Questions and Answers
Definition of shock - CORRECT ANSWER-The widespread abnormal cellular
metabolism that occurs when gas exchange with oxygenation and tissue perfusion
needs are not met sufficiently to maintain cell function.
Cells are not getting enough oxygen, and there are more waste products
Total blood volume (TBV) and cardiac output (CO) are directly or indirectly related to
MAP? - CORRECT ANSWER-Total blood volume and cardiac output are directly
related to MAP: increases in either TBV or CO raise MAP; decreases in either TBV or
CO lower MAP
Size of vascular bed is negatively or positively related to MAP? - CORRECT ANSWER-▪
The size of the vascular bed is inversely (negatively) related to MAP: Increases in the
size of the vascular bed lower MAP; decreases in the size of the vascular bed raise
MAP
What are the different types of shock - CORRECT ANSWER-] Distributive shock
(septic , neurogenic, anaphylactic)
Hypovolemic
cariogenic
Obstructive
Generalized definition of Distributive Shock and examples - CORRECT ANSWER-
Dilation of blood vessels.
Examples are septic, neurogenic, and anaphylactic
Initial tx for shock - CORRECT ANSWER-Basic Life Support (ABCs)
Definition of septic shock - CORRECT ANSWER-A widespread infection that triggers
whole body inflammation. it leads distributive shock when infections microorganisms are
present in the blood
Anaphylactic shock - CORRECT ANSWER-PUSH EPI
Manifestations of Septic Shock - CORRECT ANSWER-Tachycardia, cold skin,
hypotension
, Definition of Neurogenic shock - CORRECT ANSWER-Vasodilation due to the
overstimulation of the PNS/understimulation of the SNS
specific to brain and spinal cord (due to spinal cord injury above T5)
Neurogenic Shock presentation - CORRECT ANSWER-flaccid paralysis, bradycardia,
hypothermia
Neurogenic shock tx - CORRECT ANSWER-treat hypovolemia/prevent hypoxemia,
promote normal body temperature, monitor for dysrhythmias, and inotropic and
vasoconstrictor drugs
Definition of hypovolemic shock - CORRECT ANSWER-Occurs when there isn't enough
circulating blood volume leading to a decreased MAP, resulting in inadequate total body
perfusion and gas exchange
layman's terms: total body fluid decreased in all fluid compartments
Common causes of hypovolemic shock - CORRECT ANSWER-dehydration, poor
clotting with hemorrhage
what is the first line treatment for hypovolemic shock - CORRECT ANSWER-FLUIDS
colloids + fluids: pull from interstitum back into interstitial space (mannitol, albumin)
Fluid restrictions may be in place: Monitor for fluid overload, lung sounds, JVD,
increased pulmonary artery pressure, arterial wedge pressure, and R atrial pressures
what is the treatment for hypovolemic shock after fluids have failed to raise the blood
pressure - CORRECT ANSWER-Vasopressors
Definition of cardiogenic shock - CORRECT ANSWER-Occurs when the heart muscle is
unhealthy and pumping is impaired
(direct pump failure, but fluid volume is not affected)
Common causes of cardiogenic shock - CORRECT ANSWER--myocardial infarction
-any type of pump failure that decreases cardiac out and MAP
-any condition that causes severe dysfunction of the left ventricle (bilateral rales, JVD,
pedal edema)
Cardiogenic shock presentation - CORRECT ANSWER-hypotension/tachy, cool and
clammy skin, crackles/SOB/dyspnea, anxiety/restlessness
cardiogenic shock tx - CORRECT ANSWER-AGGRESSIVELY TREAT THE
UNDERLYING CAUSE: vasodilators (nitro), fluids, vasopressors (dopamine)