ciculatory shock

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What shock results from dimished blood flow? Usually from burns or hemmorage: Hypovolemic Shock
characterized by loss of blood vessel tone and enlargement of vessel compartment Ex anaphalaxis: Distributive Shock
Failure of heart to pump blood adequately Ex pulmonary embolism most common cause is MI: Cardiogenic Shock
What are the signs and symptoms of inital phase of shock?: Thirst
Anxiety
Mild Tachycardia
Signs and symptoms of compensatory phase of shock: Maintained BP and tissue perfusion
Signs and symptoms of Progressive Stage or Stage of Decompensated Shock: Low BP
Blood flow to heart and brain impaired
elevated capillary permeability
Sluggish blood flow
Signs and symptoms of irreversible stage of shock: blood volume may restore and vital signs may stabilize bu
DEATH WILL ENSUE
What is inadequate tissue perfussion?: SHOCK
Where is the blood diverted to when a person is in shock?: Mostly brain and heart but other vital organs as well.
Decreased kidney perfusion means what?: Decreased urinary output.
When is RAA mechanism initiated during shock?: When there is a decrease in renal blood flow and glomular filtration rate, the RAA is initiated which produces an increase in sodium reabsorption from the kidneys.
Why does a patient turn pale when in shock??: Because blood is shunted to major organs
Why does oliguria occur during shock??: It is a decrease in kidney perfusion because of blood shunt to brain and heart.
What is the best indicator of tissue perfusion?: Urinary Output
Decreased tissue perfussion leads to the following:: Decreased ATP formation
Build-up of Lactic Acid Wastes
(tachypnea = lungs compensate)
tissue hypoxia
Increased capillary permeability w/ fluid shifts
cells eventually die because of hypoxia
Acidosis
What is caused by lysosomal membranes that rupture and lysosomal enzymes that "kill" the cells?: Acidosis
What senses BP changes?: Baroreceptors
Adrenal glands release what?: Epinephrine
Corticosteroids
Treatment of shock is directed at what?: Correcting underlying problem

Also supportive care (O2, volume replacement, vasoactive drugs)
What does dopamine do?: At low doses, it improves renal blood flow and improves urinary output.
Why would you keep a patient in shock NPO?: To prevent vomiting, aspiration, D/T blood being diverted away from GI tract.
Maintain body temp but avoid overheating BECAUSE: elevated temp leads to: vasodilation
Elevated metabolic rate
Higher O2 requirements
What are 5 complications of shock?: 1. ARDS acute respiratory distress syndrome
2. Acute Renal Failure
3. GI complications
4. DIC- Disseminated Intravascular Coagulation
5. MODS- Multiple Organ Dysfunction Syndrome
What is the mortality rate with ARDS?: More than 50%
What accounts for most cases of acute renal failure?: Sepsis and Trauma
Poor perfussion of GI allows what?: Bacteria which leads to sepsis and shock
In DIC (widespread fibrin clots and occlusion of small to med sized vessels) (predominate in pregnant women) what is used to prevent further clots?: Heparin
In MoDS what is not maintained ?: Homeostasis
What are the main organ systems affected by MODS?: kidneys, lungs, liver, brain, and heart. tX is focused on support of affected organ.
What are signs and symptoms of internal bleeding?: Thirst
Tachycardia (because in early shock, blood is shunted to the brain)

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