoloration of the skin

21
Q

Psychogenic shock

A

Sudden reaction of the nervous system that produces a temporary, generalized vascular dilation, resulting in fainting

22
Q

Syncope

A

To faint

23
Q

Hypovolemic shock

A

Results of an inadequate amount of fluid or volume in the circulatory system

24
Q

Skin during anaphylactic shock

A
  • flushed, itchy, or burning
  • urticaria (hives)
  • edema
  • pallor
  • cyanosis
25
Q

Circulatory system during anaphylactic shock

A
  • dilated peripheral blood vessels
  • increased vessel permeability
  • drop in blood pressure
  • weak, barely palpable pulse
26
Q

Respiratory system during anaphylactic shock

A
  • sneezing or itching of nose
  • strider
  • upper airway obstruction
  • tightness in the chest with dry cough
  • wheezing and difficulty breathing (dyspnea)
  • constriction of the bronchi, difficulty breathing
  • forced expiration accompanied by wheezing
  • cessation of breathing
27
Q

Other signs and symptoms of anaphylactic shock

A
  • abdominal cramping
  • nausea
  • vomiting
  • altered mental status
  • dizziness
  • fainting and coma
28
Q

You should expect a patient to be in shock if he has any one of these:

A
  • multiple severe fractures
  • abdominal or chest injury
  • spinal injury
  • a severe infection
  • a major heart attack
  • anaphylaxis
29
Q

Compensated shock

A

Early stage of shock, when the body can still compensate for blood loss

30
Q

Decompensated shock

A

Late stage of shock, when blood pressure is falling

31
Q

Signs and symptoms of compensated shock

A
  • agitation
  • anxiety
  • restlessness
  • feeling impending doom
  • altered mental status
  • weak, rapid, or absent pulse
  • clammy skin (pale, cool, moist)
  • pallor, with cyanosis about the lips
  • shallow, rapid breathing
  • shortness of breath
  • nausea or vomiting
  • capillary refill of longer than 2 seconds in infants and children
  • marked thirst
  • narrowing pulse pressure
32
Q

Signs and symptoms for decompensated shock

A
  • falling blood pressure (systolic pressure of 90 or lower in adult)
  • labored or irregular breathing
  • cyanotic skin
  • thready or absent peripheral pulses
  • Dull eyes, Diana Ted pupils
  • Poor urinary output
33
Q

Signs and symptoms fo cardiogenic shock

A
  • chest pain
  • irregular pulse
  • weak pulse
  • low blood pressure
  • cyanosis
  • cool, clammy skin
  • anxiety
  • crackles (rales)
  • pulmonary edema
34
Q

Treatment for cardiogenic shock

A
  • position comfortably and administer high-flow oxygen
  • assist ventilations
  • transport promptly
  • consider ALS
35
Q

Signs and symptoms for obstructive shock

A
  • Dyspnea
  • rapid, weak pulse
  • decreased lung compliance
  • unilateral, decreased, or absent breath sounds
  • decreased blood pressure
  • jugular vein distention (JVD)
  • subcutaneous emphysema
  • cyanosis
  • tracheal deviation toward unaffected side
36
Q

Treatment for obstructive shock

A
  • ALS assist and/or rapid transport

- administer high-flow oxygen

37
Q

Signs and symptoms of septic shock

A
  • warm skin or fever
  • tachycardia
  • low blood pressure
38
Q

Treatment for septic shock

A
  • transport promptly and administer high-flow oxygen
  • assist ventilations
  • keep patient warm
  • consider ALS
39
Q

Signs and symptoms for neurogenic shock

A
  • bradycardia
  • low blood pressure
  • signs of neck injury
40
Q

Treatment for neurogenic shock

A
  • secure airway
  • spinal immobilization
  • assist ventilations with high-flow oxygen
  • preserve body heat
  • transport promptly
  • consider ALS
41
Q

Signs and symptoms for anaphylactic shock

A
  • can develop within seconds
  • itching or rash
  • burning skin
  • vascular dilation
  • generalized edema
  • coma
  • rapid death
42
Q

Treatment for anaphylactic shock

A
  • manage the airway
  • assist ventilations and administer high-flow oxygen
  • determine cause
  • assist with administration of epinephrine
  • transport promptly
  • consider ALS
43
Q

Signs and symptoms for psychogenic shock

A
  • rapid pulse

- normal or low blood pressure

44
Q

Treatment for psychogenic shock

A
  • determine duration of unconsciousness
  • position patient supine
  • record initial vital signs and mental status
  • suspect head injury if patient is confused or slow to regain consciousness
  • transport promptly
45
Q

Signs and symptoms for hypovolemic shock

A
  • rapid, weak pulse
  • low blood pressure
  • change in mental status
  • cyanosis
  • cool clammy skin
  • increased respiratory rate
46
Q

Treatment for hypovolemic shock

A
  • secure airway
  • assist ventilations and administer high-flow oxygen
  • control external bleeding
  • keep warm
  • transport promptly
  • consider ALS
47
Q

Aneurysm

A

Swelling or enlargement of a part of an artery, resulting from weakening of arterial wall

48
Q

Autonomic nervous system controls what?

A

Involuntary activities of the body such as heart rate, blood pressure, and digestion of food

49
Q

Distributive shock includes

A

Septic shock
Neurogenic shock
Anaphylactic shock
And psychogenic shock