3210 exam 5 shock

Define shock

The state of organ hypoperfusion, which leads to cellular dysfunction

Hypotension

Sometimes chronic hypertension can hide the magnitude of the hypotension, less than
90/60 mm Hg

Tachycardia

Usually present when the systolic pressure is < 90 mm Hg or the mean is < 70 mm Hg

Clinical signs of hypoperfusion

Cold and clammy skin, cyanosis and decreased urine output (< mL/kg of IBW/hr.), altered
mental status

Increased serum lactate is typically present

Indicating abnormal cellular oxygen metabolism

Define Cardiogenic Shock

When heart muscle is damaged to be unable yo pump enough blood.

What’s the most frequent cause of Cardiogenic Shock?

Myocardial infarction

What happens to the cardiac output, stroke volume and cardiac index in Cardiogenic Shock?

A decrease

With Cardiogenic Shock, what type of ABG results does a patient typically experience?

Metabolic acidosis

How will a chest x-ray appear if the patient is in Cardiogenic Shock?

How is Cardiogenic Shock diagnosed?

Lab, ekg, chest X-ray, echocardiography, angiography

What’s the treatment for Cardiogenic Shock

Intra-aortic balloon pump and left ventricular assist device

What’s the purpose for using an IABP with Cardiogenic Shock?

To increase coronary perfusion to reduce after load

What’s an LVAD? How will it affect cardiac function?

Sends oxygenated blood to the body and organs to increase cardiac function

Define Hypovolemic Shock

Reduction in the amount of circulating volume in the bloodstream

How is kidney function affected by Hypovolemic Shock?

Fluid resuscitation is important in Hypovolemic Shock. What type of fluid should be infused?

Typed and cross-matched

If there is no type and cross match for the patient, Type O blood is appropriate
b. If the patient is a female of child-bearing age, Type I Rh-negative blood is appropriate to help
prevent sensitization and further complications

Define Anaphylactic Shock

Ana allergic reaction that is rapid on onset and may cause death

During Anaphylactic Shock, what leads to a decrease in blood pressure?

Anaphylaxis

Define angioedema

Swelling occurring beneath the skin

Define pruritus

Sever itching of the skin

Define urticarial

Round rash, red welts that itch

In Anaphylactic Shock cardiac output is increase or decreased? This is the result of systemic
vasodilation or vasoconstriction?

Decrease from systemic vasodilation

Your patient is having an anaphylactic reaction. What should you do first?

Administer epinephrine

Define Septic Shock

Systemic inflammation response to infection which when complicated by drop of blood pressure it becomes

The most common cause of Septic Shock is?

Respiratory infections

Increase in PaO2/FiO2 or Decrease in PaO2/FiO

Decrease

Increase in mental status or Decrease in level of consciousness

Decrease

Increase in mean arterial pressure or Decrease in mean arterial pressure

Increase

Increase in bilirubin or Decrease in bilirubin

Increase

increases in creatinine or Decrease in creatinine

Increase

Increase in PTT or Decrease in PTT

Increase in lactic acid levels or Decrease in lactic acid level

Increase

Dull percussion note or Flat percussion note

Dull

No heart murmur or Heart murmur

Any murmur

Cool extremities or Warm extremities

Cool

Bradycardia or Tachycardia

Tachycardia

Wide pulse pressure or Narrow pulse pressure

Narrow

Bradypnea and Tachypnea

Tachypnea

What type of fluids should be administered when a patient is experiencing Septic Shock?

Crystalloid, vasopressors, dopamine

What is the vasopressor drug of choice for Septic Shock?

Norepinephrine

You just admitted a patient for an acute MI. What type of shock should you be on the look out
for? How will this type of shock affect the patient’s BP once placed on mechanical ventilation?

Cardiogenic shock

What’s the most common type of shock?