Final 5 - Perfusion

Question 1

Will you have an increase or decrease in MAP in all stages of shock

Answer 1

decreased

Question 2

Early Signs shock:

• MAP decrease _____ mmHg from Baseline
• Effective Compensation
• O2 -> Vital Organs
• _____ HR

Answer 2

Early Signs shock:

• MAP decrease 10mmHg from Baseline
• Effective Compensation
• O2 -> Vital Organs
• increased HR

Question 3

Compensatory Signs Shock:

• MAP decrased _____mmHg from Baseline
• _____ Renin
• _____ ADH
• _____ Pulse Pressure
• _____ HR
• _____ pH
• _____
• _____

Answer 3

Compensatory Signs Shock:

• MAP decreased 10-15mmHg from Baseline
• Increased Renin
• Increased ADH
• Decreased Pulse Pressure
• Increased HR
• Decreased pH
• Restless
• Apprehensive

Question 4

Progressive Signs Shock:

• MAP decreased _____mmHg from Baseline
• Tissue/Organ _____
• _____ Urine (Oliguria)
• _____, Rapid Pulse
• _____ pH
• _____ _____ _____

Answer 4

Progressive Signs Shock:

• MAP decreased 20mmHg from Baseline
• Tissue/Organ Hypoxia
• Decreased Urine (Oliguria)
• Weak, Rapid Pulse
• Decreased pH
• Sensory Neural Changes

Question 5

Refractory Signs Shock:

• Excessive Cell/Organ _____
• Multi System Organ _____
• _____ pH

Answer 5

Refractory Signs Shock:

• Excessive Cell/Organ Damage
• Multi System Organ Failure
• decreased pH

Question 6

6 Early signs of shock

• BP
• Pulse
• color
• skin
• face
• lungs

Answer 6

• normal BP
• increased HR
• normal color
• cool/moist skin
• anxious
• increased rate, increased depth

Question 7

6 late signs of shock

• BP
• Pulse
• color
• skin
• face
• lungs

Answer 7

• < 90mmHg Systolic
• increased rate/weak
• pale
• cold
• coma
• increased rate. increased shallow

Question 8

How to calculate PP (pulse pressure)

Answer 8

systolic - diastolic

Question 9

a _____ pulse pressure is an earlier sign of deterioration then a drop in systolic pressure < _____

Answer 9

narrowing

90

Question 10

normal PP

Answer 10

30-40 mmHg

Question 11

elevation of the diastolic BP releases catecholamine’s and attempts to increase venous return through _____

Answer 11

vasoconstriction

Question 12

_____ diastolic BP = _____ release = _____ venous return = _____

Answer 12

increased
catecholamine
increased
vasoconstriction

Question 13

Which stage of shock do you want to be in to try and fix things

Answer 13

compensatory stage

Question 14

With shock, you want to _____ BP do you don’t lose it

Answer 14

hold

Question 15

usually _____ alkalosis comes first, then _____ acid accumulates = _____ acidosis, but usually with _____ shock, it is mixed

Answer 15

respiratory
lactic
metabolic
septic

Question 16

which stage of shock does the LOC really change

Answer 16

progressive

- become more restless & confused

Question 17

which stage of shock do you get vasoconstriction

Answer 17

compensatory, continues in progressive

Question 18

which stage of shock do you get shunting of blood

Answer 18

compensatory

Question 19

which stage of shock do you really get a drop in BP

Answer 19

progressive

Question 20

which stage of shock does it affect lungs, heart, kidneys, and other areas

Answer 20

progressive

Question 21

which stage of shock can they go into acute renal failure

Answer 21

progressive

Question 22

which stage of shock is irreversible

Answer 22

refractory

Question 23

Shock state resulting from decreased intravascular volume due to fluid loss

Answer 23

hypovolemia

Question 24

Shock state resulting from impairment or failure of myocardium

Answer 24

cardiogenic

Question 25

Circulatory shock state resulting from overwhelming infection causing relative hypovolemia.

Answer 25

septic

Question 26

Shock state resulting from loss of sympathetic tone causing relative hypovolemia.

Answer 26

neurogenic

Question 27

Circulatory shock state resulting from severe allergic reaction producing overwhelming systemic vasodilation, relative hypovolemia.

Answer 27

anaphylactic

Question 28

_____ shock: don't want to put head down, do modified trendelenburg does NOT work

Answer 28

cardiogenic

Question 29

MONA for cardiogenic shock

Answer 29

morphine (opioids) oxygen nitroglycerin aspirin

Question 30

Stimulates beta-receptors for myocardial strength

Answer 30

dobutamine

Question 31

Vasodilator to reduce preload.

Answer 31

nitroglycerin

Question 32

improves tissue perfusion, increases co.

Answer 32

low-dose dopamine

Question 33

causes vasoconstriction, increases workload.

Answer 33

high-dose dopamine

Question 34

dilates blood vessels

Answer 34

morphine

Question 35

most shock pt's have serious dysrhythmias =

Answer 35

antiarrhythmic meds

Question 36

describe antibiotic treatment for septic shock

Answer 36

``` first = broad spectrum then = narrow spectrum ```

Question 37

What do you do very FIRST for septic shock

Answer 37

get culture & sensitivity!

Question 38

What is VERY important for all types of shock

Answer 38

FLUIDS!!!

Question 39

thermoregulation is treatment for what shock

Answer 39

neurogenic shock

Question 40

vasoactive meds are treatment for what shock

Answer 40

neurogenic & all types

Question 41

what types of fluids do you use for fluid replacement in treatment of shock

Answer 41

crystalloids | colloids