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Flashcards in EXAM 2 Shock Deck (19):
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.

syndrome; tissue perfusion
oxygen; nutrients

hypoperfusion

2

Shock can be classified as __ __ __ or __ __

low flow shock ; distributive shock

3

Low flow shock has a __ __ __.
List the types of shock that are low flow shock.

decreased cardiac output

hypovolemic shock
cardiogenic shock

4

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

increase; cardiac output; cardiac output; distributed

anaphylactic shock
septic shock
neurogenic shock

5

Hypovolemic Shock
Mechanism:
Specific Causes:

Loss of blood or plasma

Hemorrhage
Burns
Dehydration
Peritonitis
Pancreatitis

6

Cardiogenic Shock
Mechanisms:
Specific Causes:

decreased pumping capability of the heart

myocardial infarction of left ventricle
cardiac arrhythmia
pulmonary embolus
cardiac tamponade

7

Vasogenic or Neurogenic or Distributive Shock
Mechanisms:
Specific Causes:

Vasodilation owing to loss of sympathetic and vasomotor tone

Pain and fear
Spinal cord injury
Hypoglycemia (insulin shock)

8

Anaphylactic Shock
Mechanisms;
Specific Causes:

Systemic vasodilation and increased permeability owing to severe allergic reaction

Inset stings
Drugs
Nuts
Shellfish

9

Septic (endotoxic) Shock
Mechanisms:
Specific Causes:

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

Virulent microorganisms (gram-negative bacteria) or multiple infections

10

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

similar

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.

oxygenation

Sympathetic Nervous system
RAAS

12

RAAS - increased __ __ in response to lower blood pressure

ADH secretion

13

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

lethargy; weakness

14

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

anaerobic respiration
lactic acid
metabolic acidosis

15

Early clinical manifestations of shock include (1)
- b/c ___ stimulates sympathetic nervous system to stimulate the body's __ or __ __

1. anxiety and restlessness
hypotension
fight/flight response

16

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

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

17

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

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

18

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

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 )

19

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

metabolic