PNP301 - TEST 3 QUESTIONS & ANSWERS
What is shock? - Answers - Widespread abnormal cellular metabolism that occurs
when the human need for oxygenation and tissue perfusion is not met to the level
needed to maintain cell function.
What is tissue perfusion? - Answers - blood flow through body tissues
What is shock the result of? - Answers - decreased circulating blood volume leading to
decreased tissue perfusion and general hypoxia
Why is shock considered a syndrome? - Answers - Identified through S&S
Because the cellular, tissue, and organ events that occur in response to its presence
happen in a predictable sequence.
What type of response is usually triggered when someone goes into shock? - Answers
- whole-body
What are main initial manifestations of shock? (2) - Answers - - hypotension
- anaerobic cellular metabolism
What is hypovalemic shock? - Answers - extensive loss of blood/ fluid volume
What commonly causes hypovalemic shock? - Answers - Commonly caused by
hemorrhage (external or internal) and dehydration (diarrhea/vomiting)
What is cardiogenic shock? - Answers - Occurs when the heart is damaged and
unable to supply sufficient blood to the body
What is vasogenic shock? - Answers - caused by sepsis, deep anesthesia, or
anaphylaxis
circulatory failure resulting from vasodilation
What is sepsis? - Answers - - systemic inflammatory response to documented or
suspected infection
- presence of tissue perfusion abnormalities
What is anaphylaxis? - Answers - -Severe allergic reaction
- Massive vasodilation
- Increased capillary permeability
,What are clinical manifestations of anaphylaxis? - Answers - - Anxiety, confusion,
dizziness
- Sense of impending doom
- Chest pain
- Incontinence
- Swelling of the lips and tongue, angioedema
- wheezing
- respiratory distress and circulatory failure
What is neurogenic shock? - Answers - Hemodynamic phenomenon that can occur
within 30 minutes of a spinal cord injury at the fifth thoracic (T5) vertebra or above and
can last up to 6 weeks.
- spinal cord injury
- opiod overdose
Sequence of Neurogenic Shock - Answers - - loss of sympathetic tone
- venous and arterial vasodilation
- decreased BP
- decreased venous return
- decreased stroke volume
- decreased cardiac output
- decreased cellular oxgen supply
- decreased tissue perfusion
- impaired cellular metabolism
What is poikilothermia? - Answers - inability to regulate body temperature
taking on the temperature of the environment
Stages of Circulatory Shock - Answers - 1) compensatory
2) progressive
3) decompensated/refractory
What is the difference between relative and absolute hypovalemia? - Answers -
absolute = reduction in total circulating blood volume
relative = decrease in the effective circulating blood volume (ex sepsis)
What are the precipitating factors of cardiogenic shock? - Answers - - Myocardial
infarction
- Cardiomyopathy
- Blunt cardiac injury
- Severe systemic or pulmonary hypertension
- Cardiac tamponade
- Myocardial depression from metabolic problems
, Damage to heart muscle
What is SIRS? - Answers - systemic inflammatory response syndrome
What is systemic inflammatory response syndrome? - Answers - when generalized
inflammation occurs and threatens vital organs
S&S of SIRS - Answers - 1) unexplained change in mental status (confusion, not as
awake and alert as normal).
2) fever of more than 100.4° F
3) increased heart rate
4) increased respiratory rate
5) abnormal white blood cell count (over 10,000)
What is distributive shock? - Answers - Shock due to widespread vasodilation
blood volume is not lost but is distributed to the interstitial tissues where it cannot
circulate and deliver oxygen
What is anasarca? - Answers - generalized edema
What is V/Q? - Answers - Ventilation-perfusion ratio
What does V/Q mismatch mean? - Answers - occurs when either the ventilation
(airflow) or perfusion (blood flow) in the lungs is impaired, preventing the lungs from
optimally delivering oxygen to the blood
see in the progressive stage of shock
What diagnostic tests would you do to confirm cardiogenic shock? - Answers - -
arterial line
- central line
- blood work
Why do you need an arterial line to manage/confirm cardiogenic shock? - Answers - to
allow for continuous monitoring of systolic blood pressure (SBP) and mean arterial
pressure (MAP)
Why do you need a central line to manage/confirm cardiogenic shock? - Answers - in
order to administer vasoactive agents, and measure central venous pressure and
central venous oxygenation when appropriate
What would you check for in someones bloodwork to confirm/manage shock? -
Answers - - BUN
- Creatinine
What is shock? - Answers - Widespread abnormal cellular metabolism that occurs
when the human need for oxygenation and tissue perfusion is not met to the level
needed to maintain cell function.
What is tissue perfusion? - Answers - blood flow through body tissues
What is shock the result of? - Answers - decreased circulating blood volume leading to
decreased tissue perfusion and general hypoxia
Why is shock considered a syndrome? - Answers - Identified through S&S
Because the cellular, tissue, and organ events that occur in response to its presence
happen in a predictable sequence.
What type of response is usually triggered when someone goes into shock? - Answers
- whole-body
What are main initial manifestations of shock? (2) - Answers - - hypotension
- anaerobic cellular metabolism
What is hypovalemic shock? - Answers - extensive loss of blood/ fluid volume
What commonly causes hypovalemic shock? - Answers - Commonly caused by
hemorrhage (external or internal) and dehydration (diarrhea/vomiting)
What is cardiogenic shock? - Answers - Occurs when the heart is damaged and
unable to supply sufficient blood to the body
What is vasogenic shock? - Answers - caused by sepsis, deep anesthesia, or
anaphylaxis
circulatory failure resulting from vasodilation
What is sepsis? - Answers - - systemic inflammatory response to documented or
suspected infection
- presence of tissue perfusion abnormalities
What is anaphylaxis? - Answers - -Severe allergic reaction
- Massive vasodilation
- Increased capillary permeability
,What are clinical manifestations of anaphylaxis? - Answers - - Anxiety, confusion,
dizziness
- Sense of impending doom
- Chest pain
- Incontinence
- Swelling of the lips and tongue, angioedema
- wheezing
- respiratory distress and circulatory failure
What is neurogenic shock? - Answers - Hemodynamic phenomenon that can occur
within 30 minutes of a spinal cord injury at the fifth thoracic (T5) vertebra or above and
can last up to 6 weeks.
- spinal cord injury
- opiod overdose
Sequence of Neurogenic Shock - Answers - - loss of sympathetic tone
- venous and arterial vasodilation
- decreased BP
- decreased venous return
- decreased stroke volume
- decreased cardiac output
- decreased cellular oxgen supply
- decreased tissue perfusion
- impaired cellular metabolism
What is poikilothermia? - Answers - inability to regulate body temperature
taking on the temperature of the environment
Stages of Circulatory Shock - Answers - 1) compensatory
2) progressive
3) decompensated/refractory
What is the difference between relative and absolute hypovalemia? - Answers -
absolute = reduction in total circulating blood volume
relative = decrease in the effective circulating blood volume (ex sepsis)
What are the precipitating factors of cardiogenic shock? - Answers - - Myocardial
infarction
- Cardiomyopathy
- Blunt cardiac injury
- Severe systemic or pulmonary hypertension
- Cardiac tamponade
- Myocardial depression from metabolic problems
, Damage to heart muscle
What is SIRS? - Answers - systemic inflammatory response syndrome
What is systemic inflammatory response syndrome? - Answers - when generalized
inflammation occurs and threatens vital organs
S&S of SIRS - Answers - 1) unexplained change in mental status (confusion, not as
awake and alert as normal).
2) fever of more than 100.4° F
3) increased heart rate
4) increased respiratory rate
5) abnormal white blood cell count (over 10,000)
What is distributive shock? - Answers - Shock due to widespread vasodilation
blood volume is not lost but is distributed to the interstitial tissues where it cannot
circulate and deliver oxygen
What is anasarca? - Answers - generalized edema
What is V/Q? - Answers - Ventilation-perfusion ratio
What does V/Q mismatch mean? - Answers - occurs when either the ventilation
(airflow) or perfusion (blood flow) in the lungs is impaired, preventing the lungs from
optimally delivering oxygen to the blood
see in the progressive stage of shock
What diagnostic tests would you do to confirm cardiogenic shock? - Answers - -
arterial line
- central line
- blood work
Why do you need an arterial line to manage/confirm cardiogenic shock? - Answers - to
allow for continuous monitoring of systolic blood pressure (SBP) and mean arterial
pressure (MAP)
Why do you need a central line to manage/confirm cardiogenic shock? - Answers - in
order to administer vasoactive agents, and measure central venous pressure and
central venous oxygenation when appropriate
What would you check for in someones bloodwork to confirm/manage shock? -
Answers - - BUN
- Creatinine
