Shock

Question 1

What are some causes of cardiogenic shock?

Answer 1

• -AMI
• -Cardiac tamponade
• -electrolyte imbalance
• -negative inotropes

Question 2

What electrolytes can cause cardiogenic shock when they are imbalanced?

Answer 2

K+ and Ca+

Question 3

What are some manifestations of cardiogenic shock?

Answer 3

• -Reduced BP and MAP
• -Increased HR (ischemia and possible necrosis)
• -Increased LVEDP (pulmonary edema)
• -Rales
• -Reduced perfusion
• -Reduced EF and CO

Question 4

What can cause Obstructive shock?

Answer 4

• -Obstruction in heart/great vessels (reduced pumping action)
• -Impaired filling (preicardial tamponade/pneumo)
• -impaired pumping (increased afterload)

Question 5

what are some types of distributive shock

Answer 5

• -Septic shock
• -Neurogenic shock
• -anaphylactic shock

Question 6

What is going on with distributive shock?

Answer 6

Pump (heart) is not working and blood is not being distributed to periphery properly

Question 7

What are the signs of Systemic Inflammatory Response syndrome (SIRS)?

Answer 7

• -Temp >100.4 or <96.8
• -HR: >90
• -RR: >20 or PaCO2 <32
• -WBC: >12,000 or <4,000 or 10% bands

Question 8

How is sepsis classified?

Answer 8

SIRS + Infection

Question 9

How is severe sepsis classified?

Answer 9

Sepsis + end organ failure

Question 10

How is septic shock classified?

Answer 10

Severe sepsis + Hypotension

Question 11

what are signs of warm shock?

Answer 11

• -inflammatory triad

- -Hyperperfusion

Question 12

What is the inflammatory triad?

Answer 12

• -fever
• -Tachycardia
• -Flushed skin

Question 13

with hyperperfusion the patient will have a….

Answer 13

wide pulse pressure

Question 14

what will a patient with neurogenic shock present with?

Answer 14

• -reduced perfusion

- -impaired cellular metabolism

Question 15

What are the early signs of shock?

Answer 15

• -oriented/restless
• -apprehensive
• -Increased anxiety
• -increased pulse
• -low BP

Question 16

what are intermediate signs of shock?

Answer 16

• -reduced sensory perception
• -slowed speech
• -cool,moist skin
• -rapid/shallow respirations
• -Pale (cyanotic)
• -Oliguria
• -Weak, thready pulse
• -Low BP

Question 17

What are advanced signs of shock?

Answer 17

• -reduced LOC
• -Cyanosis
• -Bradycardia
• -Cool moist skin
• -Labored respirations
• -Anuria
• -BP that is getting lower

Question 18

As shock progresses, what happens to electrolyte levels?

Answer 18

• -Na decreases

- -K+ increases

Question 19

As shock progresses, what happens to glucose levels?

Answer 19

decrease

Question 20

What position do we not put a patient with cardiogenic shock?

Answer 20

Modified trendelenburg