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HOS Unit 2 > Shock 33 > Flashcards

Shock 33 Flashcards

1
Q

What is A systemic derangement in blood flow such that delivery of oxygen to tissues is inadequate to support normal function?

A

shock

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2
Q

What is A systemic derangement in blood flow such that delivery of oxygen to tissues is inadequate to support normal function?

A

shock

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3
Q

T or F-Oxygen delivery to tissues in a healthy individual is much more than the amount consumed?

A

True

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4
Q

Oxygen delivery DO2 to tissues is the product of…?

A

CO x CaO2 (cardiac output and arterial oxygen content)

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5
Q

What is VO2? normal value?

A

oxygen consumption, 3.5 ml/kg/min

VO2 increases with exercise, and maximal VO2 is a measurement of aerobic fitness

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6
Q

What is VO2? normal value?

A

oxygen consumption, 3.5 ml/kg/min

VO2 increases with exercise, and maximal VO2 is a measurement of aerobic fitness

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7
Q

T or F-Oxygen delivery to tissues in a healthy individual is much more than the amount consumed?

A

True

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8
Q

Oxygen delivery DO2 to tissues is the product of…?

A

CO x CaO2 (cardiac output and arterial oxygen content)

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9
Q

What is CaO2 dependent on?

A
  • hemoglobin concentration and saturation
  • PaO2- dissolved amount is very minuscule in determining the arterial oxygen content
  • Equation for reference (1.39ml/dl x [Hgb] x SaO2) + .003 xPaO2
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10
Q

What is VO2? normal value?

A

oxygen consumption, 3.5 ml/kg/min

VO2 increases with exercise, and maximal VO2 is a measurement of aerobic fitness

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11
Q

When does supply dependency occur in regards to oxygen delivery.

A

When oxygen delivery is decreased to less than twice oxygen consumption

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12
Q

What is oxygen extraction? Equation?

A

ERO2- percent of arterial oxygen content that is extracted for consumption
= CO x (CaO2-CvO2)
= (SaO2-SvO2)/SaO2
= VO2/DO2

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13
Q

What is a decrease in oxygen carrying capacity of the blood due to reduction of hemoglobin?

A

anemic hypoxia

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14
Q

What is the inability to adequately oxygenate the blood, as in severe pneumonia?

A

Hypoxic hypoxia

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15
Q

What results when cells are unable to take up or utilize oxygen effectively despite adequate delivery?

A

Histotoxic hypoxia

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16
Q

What results when the blood flow to the tissues is inadequate or maldistributed?

A

stagnant hypoxia

17
Q

T or F- the more severe the shock, the greater number and severity of organs that become dysfunctional

A

True

18
Q

True or false- all patients with shock see a drop in BP?

A

False

19
Q

Why does the consumption of oxygen by work during breathing increase to nearly 50% of total body consumption in patients with shock?

A

they try to prevent academia through hyperventilating—steals blood from other organs—creates huge amounts of lactic acid—needs mechanical hyperventilation

20
Q

What is the key trigger that leads to hypovolemic shock or cardiogenic shock?

A

Decrease stroke volume and decreased cardiac output

21
Q

What type of shock has a maldistribution of blood flow?

A

distributive shock- may have normal or elevated SV and CO

septic shock

22
Q

What is the key method to diagnose shock?

A

physical exam—bedside activity

23
Q

Blood pressure is determined by what two things?

A

cardiac output and systemic vascular resistance

24
Q

How do we determine stroke volume in order to estimate cardiac output at the bedside?

A

Look at the relationship between pulse pressure, stroke volume, and arterial compliance. Identifying the difference between systolic and diastolic pressures will give clues to whether there is hypotension due to shock or stiffened aortas of elderly patients. The larger the blood pressure difference between systolic and diastolic at a hypotensive pressure will clue you into shock.

25
Q

If cardiac output is not reduced what type of shock may it be?

A

distributive

26
Q

If cardiac output is reduced, what type of shock may it be?

A

cardiogenic or hypovolemic

27
Q

What is a good clinical clue toward sepsis shock over cardiogenic?

A

increased WBC and fever

as opposed to chest pain and diarrhea

28
Q

What are the physical examination findings that differentiate hemorrhage or dehydration shock to cardiogenic shock?

A

dry mucous membranes, decreased skin turgor

29
Q

What are the physical exam findings that signify cardiogenic shock over hemorrhagic?

A

S3 sounds, JVD, Cardiomegaly
Think–is the heart too full!

(also look for chest pain and history of heart DZ)

30
Q

what is it called when mitochondria lose their ability to utilize oxygen even after it is restored?

A

dysoxic shock
-the key idea here is that shock is dangerous even if it does not result in death. hypo perfusion can be damaging to many organs including the brain.

HOS Unit 2 (21 decks)

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