1.8 Physiology of Shock
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What is circulatory shock?
- Acute circulatory crisis
- Inadequate CO to meet tissue needs
- Low BP
- Inadequate peripheral flow
- Vital tissues become starved for oxygen and overloaded w/ toxic waves
What are the major causes of circulatory shock?
- Decreased CO
- Cardiac Tamponade
- Severe systemic allergic rxn
What is irreversible circulatory shock?
- All forms of known therapy are inadequate to save the person's life
What should you give to help restore coronary circulation and ventricular function?
- Thrombolytic drugs like Tissue Plasminogen activator
- t-PA = Altepase
What is the tx for Cardiogenic Shock?
Requires balance between improving CO, reducing workload, and oxygen needs of the myocardium, and increasing coronary perfusion
How much fluid loss will occur in a Hypovolemic Shock?
15-20% of total blood volume
What are the basic signs and symptoms of Hypovolemic shock?
- Hypotnesion (Systolic pressure below 90 mmHg)
- Pale, cool, clammy skin
- Frequent confusion and disorientation (drop in BP in brain)
- Rise in HR and rapid, weak pulse
- Cessation of urination
- Drop in blood pH (acidosis)
What is the most frequent cause of obstructive shock?
What is the most common cause of Cardiogenic Shock?
Failure of L. Ventricle due to CAD and MI
What are the 3 causes of Obstructive shock?
- Pulmonary Embolus
- Cardiac Tamponade
- Dissecting Aortic Aneurysm
What are the 2 types of reversible cardiogenic shock and describe them?
- Non-progressive (compensated)
- Body's normal compensatory mechanisms result in full recovery w/o outside intervention (therapy)
- Progressive (shock causes more shock)
- Outside intervention required; otherwise shock becomes progressively worse until death
What are the stages of progression of shock?
What are the different types of circulatory shock and how do each type influence the circulatory system?
- Cardiogenic - heart as a pump
- Hypovolemic - loss of fluid from the vascular compartment
- Distributive - Increase in the size of the vascular compartment that interferes w/ the distribution of blood
How does hemorrhage lead to circulatory shock?
- Hypovolemic Shock
- Loss of fluid from vascular compartment
What are the 5 main complications of severe shock?
- Pulmonary injury
- Acute renal failure
- GI ulcerations
- Disseminated IV coagulation (DIC)
- Multiple organ dysfunction syndrome (MODS)
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