Shock - Unit 1

Question 1

Shock - def

Answer 1

inadequate tissue perfusion.

Question 2

Shock is low BP - T/F?

Answer 2

FALSE - it is not low BP!

Question 3

What are some factors needed for maintain perfusion?

Answer 3

Adequate pumping, circulating fluid, and an intact vascular container.

Question 4

Oxygen - required for the majority of ____ production.

Answer 4

Energy!

Question 5

Oxygen Transport - Hemoglobin Bound = __%, dissolved in plasma - __%.

Answer 5

97%, 3%

Question 6

Monitoring - SpO2 =

pO2 =

Answer 6

SpO2 = Hemoglobin Bound
pO2 = Dissolved in plasma.

Question 7

What are some causes of shock?

Answer 7

Inadequate oxygen delivery, inadequate nutrient delivery, impaired nutrient (glucose) uptake.

Question 8

What are the 3 stages of shock?

Answer 8

Compensated - the body’s compensatory mechanisms are able to maintain some degree of perfusion.
Decompensated - the body can’t maintain tissue perfusion.
Irreversible - damage is so massive, you’re fucked.

Question 9

Shock is a symptom of its cause. T/F?

Answer 9

True!

Question 10

What are some symptoms of shock?

Answer 10

Increased pulse (rapid, weak, etc) and decreased BP!

Question 11

Cardiogenic shock - what is it?

Answer 11

When the heart can’t pump enough blood.

Question 12

Distributive Shock - what is it?

Answer 12

Inadequate blood flow in the small vessels. It disrupts an area!

Question 13

Neurogenic Shock - What is it?

Answer 13

Disruption of the autonomic system in the spine.

Question 14

Septic Shock - what is it?

Answer 14

When your body has too many toxins

Question 15

Anaphylactic Shock - what is it?

Answer 15

When you have a major allergic reaction

Question 16

Obstructive shock - what are some examples?

Answer 16

Pulmonary embolus, cardiac tamponade, tension pneumothorax

Question 17

Hypovolemic Shock - def

Answer 17

Fluid (blood or plasma) is lost from the intravascular space.

Question 18

What are some causes of hypovolemic shock?

Answer 18

Trauma (like an injury, fracture, laceration, MI, rupture) or GI tract (like esophageal varices, ulcers, lesions, etc.)

Question 19

What is stage 1 of hemorrhage?

Answer 19

Compensated - acute loss of less than 15% (750 ml) of blood volume. There are compensatory signs and symptoms here.

Question 20

What is stage 2 of hemorrhage?

Answer 20

Compensated - acute loss of 15-30% blood volume (750-1500 ml), and more increases in signs and symptoms.

Question 21

What is stage 3 of hemorrhage?

Answer 21

Uncompensated - Acute loss of 30-40% of blood volume (1500-2000 ml)

Question 22

What is stage 4 of hemorrhage?

Answer 22

Exsanguination - Acute loss of >40% of blood volume (>2000ml) - worsening to uncontrollable S/S

Question 23

What are some treatment options for hypovolemic shock?

Answer 23

Oxygen, position of patient, monitors, IV access, fluid replacement, etc.

Question 24

What are some fluid replacement options for hypovolemia and hemorrhage?

Answer 24

Hypovolemia - isotonic crystalloids and colloids (colloids have a longer lasting effect), and for Hemorrhage, it’s whole blood, packed RBC’s and isotonic crystalloids.

Question 25

If shock due to trauma, and bleeding cannot be controlled, give only enough small fluid boluses to maintain radial pulse (SBP = 80)
If bleeding can be controlled, control bleeding and administer enough fluid or blood to restore normal blood pressure.
T/F?

Answer 25

True!

Question 26

Fluids are super important in treating shock. T/F?

Answer 26

TRUE!

Question 27

With shock/hypovolemia, we shouldn’t worry about acidosis, coagulopathy (impaired blood clotting), or hypothermia. T/F?

Answer 27

FALSE - we should!