Flashcards in Test 2 Deck (23)
What are the three main types of shock?
Cardiogenic, hypovolemic, and distributive
What are three compensatory mechanisms of shock?
Neural, hormonal, and chemical
What are the four stages of shock?
Initial (usually asymptomatic), compensatory, progressive (when compensatory mechanisms fail), and refractory
What are effects of hypoperfusion in shock in each system (8)? (brain, heart, lungs, GI, GU, skin, hematologic, and metabolic)
Lungs: VQ abnormalities
GI: impaired mobility
GU: decreased GFR
Metabolic: anaerobic metabolism
A potentially fatal result of septic shock relating to the cascade of inflammation and coagulation includes:
Impaired fibrinolysis which results in the formation of clots
What is the difference between "warm shock" and "cold shock"?
Warm shock often goes undetected. By the time cold shock ensues, the patient is screwed....
What are the four components of SIRS?
>38 C or <36 C
HR > 90 BPM
RR >20 PaCO2 <32
WBC >12,000 or <4,000 or > 10%
*NEED 2 TO QUALIFY AS SIRS
What happens to SvO2 in septic shock?
DIC occurs as a result of which conditions:
Trauma, sepsis, severe disease
Describe the process of DIC:
An overabundance of fibrin degradation substance, results in difficulty clotting--at risk for hemorrhage.
How do you treat DIC?
Platelets and FFP
What are the four causes of acute resp failure? And describe each
-Failure of ventilation- inability to get air in and out (ie. obstruction)
-Failure of oxygenation- inability of oxygenation to pass through alveoli (ARDS, pneumonia, COPD, high altitude)
-Failure of oxygen delivery- inability of oxygen to perfuse the tissues (anemia, hypoxemia)
-Failure of cellular oxygen utilization- impaired cellular function (carbon monoxide poisoning, alcohol)
What are the two types of ARF and which conditions are they associated with?
Hypoxemic (Type I)- ARDS
Hypercarbia (Type II)- COPD
Explain the difference between dead space and shunting
Dead space is the inspired air which doesn't make it to the alveoli to participate in gas exchange.
Shunting is unoxygenated blood which is returned to the heart.
What are the three hallmark signs of an asthma attack?
Describe "blue bloaters" and "pink puffers"
Blue bloaters: chronic bronchitis patients (cyanotic, overweight)
Pink puffers: emphysema patients (barrel chest, pursed lip breathing)
What are the two ways the brain detects when to breathe?
1.) Build-up of CO2
2.) Low Oxygen sats (hypoxia)
What do COPD patients rely on to know when to breathe?
Low O2 sats
What are teaching points for COPD patients? (6)
Smoking cessation, exercise, proper nutrition, avoid irritants, flu shots, regular check ups
On a vent, how do you increase Oxygen?
Increase FiO2, increase PEEP
On a vent, how do you decrease CO2?
Increase respirations and volume
Non-cardiogenic pulmonary edema is synonymous with?