SHOCK

Question 1

is a life-threatening condition that occurs when the
body is not getting enough blood flow.
➢ Affects all body systems

Answer 1

SHOCK

Question 2

The cell swells and the cell membrane becomes more
permeable, and fluids and electrolytes seep from and
into the cell. Mitochondria and lysosomes are
damaged, and the cell dies

Answer 2

Cellular Effects of Shock

Question 3

Compensatory stage of shock

Answer 3

Blood pressure norm
Vasoconsriction
HR normal
Fight or flight respone
Skin cold and clammy
Decrease ADH

Question 4

In the progressive stage of shock, the mechanisms
that regulate blood pressure can no longer
compensate and the MAP falls below normal limits,
with an average systolic blood pressure of less than
90 mm Hg.

Answer 4

PROGRESSIVE

Question 5

The irreversible (or refractory) stage of shock
represents the point along the shock continuum at
which organ damage is so severe that the patient
does not respond to treatmen

Answer 5

IRREVERSIBLE

Question 6

can occur as a progression
along the shock continuum or as a syndrome unto
itself

Answer 6

Multiple organ dysfunction

Question 7

Overall Management Strategies in Shock

FVN

Answer 7

Fluid replacement
Vasoactive medications
Nutritional support

Question 8

to restore
vasomotor tone and improve cardiac function

Answer 8

Vasoactive medications

Question 9

to address the
metabolic requirements that are often
dramatically increased in shock

Answer 9

Nutritional support

Question 10

are administered in all forms
of shock to improve the patient’s hemodynamic
stability when fluid therapy alone cannot maintain
adequate MAP.

Answer 10

VASOACTIVE MEDICATION THERAPY

Question 11

occurs when there is a reduction
in intravascular volume of 15% to 25%. This would
represent a loss of 750 to 1,300 mL of blood in a
70-kg (154-lb) person.

Answer 11

Hypovolemic shock

Question 12

MEDICAL MANAGEMENT
Hypovolemic shock

Answer 12

restore intravascular volume to reverse the sequence
of events leading to inadequate tissue perfusion
2. redistribute fluid volume
3. correct the underlying cause of the fluid loss as
quickly as possible

Proper positioning (modified Trendelenburg)

Question 13

What to remember for hpovol shock for crystalloid solution?

Answer 13

Remember the 3:1 rule for crystalloid solutions: For
every 1 mL of approximate blood loss, 3 mL of crystalloid
solution is given

Question 14

occurs when the heart’s ability to
contract and to pump blood is impaired and the
supply of oxygen is inadequate for the heart and
tissues

Answer 14

CARDIOGENIC SHOCK

Question 15

The causes of cardiogenic shock are known
as either

Answer 15

coronary or non-coronary.

Question 16

seen most often in
patients with
myocardial infarction

occurs when a
significant amount of
the left ventricular
myocardium has been
destroyed

Answer 16

CORONARY

Question 17

causes can be related to
metabolic problems and tension
pneumothorax

Answer 17

NON-CORONARY

Question 18

INITIATION OF FIRST-LINE TREATMENT
First-line treatment of cardiogenic shock involves the following
actions:

Answer 18

Supplying supplemental oxygen
● Controlling chest pain
● Providing selected fluid support
● Administering vasoactive medications

Question 19

Caused by a mechanical obstruction that prevents an
adequate volume of blood from filling the heart
chambers

Answer 19

OBSTRUCTIVE SHOCK

Question 20

Obstructive Shock: Management

Answer 20

Control airway
● Intubation
● Treat the underlying cause

Question 21

results from a maldistribution or mismatch of blood
flow to the cells.
➢ shock state resulting from displacement of blood
volume creating a relative hypovolemia

Answer 21

CIRCULATORY OR DISTRIBUTIVE SHOCK

Question 22

Fluid replacement must be instituted to correct the
hypovolemia

Answer 22

Crystalloids, colloids, and blood products may be
administered to increase the intravascular volume

Question 23

Classification of Circulatory shock

Answer 23

1. Septic shock
2. Neurogenic shock
3. Anaphylactic shock

Question 24

The disorder is thought to be a response to that
release microbes or immune mediators, such as

Answer 24

tumor necrosis factor and interleukin- 1.

Question 25

occurs due to sepsis and leads to a
major decrease in tissue perfusion to organs and
tissues.

Answer 25

Septic shock

Question 26

Resuscitation goals include:

Answer 26

• MAP more than 65 mmHg
• Target CVP of 8-12 mmHg (12-15 mmHg if
  ventilated)
• Central venous O2 saturation (ScvO2) equal or
  more than 70%

Question 27

results in massive
vasodilation and a decrease in peripheral vascular
resistance, causing blood to pool in the venous
system.

Answer 27

This loss of sympathetic tone

Question 28

occurs rapidly and is
life-threatening.

Answer 28

ANAPHYLACTIC SHOCK

Question 29

Medical Management
ANAPHYLACTIC SHOCK

Answer 29

Removing the causative antigen, administering
medications that restore vascular tone, and providing
emergency support of basic life functions.
● Epinephrine is given for its vasoconstrictive action.

Question 30

Any pathogenic organism can cause septic shock.
❖Gram-negative bacteria, such as E

Answer 30

Escherichia coli,
Klebsiella pneumoniae, Serratia, Enterobacter, and
Pseudomonas rank as the most common causes and
account for up to 70% of all cases