Shock- CH 9 Flashcards
(31 cards)
What is Shock?
defined as “inadequate tissue perfusion”
Tissue hypoxia results in hypoperfusion
Common causes of shock include:
Cardiac Output: HF, hemorrhage
Anaphylaxis
Sepsis
Neurological alterations
SIGNS of initiate stage of Shock
tachycardia tachypnea restlessness anxiety cool, clammy skin pallor
Mechanisms of shock
Blood pressure falls
SNS- Epinephrine/norepinephrine
Vasoconstriction & retention of sodium and water
What are the stages of shock?
Mild/compensated
Moderate/progressive
Severe irreversible/decompensated
What are symptoms of Moderate/ progressive shock?
tachycardia >150 Weak thready pulse Systolic BP <90/ diastolic dec. Tachypnea, crackles, shallow Confused, lethargic Moist, cold, clammy, pale skin Dec. urine output
What are symptoms of severe irreversible/ decompensated shock?
Slowing HR Pulse Absent Slow, irregular, shallow RR Unconscious/comatose Cyanosis, mottled, cold, clammy Anuria
What is anaerobic metabolism?
inefficient form of metabolism that supplies energy to cells for only a few minutes
-caused by lack of oxygen to tissue
Anaerobic metabolism results in…
build up of lactic acid
causing ACIDOSIS
-ph < 7.35
What is toxemia?
Results from absorbing normal occurring bacteria and endo toxins from bowel into circulation
- Dec. production of plasma proteins
- Inc. ammonia, bilirubin, liver enzymes
Complications of Shock include:
Acute Respiratory System
DIC-thrombi
Multiple organ dysfunction
What are the classifications of shock?
Hypovolemic shock
Cardiogenic shock
Extracradiogenic obstructive shock
Distributive shock
Distributive shock includes:
anaphylactic
septic
neurogenic
Signs and symptoms of hypovolemia shock
Tachycardia, tachypnea, hypotension, cyanosis, oliguria
flat non-distended peripheral veins
dec. jugular veins
altered mental status
What is pericardial tamponade?
filling of the pericardial sac with blood, compresses heart
limits filling capacity
What is tension pneumothroax?
compression of heart from abnormal collection of air in pleural space
What is acute pulmonary hypertension?
sudden abnormal elevated pressure in pulmonary artery
increases resistance for blood flowing out of right side
What are causes of Extracardiac obstructive shock?
Pericardial tamponade
Tension pneumothorax
Acute pulmonary hypertension
Tumors/pulmonary emblosim
How will jugular and peripheral veins present with hypovolemic, cardiogenic, and extracardiac obstructive shock?
Hypolvolemic- flat, non distended
Cardiogenic- peripheral and jugular distended
Extracardiac obstructive- juglar veins distended
What is urticaria?
hives
What is angiodema?
edema of skin, mucous membranes, internal organs
Wheezing may be heard in the patient with ______ shock.
anaphylactic shock
Crackles may be heard in the patient with ________ shock.
Cardiogenic shock
or with too much IV fluids
Medications for septic shock
Broad spectrum antibiotic w/in 1 hr of diagnosis`
