Shock

Question 1

how does shock lead to circulatory failure?

Answer 1

inadequate perfusion–>cellular dysfunction–>organ failure

Question 2

sx circulatory failure

Answer 2

tachycardia
decreased UOP
adventitious breath sounds
tissue hypoxia
metabolic acidosis
hypoTN

Question 3

types of shock

Answer 3

hypovolemic
distributive
cardiogenic
obstructive

Question 4

causes of hypovolemic shock

Answer 4

“insufficient pumping”

blood loss, burns, peritonitis

Question 5

effects of hypovolemic shock

Answer 5

decreased BP, increased HR, decreased CVP

poor cap refill

Question 6

causes of cardiogenic shock

Answer 6

“pump fails”

cardiac surgery, dysrhythmias (AV block, SVT), primary pump failure, myocarditis, heart failure

Question 7

effects of cardiogenic shock

Answer 7

decreased cardiac output

Question 8

types of distributive shock

Answer 8

“prevents blood from proper distribution”

1. neurogenic
2. anaphylactic
3. septic

Question 9

causes of neurogenic shock

Answer 9

spinal cord injuries, lack of nervous system tone

Question 10

effects of neurogenic shock

Answer 10

massive vasodilation

Question 11

causes of anaphylactic shock

Answer 11

hypersensitivity rxn

Question 12

effects of anaphylactic shock

Answer 12

massive vasodilation, capillary leakage

Question 13

sx of anaphylactic shock

Answer 13

respiratory: stridor, wheezing, rhinitis
cardiovascular: tachycardia, hypoTN
cutaneous: flushing, hives, angioedema
GI: N/V/D
CNS: LOC, seizures, HA

Question 14

Epinephrine pen

Answer 14

0.01-0.3 mg/kg if first line of medication for anaphylactic shock

must be taken along at all times

Question 15

causes of septic shock

Answer 15

primary infection incites inflammatory response which can lead to cellular dysfunction

Question 16

effects of septic shock

Answer 16

massive vasodilation, capillary leakage, maldistribution of blood, organ failure (MODS)

Question 17

causes of obstructive shock

Answer 17

“blockage of blood”

tension pneumothorax, cardiac tamponade, PE, congenital heart lesion

Question 18

sx of shock

Answer 18

hypotensive
chills / fever
 vasodilation
warm extremities initially
tachypnea
oliguria
cool, pale extremities
change in LOC
tissue hypoxia leading to organ death
metabolic acidosis
DIC

Question 19

sx of compensated shock

Answer 19

apprehension, irritability
nml B/P
narrowing pulse pressure
thirst
pallor
decreased UOP
mild Tachycardia
decreasing peripheral perfusion

Question 20

tx of shock

Answer 20

oxygenation, medications, fluid administration (NS, LR, albumin, blood)

Question 21

causes of toxic shock syndrome (TSS)

Answer 21

Staphylococcus bacteria

sinusitis, pneumonia, catheter inf, skin inf, wound inf, contraceptive diaphragms, IUDs

Question 22

sx of TSS

Answer 22

increased temperature
V/D
macular erythroderma
hypotension
late sign: desquamation of palms