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14 Cards in this Set
- Front
- Back
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Define shock.
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Failure of the circulatory system to meet metabolic needs of vitals organs such as brain, heart and kidneys.
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Define cardiac output
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The amount of blood pumped out the left ventricle per minute. Cardiac output normal is 4-8 liters per minute.
Cardiac Output = Stroke Volume x Heart Rate |
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Define stroke volume
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The volume of blood ejected by the ventricle with each contraction.
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Define preload
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The volume of blood filling the ventricle just before ventricular contraction.
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Define afterload
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The resistance to blood flow out of the ventricle during ventricular contraction.
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Define contractility
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The forcefulness of myocardial contraction.
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3. Compare and contrast hypovolemic shock with septic, anaphylactic, and toxic
shock |
Hypovolemic Shock is loss of blood volume due to hemorrhage and dehydration.
Septic, Anaphylactic, Toxic Shock is caused by vasodilation, decrease afterload (resistance to blood flow out of the ventricle during ventricular contraction) and hypotension. |
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3. Identify the etiologies for the various forms of shock
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: Hypovolemic Shock - a form of shock where the heart is unable to supply enough blood to the body because of blood loss of inadequate blood volume.
: Septic Shock - is a serious, abnormal condition that occurs when an overwhelming infection leads to low blood pressure and low blood flow. Vital organs, such as the brain, heart, kidneys and liver may not function properly or may even fail. : Anaphylactic Shock - Dilation of peripheral vasculature from an allergic response that results in circulatory failure. : Toxic Shock - symdrone is a severe disease caused by a toxin made by Staphylococcus aureus, characterized by shock and multiple organ dysfunction. |
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4. Identify the clinical signs of shock.
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Typical signs include: Hypotension, tachypnea, tachycardia, oliguria (decreased urine output), altered sensorium, cool and/or clammy skin
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5.Identify and describe the laboratory findings pertaining to shock.
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: ABG's often show hypoxemia, metabolic acidosis including lactic acid.
: Electrolytes show Hypernatremia (increased sodium), : Anion gap >16 mEq/L indicating lactic acidosis which tells us that shock is severe enough to cause lactic acidosis. Lactic acid is produced at a faster rate than normal when there is inadequate oxygenation of skeletal muscle and other tissues. : Formula for Anion Gap = Na+ - (Cl- + Hco3-) Normal is 8-16 mEq/Liter. : Leukocytos (increase in WBC's) in septic shock. |
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6. Compare and contrast the changes seen in hemodynamic values for septic and
hypovolemic shock (in general). |
Septic Shock -
Increased in CO (normal is 4-8 L/min.) Decreased SVR - normal is 900-1400 dynes/second/cm5. Normal pulmonary capillary wedge pressure (PCWP) : Hypovolemic Shock - Decreased Central venous pressure (CVP) Decreased PCWP Decreased CO Increased SVR |
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7. Define and explain the significance of the anion gap
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Anion gap >16 mEq/L indicating lactic acidosis, which means the shock is severe enough to cause lactic acidosis. Lactic acidosis is the accumulation of lactic acid in the blood. Lactic acid is produced at a faster rate than normal when there is inadequate oxygenation of skeletal muscle and other tissues
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8. Know the equation for determining anion gap.
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Equation for Anion Gap is: Na+ - (Cl- + Hco3-). Normal is 8-16 mEq/Liter
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10. Describe the treatment for shock.
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Treatment includes:
~Oxygen therapy - high concentration ~Mechanical ventilation - CMV with Peep; CPAP for respiratory muscle fatigue and decreased sensorium ~ Replacement of blood volume in hypovolemic shock (BP <90mmHg) Replace blood if from hemmorhage and use lactated ringers or saline IV for volume expansion. ~ Antibiotics for septic shock ~Vasopressor therapy (increases resistance to the flow of blood thereby increasing blood pressure) for septic shock. |
