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CP Test 4 > B4-008 CBCL Hemodynamic Shock > Flashcards

B4-008 CBCL Hemodynamic Shock Flashcards

1
Q

TBW calculation as a percent of body weight

A

TBW = 60% of BW

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2
Q

calculation of TBW as a percent of lean body mass

A

LBM = BW - Fat weight
TBW= 72% of LBM

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3
Q

most accurate method of calculating TBW

A

using lean body mass

fat cells contain less water

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4
Q

water movement between ECF and ICF is driven by

A

osmotically active solutes

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5
Q

water movement within the ECF depends on

A

hydrostatic and oncotic pressure

starling forces

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6
Q

water follows

A

solute

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7
Q

water will move from [..] to […] osmotic pressure compartments

A

low to high

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8
Q

gives you information about the number of molecules dissolved in the solution, but may not allow you to predict how cells will respond

A

osmolarity

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9
Q

defines the effect a solution has on the steady state volume of a cell

A

tonicity

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10
Q

causes cell volume to increase

A

hypotonic

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11
Q

does not change initial cell volume

A

isotonic

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12
Q

causes cell volume to decrease

A

hypertonic

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13
Q

body fluid disturbance arise from changes in

2 things

A
  1. osmolarity (tonicity)
  2. volume (expansion/contraction)
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14
Q

hypotonic, isotonic, hypertonic indicate change in

2 things

A
  1. osmolarity
  2. ICF volume
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14
Q

hypotonic, isotonic, hypertonic indicate change in

2 things

A
  1. osmolarity
  2. ICF volume
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15
Q

expansion, contraction
indicate a change in

A

ECF volume

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16
Q

increase in ECF/plasma volume (expansion) will increase venous return, preload, SV and CO. As a result […] will increase

A

MAP

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17
Q

a decrease in ECF/plasma volume (contraction) will reduce venous return, preload, SV and CO. As a result, this will decrease […]

A

MAP

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18
Q

excessive H2O intake is an example of

tonicity/volume

A

hypotonic expansion

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19
Q

how does hypotonic expansion effect:
ECF osmolality:
ECF volume:
ICF osmolality:
ICF volume:

A

ECF osmolality: decrease
ECF volume: increase
ICF osmolality: decrease
ICF volume: increase

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20
Q

how does hypotonic contraction effect:
ECF osmolality:
ECF volume:
ICF osmolality:
ICF volume:

A

ECF osmolality: decrease
ECF volume: decrease
ICF osmolality: decrease
ICF volume: increase

[loss of NaCl]

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21
Q

how does isotonic expansion effect:
ECF osmolality:
ECF volume:
ICF osmolality:
ICF volume:

A

ECF osmolality: no change
ECF volume: increase
ICF osmolality: no change
ICF volume: no change

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22
Q

how does isotonic contraction effect:
ECF osmolality:
ECF volume:
ICF osmolality:
ICF volume:

A

ECF osmolality: no change
ECF volume: decrease
ICF osmolality: no change
ICF volume: no change

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23
Q

how does hypertonic expansion effect:
ECF osmolality:
ECF volume:
ICF osmolality:
ICF volume:

A

ECF osmolality: increase
ECF volume: increase
ICF osmolality: increase
ICF volume: decrease

[gain of NaCl]

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24
how does **hypertonic contraction** effect: ECF osmolality: ECF volume: ICF osmolality: ICF volume:
ECF osmolality: increase ECF volume: decrease ICF osmolality: increase ICF volume: decrease [loss of water]
25
salt loss is an example of | tonicity/volume
hypotonic contraction [loss of NaCl]
26
IV infusion of .9% saline is an example of | tonicity/volume
isotonic expansion
27
hemorrhage is an example of | tonicity/volume
isotonic contraction
28
IV infusion of hypertonic saline is an example of | tonicity/volume
hypertonic expansion
29
dehydration/severe sweating is an example of | tonicity/volume
hypertonic contraction [water loss]
30
hemorrhage, burns and excessive fluid loss cause what kind of shock?
hypovolemic
31
septic, anaphylactic, and neurogenic cause what kind of shock?
distributive
32
cardiac tamponade, heart failure, MI cause what kind of shock?
cardiogenic
33
all types of shock cause decreased MAP and
inadequate tissue perfusion
34
* inadequate CO * cold/clammy skin * low central venous pressure
hypovolemic shock
35
* systemic vasodilation (decreased TPR) * normal blood volume * skin feels warm
distributive shock
36
caused by low blood volume
hypovolemic shock
37
caused by arteriolar problem | decreased TPR
distributive shock
38
* inadequate CO by diseased/impaired heart * venous pressure increased * skin cold/clammy
cardiogenic shock
39
caused by a pump problem
cardiogenic shock
40
decreased venous return lowers EDV, SV and CO ultimately lowering MAP
hypvolemic shock
41
accompanied by weak pulse
hypovolemic shock
42
* decrease EDV, SV, CO --> MAP * decreased pulse pressure
hypovolemic shock
43
* excessive NO production leads to arteriolar vasodilation * decreased TPR, MAP
septic (distributive) shock
44
systemic arteriolar dilation results in higher rate of runoff
distributive shock
45
cause of low MAP in all types of distributive shock
decreased TPR
46
mast cell degranulation triggers the release of histamine causing arteriolar vasodilation and increased vascular permeability
anaphylactic (distributive) shock
47
degranulation of mast cells in response to allergen
anaphylactic (distributive) shock
48
epi pens activate what receptors?
alpha 1 and beta2
49
causes decreased sympathetic activity and generalized arteriolar dilation resulting in low TPR
neurogenic (distributive) shock
50
deep anesthesia, pain reflex from deep trauma, and vasovagal syncope are causes of what kind of shock?
neurogenic | distributive
51
* fluid accumulation in the pericardial sac causes impaired filling of the heart * decreases SV, CO and MAP
cardiogenic shock
52
jugular venous distension will be observed in what kind of shock?
cardiogenic
53
increased sympathetic firing will have what effects on beta 1 and alpha 1 receptors?
beta 1: increase HR and SV alpha 1: arteriolar constriction and venoconstriction
54
decreased parasympathetic firing in shock will cause
increased HR
55
impaired oxygen delivery to tissues leads to
anaerobic metabolism | lactic acid = acidosis
56
decreased MAP will decrease baroreceptor stretch leading to a reduction in the release of
atrial natriuretic peptide
57
angiotensin II and ADH would be expected to [...] in response to decreased MAP
rise
58
decreased MAP leads to increased sympathetic firing, [...] the metabolites of NE in plasma
increasing
59
cold skin and jugular vein distension indicates what kind of shock?
cardiogenic
60
[...] serum lactate would indicated adequate volume replacement
decreased | indicates adequate tissue oxygenation
61
* hypotensive with signs of HF * JVD * cold, clammy extremities | what kind of shock?
cardiogenic
62
in what type of shock is CO greater than normal?
distributive
63
* low MAP * skin feels warm * high heart rate
distributive shock
64
increased rate of runoff of blood from systemic arteries to veins
distributive shock
65
extensive burns cause loss of plasma, but not RBC. what kind of shock is this?
non hemmorrhagic | hypovolemic
66
* central venous pressure low * EKG normal
hypovolemic shock
67
* venous return decreased * EDV decreased
hypovolemic shock
68
in response to low BP, the baroreflex will
increase HR
69
when whole blood is lost, that is | tonicity/volume
isotonic contraction
70
hypovolemic shock causes [...] stroke volume
decreased
71
decreased venous return and cardiac output
hypovolemic shock
72
increased sympathetic firing to ventricular myocytes will cause
increased cytosolic calcium
73
increased sympathetic firing to systemic arterioles will cause
increase TPR
74
during hypovolemic shock, capillary pressure is
low | filtration of fluid out of capillary is decreased
75
giving 2.0% saline would cause | tonicity/volume
hypertonic expansion
76
severe dehydration causes | tonicity/volume
hypertonic contraction
77
normal compensatory response for shock | 2
* increase HR * increase arteriolar constriction
78
what causes the decrease in hematocrit in hemorrhagic shock?
* decreased capillary pressure reduces filtration * net reabsorption of fluid into plasma | decreases crit and ECF volume
79
* the volume of the ECF is increased, increasing the plasma volume as well as the interstitial fluid volume * ICF volume will decrease | tonicity/volume
hypertonic expansion
80
calculate ICF volume
2/3 x TBW
81
calculate ECF volume
1/3 x TBW
82
calculation for TBW using lean body mass
(weight - body fat) x .72
83
when calculating ECF after an infusion remember to add
liters infused to the ECF value
84
an infusion of 0.45% NaCl would cause | tonicity/volume
hypotonic expansion
85
an infusion of isotonic saline to a person with dilutional hyponatremia will [...] ICF volume and [...] intracellular osmolality
decrease volume increase osmolality
86
infusion with 5% dextrose is the equivalent of
administering water
87
infusion of [...] will increase both extracellular and intracellular fluid volumes
5% dextrose | similar to administering water (hypotonic expansion)
88
ingesting a large amount of water will have what effect on ICF volume ICF osmolality ECF volume ECF osmolality
ICF volume: increase ICF osmolality: decrease ECF volume : increase ECF osmolality: decrease | hypotonic expansion
89
effect of EpiPen on alpha 1 and beta 2 receptors?
alpha 1: vasoconstriction beta 2: relaxation of airway smooth muscle
90
administering 5% dextrose plus 0.9% NaCl would result in | volume/tonicity
isotonic expansion
91
administering 5% dextrose would result in | volume/tonicity
hypotonic expansion
92
elevated plasma osmolality suggests what kind of shock?
hypovolumic | dehydration
93
in hypovolumic shock due to dehydration, the person should be given [...] to increase total body water
5% dextrose solution
94
increased rate of runoff off blood from sytemic arteries to veins
distributive shock
95
* low MAP * warms skin * high heart rate | what kind of shock?
distributive
96
* low MAP * cold skin * no JVD * weak pulse | what kind of shock?
hypovolemic
97
* cardiac output is increased due to baroreflex * warm skin | what type of shock?
distributive
98
cool, clammy skin indicates the cause of the low MAP is | 2
either hypovolemic or cardiogenic
99
cardiac tamponade impairs ventricular filling, causing | effect on preload and SV
decreased preload and SV
100
decreased MAP increases SYM firing to the heart causing
increased inotropy | increased HR
101
decreased MAP decreases PARA firing to the heart via the baroreflex causing
increased HR
102
mast cell degranulation causes dilation of systemic arterioles and decreased TPR
anaphylactic (distributive) shock

CP Test 4 (15 decks)

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