Chapter 12: Shock

Occurs when a person reacts violently to a substance to which he or she has been sensitized. Each subsequent exposure tends to produce a more severe reaction

anaphylactic shock

What are the 4 common types of distributive shock?

anaphylactic, neurogenic, septic, and psychogenic

What is a major problem of cardiogenic shock?

backup of fluid into the lungs, also known as pulmonary edema

What are the differences between arteries, veins, and capillaries?

-Arteries carry blood away from your heart. -Veins carry blood back toward your heart. -Capillaries, the smallest blood vessels, connect arteries and veins

Cyanosis

A blue skin discoloration that is cased by a reduced level of oxygen in the blood.

cardiogenic shock

A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. it can be a severe complication of a large acute myocardial infarction, as well as other conditions.

When should nonlifesaving interventions be performed for your multisystem trauma patient? Select one: A. En route to the hospital B. Prior to transport C. During the primary assessment D. Immediately after the injuries are discovered

A. En route to the hospital

Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________. Select one: A. compensated shock B. decompensated shock C. late shock D. irreversible shock

A. compensated shock

Hypovolemic shock caused by severe burns is the result of a loss of: Select one: A. plasma. B. platelets. C. whole blood. D. red blood cells.

A. plasma

Shock due to severe infection is called ________. Select one: A. septic shock B. neurogenic shock C. anaphylactic shock D. hypovolemic shock

A. septic shock

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as: Select one: A. the skin. B. the heart. C. the brain. D. the lungs.

A. the skin.

Which of the following injuries would MOST likely cause obstructive shock? Select one: A. Liver laceration B. Cardiac tamponade C. Simple pneumothorax D. Spinal cord injury

B. Cardiac tamponade

As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be? Select one: A. Check for a pulse. B. Control the bleeding. C. Open the airway. D. Administer oxygen.

B. Control the bleeding.

Foods, medications, and insects are common causes of ________. Select one: A. septic shock B. anaphylactic shock C. neurogenic shock D. psychogenic shock

B. anaphylactic shock

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should: Select one: A. apply pressure to the brachial artery. B. apply a tourniquet proximal to the wrist. C. administer high-flow supplemental oxygen. D. wrap the towel with pressure bandages.

B. apply a tourniquet proximal to the wrist.

When assessing a patient with signs and symptoms of shock, it is important to remember that: Select one: A. the patient's respirations are deep during the early stages of shock. B. blood pressure may be the last measurable factor to change in shock. C. multiple fractures are the most common cause of hypovolemic shock. D. irreversible shock often responds well to a prompt blood transfusion.

B. blood pressure may be the last measurable factor to change in shock.

Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________. Select one: A. hypovolemic shock B. cardiogenic shock C. neurogenic shock D. septic shock

B. cardiogenic shock

Inadequate circulation of blood throughout the body is called ________. Select one: A. hypotension B. shock C. perfusion D. hypoxia

B. shock

Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax? Select one: A. Early administration of high-flow oxygen B. Rapid administration of intravenous fluids C. Decompression of the injured side of the chest D. Positive-pressure ventilation with a bag-valve mask

C. Decompression of the injured side of the chest

Pulmonary edema and impaired ventilation occur during: Select one: A. septic shock. B. neurogenic shock. C. cardiogenic shock. D. anaphylactic shock.

C. cardiogenic shock.

You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________. Select one: A. an increased heart rate B. peripheral vasodilation C. peripheral vasoconstriction D. hypothermia

C. peripheral vasoconstriction

What happens when a massive pulmonary embolism occurs?

Can result in complete backup of blood in the right ventricle. Also leads to catastrophic obstructive shock and complete pump failure

Cardiac Tamponade

Compression of the heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cardiac output.

What are the three components of the "perfusion triangle"? Select one: A. Arteries, veins, capillaries B. Plasma, red blood cells, platelets C. Heart, brain, lungs D. Heart, blood vessels, blood

D. Heart, blood vessels, blood

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? Select one: A. High-flow oxygen administration B. Full immobilization of her spine C. Intravenous fluid administration D. Rapid transport to a trauma center

D. Rapid transport to a trauma center

When treating an 80-year-old patient who is in shock, it is important to remember that: Select one: A. compensation from the respiratory system usually manifests with increased tidal volume. B. the older patient's central nervous system usually reacts more briskly to compensate for shock. C. medications older patients take for hypertension often cause an unusually fast heart rate. D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting

In an acute injury setting, neurogenic shock is commonly accompanied by: Select one: A. hypovolemia. B. tachycardia. C. diaphoresis. D. hypothermia.

D. hypothermia.

Distributive shock occurs when: Select one: A. an injury causes restriction of the heart muscle and impairs its pumping function. B. severe bleeding causes tachycardia in order to distribute blood to the organs faster. C. temporary but severe vasodilation causes a decrease in blood supply to the brain. D. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

D. widespread dilation of the blood vessels causes blood to pool in the vascular beds

Shock caused by an uncontrolled dilation of the blood vessels.

Distributive shock

What are the signs and symptoms of decompensated shock?

HYPOTENSION, Unresponsiveness, Bradycardia, Bradypnea, respiratory and Cardiac Arrest Imminent

Occurs when there is an "obstruction" of a major vessel that causes less blood to be pumped by the heart

Obstructive shock

What is your treatment of shock?

Perform primary assessment • Ensure ABCs are properly supported & monitored • Control any obvious hemorrhage • Administer O2 as needed • Keep the patient in the supine position • MAINTAIN NORMAL BODY TEMPERATURE • Calm & reassure the patient • Do not give anything by mouth • Monitor V/S (every 5 minutes for a critical patient)

What is the disruption of O2 transfer into the cells or cells unable to utilize the O2. This can be caused by cyanide andCO poisoning.

Respirator/ Metabolic Shock

What are the signs and symptoms of compensated shock?

Restlessness, Altered Mental Status, Tachycardia, Tachypnea, Pale/Cool/Diaphoretic Skin- Sluggish Pupils- Nausea/Vomiting, NORMAL BP

a state of collapse and failure of the cardio vascular system

Shock

Obstructive condition that is caused by damage to lung tissue. The air normally held within the lung escapes into the chest cavity. The lung collapses, and air applies pressure to the organs, including the heart and great vessels.

Tension pneumothorax

What occurs in the body when it attempts to compensate for shock?

The blood flow is directed from organs that are more tolerant of low flow to organs that cannot tolerate low blood flow

What does systolic blood pressure represent?

The blood pressure when the heart is contracting.

pulmonary embolism

a blood clot that blocks the flow of blood through pulmonary vessels

pericardial effusion

a collection of fluid between the pericardial sac and the myocardium

shock

a condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypo perfusion.

hypothermia

a condition in which the internal body temperature falls below 95 degrees

distributive shock

a condition that occurs when there is widespread dilation of the small arterioles, small venules, or both

syncope

a fainting spell or transient loss of consciousness.

Aneurysm

a swelling or enlargement of a part of an artery, resulting from weakening of the arterial wall.

Also known as pump failure. Occurs when the heart is not able to pump efficiently to maintain adequate perfusion.

cardiogenic shock

sphincters

circular muscles that encircle and, by contracting, constrict a duct, tube, or opening

neurogenic shock

circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries

The late stage of shock when blood pressure is falling.

decompensated shock

occurs when there is an inadequate amount of fluid in the body, either blood or other fluids such as water and plasma.

hypovolemic shock

What are the 4 categories of exposure for anaphylactic shock?

injections, stings, ingestion, and inhalation

What can cause hemorrhagic hypovolemic shock?

injuries involving blood loss

The stage of shock that is past the point of no return

irreversible shock

Occurs when the spinal cord is damaged and unable to control vasomotor tone. Usually, the result of high spinal cord injury.

neurogenic shock

Signs of this type of shock include the absence of sweating below the level of injury, normal and low heart rate in the presence of hypotension, and normal warm skin

neurogenic shock

Occurs as a result of severe infections in which toxins are generated by bacteria or by infected body tissues

septic shock

Anaphylactic shock

severe shock caused by an allergic reaction

psychogenic shock

shock caused by a sudden, temporary reduction in blood supply to the brain that causes syncope

hypovolemic shock

shock caused by fluid or blood loss.

septic shock

shock caused by severe infection, usually bacterial infection.

obstructive shock

shock that occurs when there is a block to blood flow int he heart or great vessels, causing an insufficient blood supply to the body's tissues.

How do you calculate a patient's pulse pressure?

subtract the diastolic pressure from the systolic pressure

cyocardial contractility

the ability of the heart muscle to contract.

perfusion

the circulation of an adequate amount of blood to meet the cells' current needs

pulse pressure

the difference between the systolic and diastolic pressures.

Compensated Shock

the early stage of shock, in which the body can still compensate for blood loss.

De-compensated shock

the late stage of shock when blood pressure is falling

edema

the presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.

What does the diastolic blood pressure represent?

the pressure maintained within the arteries while the heart rests between heartbeats

What are the three parts of the cardiovascular system?

the pump(heart), the pipes/container(blood vessels or arteries ), and the fluid/contents(blood)

What is the medical term for hives?

urticaria

What can cause non-hemorrhagic hypovolemic shock?

vomiting, diarrhea, dehydration

How long does anaphylactic shock take to develop?

within minutes or even seconds of contact with substance