ACNP Shock States- Questions and Answers

ACNP Shock States- Questions and
Answers
SvO2 Decreased Correct Ans-Implies increased tissue extraction of O2; the patient has
tapped the venous reserve of O2

Causes: decreased O2 supply (decreased CO, decreased FiO2, anemia) or increased O2 demande
(Fever, shivering, increased WOB)



SvO2 Elevation Correct Ans-Implies decreased tissue extraction of oxygen; high return of O2
is often a most early indicator of patient status changes

Causes: increased O2 supply (FiO2> need), decreased O2 demand (hypothermia), or decreased
effective O2 delivery and uptake by the cells (sepsis, shit of the oxyhemoglobin curve to the left)



Shock States Correct Ans-Clinical syndrome of systemic hypotension, acidemia, and
impairment of vital organ function resulting from tissue hypoperfusion



Hypovolemic Shock Correct Ans-Results from a loss of greater than 20% of circulating blood

Causes:

Internal/External bleeding

Burns

DKA/HHNK

Severe dehydration



Labs and Diagnostics of Hypovolemic Shock Correct Ans-Decreased CO/CI

, Decreased CVP

Decreased PWCP

*Increased SVR

Decreased SvO2



Management of Hypovolemic Shock Correct Ans-Fluid resuscitation is mainstay of treatment

PRBCs when indicated by Hgb/Hct



Cardiogenic Shock Correct Ans-A loss of effective contractile function results in impaired
cardiac output, impaired O2 delivery, and reduced tissue perfusion

Causes: "acute pump failure"

Acute MI

Ventricular aneurysm

Dysrhythmia

Pericardial tamponade

Hypoxemia

Pulmonary edema

Acute valvular regurgitation

Acute VSD



Labs and diagnostics of Cardiogenic Shock Correct Ans-Decreased CO/CI

Increased CVP

Increased PWCP