Shock Module

Question 1

When does shock occur?

Answer 1

When the CV system fails to serve the body’s needs

Question 2

What does shock result in?

Answer 2

Impairment of cellular metabolism and tissue function

Question 3

What is the common characteristic of all types of shock?

Answer 3

Decreased oxygen delivery or increased tissue demand for oxygen

Question 4

What determines O2 delivery? (5)

Answer 4

• BP
• SVR
• CO
• SV
• O2 content

Question 5

BP =

Answer 5

CO X SVR

Question 6

SVR=

Answer 6

(Viscosity x length)/radius^4

Question 7

CO

Answer 7

SV XHR

Question 8

SV =

Answer 8

preload, afterload, contractility

Question 9

O2 content =

Answer 9

partial pressure of oxygen, [hemoglobin]

Question 10

What helps move oxygen from air to blood to tissues?

Answer 10

differences in partial pressure

Question 11

What increases O2 demand? (5)

Answer 11

• increased BMR
• infection/fever
• increased work of organs
• agitation or pain
• increased workload of heart

Question 12

Impaired O2 delivery will result in ___

Answer 12

shift from aerobic respiration to anaerobic respiration

Question 13

What are the 4 different stages of response to shock?

Answer 13

• initial stage
• compensatory stage
• progressive stage
• refractory stage

Question 14

What does the initial stage of shock entail?

Answer 14

cellular alterations as a result of decreased O2 delivery and utilization (no clinical symptoms are evident except for elevated lactate levels

Question 15

What does the compensatory stage of shock entail?

Answer 15

neural, hormonal, chemical responses designed to improve tissue perfusion and oxygen delivery

Question 16

What does the progressive stage of shock entail?

Answer 16

reached if compensatory mechanisms are unsuccessful in providing perfusion; multiple organs may shut down

Question 17

What does the refractory stage of shock entail?

Answer 17

reached if medial interventions are unsuccessful; organ damage is extensive, permanent damage to pericardium, death is inevitable

Question 18

What are the neural responses in the compensatory stage of shock?

Answer 18

• baroreceptors sense the decreased BP
• increased sympathetic output increased PVR, HR, CO, BP
• reduced blood flow to kidneys, GI, skin

Question 19

What are the hormonal responses in the compensatory stage of shock?

Answer 19

• adrenal medulla releases catecholamines
• posterior pituitary releases ADH
• reduced blood flow to kidneys results in the activation of RAAS

Question 20

What is the chemical response in the compensatory stage of shock?

Answer 20

hypoexmia and acidosis stimulate increase in respiratory depth and rate in effort to imrpove blood oxygenation and to blow off CO2 to correct for the acidosis

Question 21

Hypovolemic shock disrupts homeostasis by ___

Answer 21

reducing BV and BP

Question 22

What are types of cardiogenic shock?

Answer 22

• MI
• arrhythmias
• cardiomyopathy
• valve problems
• problems in ventricular flow/filling

Question 23

What causes cardiogenic shock?

Answer 23

Reduced SV/HR

Question 24

T or F: skin feels cool or cold in cardiogenic shock

Answer 24

TRUE

Question 25

What are types o obstructive shock?

Answer 25

- pulmonary embolism - pericardial effusion (tamponade) - tension pneumo-thorax

Question 26

What causes obstructive shock?

Answer 26

Impaired blood flow

Question 27

T or F: skins appears blue in obstructive shock

Answer 27

TRUE

Question 28

What are types of hypovolemic shock?

Answer 28

- bleeding | - dehydration

Question 29

What causes hypovolemic shock?

Answer 29

REDUCEED PRELOAD

Question 30

T or F: peripheral pulses are palpable in hypovolemic shock

Answer 30

FALSE

Question 31

What are types of distributive shock?

Answer 31

- sepsis - anaphylaxis - acute spinal cord injury - venoms - overactive thyroid

Question 32

What causes distributive

Answer 32

Low SVR

Question 33

T or F: skin appears pink/flushed and warm in distributive shock

Answer 33

TRUE

Question 34

Clinical changes in which vital organs serve to identify the presence of shock?

Answer 34

Brain, heart, kidneys

Question 35

What is the mortality rate of septic shock?

Answer 35

24-35%

Question 36

What is the mortality rate of cardiogenic shock?

Answer 36

35-56%