What are the 3 types of shock? - Answers Hypovolemic, Cardiogenic, Distributive
3 Subdivisions of Distributive Shock - Answers Septic Shock
Anaphylactic Shock
Neurogenic Shock
Hypovolemic and Cardiogenic shock signs. (CO, HR, RR, BP, Temp, Pulse) - Answers Low CO
High HR
High RR
Low BP
Cold Temp
Weak Pulse
How does septic and anaphylactic shock differ from the others? - Answers Warm temperature
and strong pulse
How does neurogenic shock differ from the others? - Answers Low Heart Rate
Warm Temp
Strong Pulse
What is the main problem with hypovolemic shock? - Answers Inadequate fluid volume in the
vascular space (low preload, low cardiac output)k
What is the most common form of shock? - Answers Hypovolemic
What are the two etiologic factors of hypovolemic shock? - Answers Absolute (loss of blood,
plasma, or other bodily fluids)
Relative (Vasodilation, increased capillary permeability, decreased osmotic pressure)
What percentage of fluid loss is categorized as mild? - Answers 15% fluid loss, up to 750 mL;
Compensatory mechanisms are adequate
What percentage of fluid loss is considered mild to moderate? - Answers 15-30%, 750-1500 mL
More intense compensatory response is required
What are the characteristics of moderate fluid loss? - Answers 30-40% fluid loss, 1500-2000 mL
,Compensatory mechanisms are overwhelmed and ineffective tissue perfusion occurs
(tachycardia, arrhythmias, acidosis, confusion)
What are the characteristics of severe fluid loss? - Answers >40% fluid loss, >2000 mL
Tachycardia, hypotension, lactic acidosis, cyanosis, organ failure, no urine output
What are the compensatory mechanisms for hypovolemic shock? - Answers Catecholamine
release (increases SVR, HR, and contractility)
Shift of interstitial fluid
Release Aldosterone, ADH
Splenic Discharge
What are the assessment findings for hypovolemic shock? - Answers Decreased Cardiac Output
Decreased Preload d/t decreased venous return
Decrease CVP and PAWP
Increase in SVR due to increased afterload from arterial vasoconstriction.
What blood pressure measurement do you use in hypovolemic shock? Why? - Answers MAP is
more reliable because systolic and diastolic will be artificially high due to vasoconstriction.
What are the three goals of hypovolemic shock medical management? - Answers Correct the
cause of hypovolemia
Restore tissue perfusion
Prevent Complications
What types of fluids do you use to replace circulating volume? - Answers Crystalloid solution,
a colloid solution,
blood products,
or a combination
What types of medications are used to maintain perfusion until volume is restored? - Answers
Vasopressors
How often do you assess shock patients? - Answers Every 15 min until shock is controlled
What should be monitored in hypovolemic shock? - Answers LOC, Pulse, BP, Pulse Pressure,
, CVP, Respirations, Skin Color, O2 Sat, Cognition, Urine Output
How do you position a patient with hypotension? - Answers Legs elevated, trunk flat, with head
and shoulders above chest.
What is the definition of cardiogenic shock? - Answers The result of failure of the heart to
effectively pump blood forward. It can occur with dysfunction of the right or left ventricle, or
both. The lack of adequate pumping function leads to decreased tissue perfusion and
circulatory failure.
What are the three etiologies of cardiogenic shock? - Answers Problems affecting the cardiac
rhythm (MI- STEMI/NSTEMI)
Problems affecting the muscular function
Problems affecting the mechanical function of the heart. (Valvular disease, cardiac tamponade/
pulmonary embolus)
What are the signs/symptoms in the initial phase of cardiogenic shock? - Answers (Clinical
manifestations reflect the decline in cardiac output.)
SBP <90 mmHg
MAP <65 mmHg
Acute drop in BP >30 mmHg
Urine Output <30 mL/hr
Weak, thready pulses
Cool, pale moist skin
Difficulty breathing
Cough with frothy sputum, white or sometimes pink
Swelling in the feet and ankles
What are the signs and symptoms of the compensatory phase of cardiogenic shock? - Answers
Increased heart rate
Diminished S1, S2 heart sounds d/t decreased contractility
Increased Respiratory Rate
Hypotension
Hypoxia