Chapter 15 Flashcards
(49 cards)
shock/hypoperfusion
inadequate perfusion of cells, tissue, and organs with oxygen and other nutrients resulting in cell, tissue, and organ dysfunction.
etiology
causation of disease/condition
etiologies of shock
inadequate volume
inadequate pump
inadequate vessel
4 categories of shock
hypovolemic, distributive, cardiogenic, obstructive
5th category of shock
metabolic
hypovolemic shock
low blood volume
most common form of shock
types:
hemorrhagic, nonhemorrhagic, burn
distributive shock
decrease in intravascular volume caused by massive systemic vasodilation and an increase in capillary permeability
types:
neurogenic, septic, anaphylaxis
obstructive shock
results from a condition that obstructs forward blood flow. The volume is adequate, the heart is not damaged, and the vessels are of a normal size with adequate resistance.
cardiogenic shock
caused by ineffective pump function of the heart
metabolic shock
described as a dysfunction in the ability of oxygen to diffuse into the blood, be carried by hemoglobin, off-load at the cell, or be used effectively by the cell for metabolism.
hemorrhagic shock
whole blood from the intravascular space. The term hemorrhagic specifically indicates whole blood loss that can occur from a traumatic injury or a medical illness
nonhemorrhagic hypovolemic shock
caused by the shift of fluid out of the intravascular space; however, red blood cells and hemoglobin remain within the vessels. It is primarily water, plasma proteins, and electrolytes that are lost.
examples:severe diarrhea, vomiting, excessive sweating, and excessive urination.
burn shock
specific form of nonhemorrhagic hypovolemic shock resulting from a burn injury. Burns can interrupt the integrity of the capillaries and vessels and allow them to leak plasma and plasma proteins.
anaphylactic shock
Chemical mediators that are released in the anaphylactic reaction cause massive and systemic vasodilation. These chemical mediators also cause the capillaries to become permeable and to leak.
septic shock
results from sepsis, which is an exaggerated inflammatory response to an infection that causes the vessels throughout the body to dilate and become permeable. Fluid leaks out of the vessels into the interstitial space.
sepsis
the body’s exaggerated inflammatory response to an infection, typically fungal, viral, or bacterial, that overwhelms the body’s normal defense and regulatory systems causing a disruption in cell and organ function.
sepsis pathophsyiology
Increased capillary permeability
Vasodilation
Myocardial depression
Alveolar/capillary membrane damage allowing fluid to accumulate in the alveoli
sepsis s/s
Tachycardia
Tachypnea
Hyperthermia or hypothermia
Hypotension
flushed warm skin (early)
cyanotic (late)
respiratory based sepsis s/s
Productive cough
Fever
Chills
Upper respiratory symptoms (runny or stuffy nose, sneezing)
Throat or ear pain
Crackles upon auscultation (may indicate pneumonia)
GI Based Sepsis s/s
Abdominal pain or flank tenderness
Nausea and vomiting
Diarrhea
Dysuria
Polyuria
robson screening tool
for suspected sepsis
Sepsis is suspected if two of the following findings are present
temp <96.88 or >100.98
hr > 90
RR > 20/min
acute ams
BGL < 120
BAS 90-30-90 scale
for susptected sepsis
Sepsis is suspected if one or more of the following findings are present
systolic bp < 90
RR > 30/min
spo2 < 90
qsofa scale
Sepsis is suspected if two or more of the following findings are present
RR >= 22/min
AMS GCS<13
systolic bp <100
neurogenic shock
Spinal cord injury is a cause of neurogenic shock. A spinal cord injury may damage the sympathetic nerve fibers that control vessel tone below the level of injury. Loss of sympathetic tone causes the vessels to dilate. If the injury is high in the thoracic spinal cord or in the cervical region, enough vessel tone may be lost to cause a drop in systemic vascular resistance, blood pressure, and perfusion.
