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22 Cards in this Set
- Front
- Back
circulatory shock:
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-failure of the heart to pump blood adequately
-imbalance btn O2 supply and O2 demand at the cellular level -causes cellular hypoxia resulting in impairment of cells, tissues, organs and systems |
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What determines CO?
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stroke volume, preload, afterload, contractility
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What happens to CO during shock?
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-CO decreases and metabolic rate increases
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3 Stages of shock:
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1. compensatory
2. progressive 3. irreversible |
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compensatory shock:
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-SNS stimulated
-vasoconstriction causing increase in BP -increase in rate and depth of breathing (chemoreceptors) -prevents cell damage |
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progressive shock:
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-unable to compensate
-cellular metabolism decreases causing a decrease in oxygen consumption -edema as result of increase in capillary hydrostatic pressures -arrhythmias as result of decrease of ATP -glycolysis increases lactic acid causing metabolic acidosis |
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3 classifications of shock:
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1. cardiogenic
2. hypovolemic 3. vasogenic (not cardiovascular) |
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3 types of vasogenic shock:
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1. septic (causes severe vasodilation)
2. anaphylactic 3. neurogenic |
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List 4 major complications of shock:
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1. ARDS
2. ARF 3. DIC 4. multiple organ failure |
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Causes of cardiogenic shock:
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-most commonly due to MI
-compensatory mechanisms cause a decrease in CO and increase in myocardial oxygen demand |
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Clinical effects of cardiogenic shock:
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-narrowing of pulse pressure
-peripheral vasoconstriction -respirations become rapid and deep -decrease in urinary output |
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Tx of cardiogenic shock:
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1. thrombolytic agent (early)
2. + inotropic drugs 3. vasodilator 4. diuretics 5. IABP |
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hypovolemic shock:
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-blood volume deficiency of 15-25% due to hemorrhaging or extensive 3rd degree burns
-blood volume lowers CO, body vasoconstricts, increases ADH |
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hemorrhagic shock:
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-crystalloid and blood replacement as needed
-test with cap refill |
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aka for cap refill:
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capillary blanch test
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Tx for hypovolemic shock
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1. control source of blood loss
2. fluid therapy-colloids, crystalloids, blood products 3. dopamine to restore BP |
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types of septic shock:
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-bacteriemia, septicemia, septic shock
-mortality is 40-85% |
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Who are mostly at risk for septic shock?
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infants, aged, immunosuppressed
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sources of sepsis:
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invasive procedures, surgery, invasive lines and catheters
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anaphylactic shock:
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overaction of the immune system
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neurogenic shock:
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depression of vasomotor center of the medulla
Ex. drug overdose |
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Tx of anaphylactic/neurogenic shock:
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1. airway management-bronchodilators, intubation
2. fluid therapy 3. steroids 4. antihistamines |