NUR 213 Exam #1 Question with verified answers
When shock occurs- √√body shunts blood to the heart, brain
Shock is triggered by- √√sustained drop in MAP- co drop
results in decreased blood volume
activating peripheral vasodilatation
- shock is severe or long lasting
- cellular hypoxia, cell death occurs
Initial (Early) shock- √√- sustained drop in MAP of less than 10 mmHg from normal levels
- circulating blood volume may decrease
- SNS increases HR, force of cardiac contraction, increased CO
- rise in arterial pressure
- perfusion is maintained
- symptoms mostly undetectable- mild rise in HR
Compensatory Shock- √√MAP falls 10-15 mmHg below normal levels
15-30% blood volume reduction
compensatory mechanisms
- decreased renal blood flow
- decreased hydrostatic pressure occurs
- only maintains for a short time
Oxygenation of heart and brain maintains
compensatory mechanisms soon become harmful
Progressive Shock- √√Sustained decrease in MAP of 20mmHg or more below normal levels
blood volume loss of 30-40%
Lactic acid formation- acidotic state
lacking energy, sodium-potassium pumps fail- causing potassium to move out of cell-
sodium & water move inward
Triggers cellular swelling- cells rupture
Urine output <20 ml/hr
Refractory shock- √√- generalized tissue anoxia, widespread cellular death occurs
- not responsive to treatment
Effects of shock on body systems- √√- initially normal HR & BP
, - HR rises- reduced CO output
- hypoxemia & tachypnea- ARDS
- liver becomes ineffective- metabolic acidosis- due to toxin buildup
- LOC- brain damage
- renal damage
- Acute tubular necrosis
- reduced skin color
- paleness of lips
- mucous membranes
- nail beds
- conjunctiva
- sweat glands- rid toxins
hypovolemic shock- √√- most common type of shock- often occurs with other types
- Decrease in intravascular volume, SV, CO, BP decrease
Decrease is circulating blood results from- √√- Hemorrhage
- Loss of intravascular fluid such as burns
- severe dehydration
- severe vomiting or diarrhea
- renal fluid loss
- fluid shifts to interstitial space, third spacing
- shock stage progresses with sustained loss of > 100 mL
Cardiogenic shock- √√- pumping ability cannot maintain CO
- MI (most common cause)
- cardiac tamponed
- Restrictive pericarditis
- cardiac arrest
- dysrhythmias
- pathologic changes in valves, cardiomyopathies
- complications of cardiac surgeries
- electrolyte imbalances
- drugs affecting cardiac muscle contractility
- head injuries causing damage to cardio regulatory center
What happens to body in cardiogenic shock- √√Decrease in CO leads to decrease in MAP
When shock occurs- √√body shunts blood to the heart, brain
Shock is triggered by- √√sustained drop in MAP- co drop
results in decreased blood volume
activating peripheral vasodilatation
- shock is severe or long lasting
- cellular hypoxia, cell death occurs
Initial (Early) shock- √√- sustained drop in MAP of less than 10 mmHg from normal levels
- circulating blood volume may decrease
- SNS increases HR, force of cardiac contraction, increased CO
- rise in arterial pressure
- perfusion is maintained
- symptoms mostly undetectable- mild rise in HR
Compensatory Shock- √√MAP falls 10-15 mmHg below normal levels
15-30% blood volume reduction
compensatory mechanisms
- decreased renal blood flow
- decreased hydrostatic pressure occurs
- only maintains for a short time
Oxygenation of heart and brain maintains
compensatory mechanisms soon become harmful
Progressive Shock- √√Sustained decrease in MAP of 20mmHg or more below normal levels
blood volume loss of 30-40%
Lactic acid formation- acidotic state
lacking energy, sodium-potassium pumps fail- causing potassium to move out of cell-
sodium & water move inward
Triggers cellular swelling- cells rupture
Urine output <20 ml/hr
Refractory shock- √√- generalized tissue anoxia, widespread cellular death occurs
- not responsive to treatment
Effects of shock on body systems- √√- initially normal HR & BP
, - HR rises- reduced CO output
- hypoxemia & tachypnea- ARDS
- liver becomes ineffective- metabolic acidosis- due to toxin buildup
- LOC- brain damage
- renal damage
- Acute tubular necrosis
- reduced skin color
- paleness of lips
- mucous membranes
- nail beds
- conjunctiva
- sweat glands- rid toxins
hypovolemic shock- √√- most common type of shock- often occurs with other types
- Decrease in intravascular volume, SV, CO, BP decrease
Decrease is circulating blood results from- √√- Hemorrhage
- Loss of intravascular fluid such as burns
- severe dehydration
- severe vomiting or diarrhea
- renal fluid loss
- fluid shifts to interstitial space, third spacing
- shock stage progresses with sustained loss of > 100 mL
Cardiogenic shock- √√- pumping ability cannot maintain CO
- MI (most common cause)
- cardiac tamponed
- Restrictive pericarditis
- cardiac arrest
- dysrhythmias
- pathologic changes in valves, cardiomyopathies
- complications of cardiac surgeries
- electrolyte imbalances
- drugs affecting cardiac muscle contractility
- head injuries causing damage to cardio regulatory center
What happens to body in cardiogenic shock- √√Decrease in CO leads to decrease in MAP
