Shock 2
Terms
undefined, object
copy deck
- What is shock?
- when the cardiovascular system fails to perfuse tissues adequately, resulting in widespread impairment of cellular functions.
- Cardiogenic shock results from___. Most cases follow myocardial infarction or surgery requiring cardiopulmonary bypass.
- heart failure
- Cardiogenic shock is notoriously___. Mortality is ____%.
-
unresponsive to treatment
50-80 - Clinical manifestations of cardiogenic shock include:
- impaired mentation, systemic and pulmonary edema, low cardiac output, dusky skin color, low blood pressure, oliguria, ileus, and dyspnea
- Oliguria
- low urine output
- Ileus
- failure of gastric motility without obstruction
- Dyspnea
- difficulty breathing
- Mentation
- any mental activity including conscious and unconscious process
- Hypovolemic shock is caused by:
- loss of blood, plasma, or interstitial fluid in large amounts.
- Hypovolemic shock begins to develope when volume has decreased by___%.
- 15
- Clinical manifestations of hypovolemic shock:
- poor skin turgor, thirst, oliguria, and rapid heart rate.
- Burn patients and catheters causing diureses can promote____ shock.
- hypovolemic
- Neurogenic shock:
- massive vasodilation that results from imbalance between parasympathetic and sympathetic stimulation of vascular smooth muscle and extreme, persistant vasodilation.
- Extreme, persistant vasodilation:
- blood volume has not changed but the space containing blood has increased so SVR(systemic vascular restriction) decreases drastically.
- Causes of neurogenic shock are:
- trauma to the spinal cord or medulla, depressive drugs, anesthesia, severe emotional stress and pain.
- Clinical manifestations of neurogenic shock are:
- very low blood pressure, bradycardia, and fainting
- Anaphylactic shock is the most___ and the onset is____.
-
severe
sudden - Anaphylactic shock begins as:
- an allergic reaction
- Examples of anaphylactic shock causes are:
- snakebite venom, pollens, insect venom, shellfish, PCN
- Clinical manifestations of anaphylactic shock:
- vasodilation, peripheral pooling, relative hypovolemia leading to decreased tissue perfusion and impaired cellular metabolism.
- During anaphylactic shock:
- smooth muscle constriction occurs in the airway causing respiratory difficulty
- During anaphylactic shock progression to:
- death can occur in minutes without emergency treatment
- The first signs of anaphylactic shock are:
- anxiety, difficulty breathing, edema, hives, burning or itching of the skin.
- Treatment of anaphylactic shock:
- epinephrine administered to cause vasoconstriction and reverse airway constriction, volume expanders given IV (lactated ringers), antihistamines and steroids given to stop the inflammatory reaction
- Septic shock begins with an___, progresses to____, then____, then____, then___.
-
infection
bacteremia
sepsis
septic shock
multiple organ dysfunction syndrome - Septic shock is most often caused by:
- gram negative bacteria
- Clinical manifestations of septic shock:
- low BP, hypoxia, tachycardia, temp. instability, renal dysfunction, jaundice, clotting problems, deterioration of mental status and tachypnea
- Hypoxia
- inadequate oxygen tension at the cellular level
- Tachypnea
- abnormally rapid rate of breathing
- Treatment of septic shock:
- multiple drug antimicrobial therapy, fluid resusitation and vasoactive medications
- All unresolved infections can lead to___.
- septic shock
- First-degree burns:
- partial-thickness injury
- Example of first-degree burn:
- common sunburn when it blisters the next day
- Second-degree burns:
-
superficial partial-thickness injury
deep partial-thickness injury - A clinical manifestation of a superficial partial-thickness injury would be:
- when a blister forms immediatley
- Clinical manifestations of a deep partial-thickness injury would be:
-
waxy, white appearence
hair follicles and sweat glands gone but will reappear. - Third-degree burns:
- full-thickness injury
- A full-thickness injury results in no:
- pain because nerves gone