shock
Terms
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- adequate blood flow requires which 3 things?
-
Adequate pump
sufficiant blood volume
efficient vascular/circulatory system - permiablity--cell membranes become more permiable and fluid shifts occur. This is called
- third spacing
- if you have a problem with the pump the ____ are going to ____ to change the pressure
- vessles, constrict or dialate
- if you have a problem with loss of volume, the heart is going to ______ and the blood vessles are going to _____
- beat faster, get smaller
- 3 states of shock are
- compensatory, progressive and irreversable
- mental confusion, vessels constrict, heart rate speeds up, < urinary output, hypoactive BS
- first signs...compensatory
- when you get constriction in the capilary level, you don't get ___back and forth and this is when you see ___
- O2, cellular permeability
- cells start swelling, fluid leaks out and you start third spacing..puffy and edemetous
- cellular permeability
- blood pressure regulation no longer compensating, organs suffer from hypoperfusion
- progressive shock
- MAP falls below 90, heart/pump failure,tachy, >Resp, angina, PVC's
- progressive
- organ damage so severe that patient does not respond to treatment and will not survive
- irreversable
- the goal of treatment for all types of shock is...
- to reduce and reverse the severity of shock
- all phases of shock and managment include
-
replacement of fluids
vasoactive medications
nutritional support - 2 most common crystalloids used are
- NS, LR
- disadvantage of crystalloids
- 3 parts of the vol given are lost to interstitial compartments for each one part that remains
- larger molecule plasma protiens, IV solutions, or blood products
- colloids
- you should not use which colloid in hemorragic shock and coagulopathy
- dextran..interfere with platelet aggragation
- shock patients require >? cal per day?
- 3000
- most common type of shock
- hypovolemic
- parenteral or enteral nutrition should be administered _____ within the first ___ hours
- as early as possible, 24