shock

Question 1

define shock (4)

Answer 1

• state in which profound and widespread reduction of tissue perfusion
• leads to reversible, but if prolonged, irreversible cellular injury
• altered blood flow or impaired oxygen delivery to tissues
• is a physiological condition

Question 2

what are the 6 common causes of shock

Answer 2

• trauma
• anesthetic problems
• anaphylaxis
• colic
• GI obstruction
• severe bacterial infection

Question 3

what is the by product of anaerobic metabolism

Answer 3

lactic acid

Question 4

what does anaerobic metabolism lead (3) to

Answer 4

lactic acid leading to metabolic acidosis and tissue damage

Question 5

define glycolysis

Answer 5

anaerobic respiration

Question 6

what are the 4 types of shock

Answer 6

• cardiogenic shock
• hypovolemic shock
• distributive shock
• obstructive shock

Question 7

compensation for cardiogenic shock

Answer 7

increase HR

Question 8

compensation of hypovolemic shock (2)

Answer 8

• contraction of the spleen (releases RBCs)
• constrict blood vessels

Question 9

compensation of distributive shock

Answer 9

vasoconstriction of non-vital organs

Question 10

what are the 4 compensatory mechanisms for shock

Answer 10

• sympathetic NS releases epinephrine
• renal shut down
• shunting from unnecessary to necessary organs
• splenic contraction

Question 11

physiological things that happen during DIC

Answer 11

• associated with blood pooling and acidosis
• massive vasodilation
• excessive activation of the clotting mechanism
• fibrin clots form in small blood vessels
• eventually depletion of all clotting factors
• excessive bleeding

Question 12

the basic physiological problem of shock is

Answer 12

decreased cardiac output

Question 13

signs of cardiogenic shock (3)

Answer 13

• decreased BP
• increased HR
• weak pulse

Question 14

describ hypovolemic shock (physiology) (3)

Answer 14

• decreased fluid
• remaining blood gets thick
• Slpenic contraction and vasoconstriction may occur

Question 15

hypertrophicardiomyopthy

Answer 15

• thickening of the heart wall
• common in male orange cats

Question 16

what shock is also termed vasogenic

Answer 16

distributive

Question 17

describe distributive shock

Answer 17

• caused by loss of peripheral resistance
• blood volume is normal, but the blood vessels become flabby and dilated
• as blood vessels dilate, blood pools in them, resulting in little blood returning to the heart
• eg: sepsis, anaphylaxis, trauma, neurogenic

Question 18

how is sympathetic NS releases epinephrine a shock compensatory method?

Answer 18

• body detects decreased BP
• S NS is activated
• The adrenal gland is stimulated to release epinephrine
• causes increased HR and greater force
• also causes blood vessels to constrict

Question 19

describe shunting from unnecessary to necessary organs as a shock compensatory mechanism

Answer 19

• Activation of S NS results in vasoconstriction
• order of constriction:
  
  1. skin, fat, and muscle vessels.
     seen by blanched, cold extremities
  2. GIT, and liver (anesthesia now can’t be eliminated)
  3. kidney

Question 20

what causes the splenic contraction as a shock compensatory method?

Answer 20

• the epinephrine released by S NS stimulation

Question 21

why might you see a normal PCV for a few hours after a severe hemorrhge?

Answer 21

splenic contraction resulting in increased circulating RBCs

Question 22

hypoxia and acidosis trigger the release of what ‘bad’ chemicals

Answer 22

• histamine
• serotonin
• leukotrienes
• complement
• platelet-activating factors

Question 23

signs of shock

Answer 23

• prolonged cap refill time
• weak pulse
• tachycardia
• pale mm (or red)
• cold mm and extremities
• decreased urine production
• increased RR
• progressive weakness, confusion, disorientation, coma

Question 24

aims of shock therapy (7)

Answer 24

optimize tissue oxygen delivery by:
- maintaining oxygen saturation
- restore blood volume and raise BP
- restore blood volume and raise blood pressure
- reverse matabolic acidosis
- support the heart
- monitor closely

Question 25

order of shock treatment

Answer 25

1. ABC 2. support circulation (crystalloids) 3. support circulation (colloids) (if they did not respond to crystalloids) 4. treat blood loss 5. nursing care 6. drugs

Question 26

which 2 cardiac stimulants are useful in treating refractory (unresponsive) shock

Answer 26

- dopamine - dobutamine

Question 27

what might be added to the fluids of a patient in shock to treat the acidosis?

Answer 27

sodium bicarbonate

Question 28

what type of drug is doxapram?

Answer 28

respiratory stimulant

Question 29

what is epinephrine used to treat?

Answer 29

- cardiac arrest - anaphylaxis - last resort

Question 30

If a patient doesn't start to urinate within one hour of fluid therapy, what should be given?

Answer 30

Diuretic - furosimide

Question 31

normal urin output

Answer 31

1-2 mL/kg/hr

Question 32

The amount of urine production to be diagnosed with oliguria

Answer 32

0.27 mL/kg/hr

Question 33

how often should cap refill time be assesed on a patient in shock?

Answer 33

q 15s (to establish a trend)

Question 34

13 parameters to monitor on a patient in shock

Answer 34

- urine output - BP - cap refill time + mm colour - pulse - respiration - HR and circulation - temperature - animals attitude and activity - lab work monitor fluids

Question 35

Describe septic inflammatory response syndrome

Answer 35

- in this state, the temperature will exceed 39.7C - initiated by sepsis

Question 36

how often should fluid rate be reassesed on a patient in shock?

Answer 36

q 10min

Question 37

for each 0.1 kg of weight loss, how much additional fluid should be supplemented?

Answer 37

100ml