Chapter 10 Shock

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Chapter 10 Shock
2014-03-05 13:27:07
Chapter 10 Shock

Chapter 10 Shock
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  1. Two non-cardiovascular causes of shock include:
    • respiratory insufficiency
    • anaphylaxis
  2. The Golden Period refers to the first 60 minutes after:
    the injury occurs.
  3. The body is perfused via the:
    circulatory system.
  4. Refers to a state of collapse and failure of the cardiovascular system that leads to inadequate circulation.
  5. Two types of shock associated with pump failure:
    • obstructive
    • cardiogenic
  6. Two types of shock due to low fluid volume:
    • Hemorrhagic
    • Nonhemorrhagic
  7. Type of shock due to poor vessel function:
  8. Four types of distributive shock:
    • Septic
    • Neurogenic
    • Anaphylactic
    • Psychogenic
  9. ____ shock is caused by inadequate function of the heart, or pump failure.
  10. A major effect of cardiogenic shock:
    backup of blood into the lungs
  11. Build up of fluid into the lungs:
    pulmonary edema
  12. The presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.
  13. ____ shock develops when the heart cannot maintain sufficient output to meet the demands of the body.
  14. ____ shock occurs when conditions that cause mechanical obstruction of the cardiac muscle also affect the pump function.
  15. Two common causes of obstructive shock:
    • Cardiac tamponade
    • Tension pneumothorax
  16. -It is a collection of fluid between the pericardial sac and the myocardium.
    -It is caused by blunt or penetrating trauma and can progress rapidly.
    -Blood leaks into the tough fibrous membrane known as the pericardium, causing an accumulation of blood within the pericardial sac.
    -This accumulation leads to compression of the heart.
    Cardiac tamponade
  17. Signs and symptoms of cardiac tamponade are referred to as ____ triad:
    • Beck’s
    • the presence of jugular vein distention
    • muffled heart sounds
    • systolic and diastolic blood pressure starting to merge
  18. -It is caused by damage to lung tissue.
    -The damage allows air normally held within the lung to escape into the chest cavity.
    -This air applies pressure to the organs, including the heart.
    Tension pneumothorax
  19. ____ shock results when there is widespread dilation of small arterioles, venules, or both.  The circulating blood volume pools in the expanded vascular beds and tissue perfusion decreases.
  20. ____ shock occurs as result of severe infections, usually bacterial, in which toxins are generated by the bacteria or by infected body tissues.  The toxins damage the vessel walls, causing increased cellular permeability.  The vessel walls leak and are unable to contract well.  Widespread dilation of vessels, in combination with plasma loss through the injured vessel walls, results in shock.
  21. ____ shock is a complex problem.
    -There is an insufficient volume of fluid in the container, because much of the plasma has leaked out of the vascular system (hypovolemia).
    -The fluid that has leaked out often collects in the respiratory system, interfering with ventilation.
    -The vasodilation leads to a larger-than-normal vascular bed to contain the smaller-than-normal volume of intravascular fluid.
  22. ____ shock is usually a result of injury to the part of the nervous system that controls the size and muscle tone of the blood vessels.
  23. In ____ shock, the muscles in the walls of the blood vessels are cut off from the sympathetic nervous system and nerve impulses that cause them to contract.
    -All vessels below the level of the spinal injury dilate widely, increasing the size and capacity of the vascular system and causing blood to pool.
    -The available 6 L of blood in the body can no longer fill the enlarged vascular system.
    -Even though no blood or fluid has been lost, perfusion of organs and tissues becomes inadequate, and shock occurs.
  24. ____ occurs when a person reacts violently to a substance to which he or she has been sensitized.
  25. Note that ____ is a late sign of anaphylactic shock.
  26. A patient in ____ shock has had a sudden reaction of the nervous system that produces a temporary, generalized vascular dilation, resulting in fainting, or syncope.
  27. Life-threatening causes of psychogenic shock include (two things):
    • irregular heartbeat
    • brain aneurysm
  28. ____ shock is the result of an inadequate amount of fluid or volume in the system.
  29. ____ shock also occurs with severe thermal burns.  Intravascular plasma is lost.  Plasma leaks from the circulatory system into the burned tissues that lie adjacent to the injury.
  30. An insufficient concentration of ____ in the blood can produce shock as rapidly as vascular causes.
  31. Certain types of poisoning may affect the ability of cells to metabolize or carry oxygen including (two things):
    • Carbon monoxide poisoning
    • Cyanide poisoning
  32. ____ occurs when there is an abnormally low number of red blood cells.
  33. In early stages of shock, the body can still compensate for blood loss.
    Compensated shock
  34. The late stage of shock, when blood pressure is falling.
    Decompensated shock
  35. Terminal stage of shock where a transfusion of any type will not be enough to save a patient’s life.
    Irreversible shock
  36. The last measurable factor to change in shock.
    Blood pressure
  37. A rapid pulse suggests ____ shock.
  38. Increasing cardiac output should be the priority in treating ____ ____.
    cardiac tamponade
  39. Apply high-flow oxygen however surgery is the only definitive treatment for ____ ____.
    cardiac tamponade
  40. ____, which involves penetrating the pericardium with a needle and withdrawing the accumulated blood from the pericardial sac, is the only practical ALS prehospital approach for cardiac tamponade.
  41. In ____ ____, high-flow oxygen via nonrebreathing mask should be applied to prevent hypoxia.
    tension pneumothorax
  42. Usually the only action that can prevent eventual death from a ____ ____ is decompression of the injured side of the chest, relieving the pressure in the chest and allowing the heart to expand fully again.
    tension pneumothorax
  43. The proper treatment of ____ shock requires complex hospital management, including antibiotics.
  44. A condition that occurs when there is widespread dilation of the small arterioles, small venules, or both.
    distributive shock
  45. A swelling or enlargement of part of a blood vessel, resulting from weakening of the vessel wall.
  46. The force or resistance against which the heart pumps.
  47. The precontraction pressure in the heart as the volume of blood builds up.
  48. The three basic causes for shock are poor pump function, dilating blood vessels, and:
    blood or fluid loss.
  49. At what systolic blood pressure should you recognize that an adult patient is in decompensated shock?
    90 mm Hg
  50. When treating a patient who exhibits signs and symptoms of shock, which of the following actions would not be appropriate?
    A. Provide high flow oxygen via nonrebreather mask.
    B. Splint all suspected extremity fractures.
    C. Request ALS back-up.
    D. Control external breathing.
    B. Splint all suspected extremity fractures.
    (this multiple choice question has been scrambled)
  51. A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You
    administer 100% oxygen and give him epinephrine via subcutaneous injection.  Upon reassessment, you determine that his condition has not improved. You should:
    A. repeat the epinephrine injection after consulting with medical control.
    B. transport him immediately and provide supportive care while en route.
    C. request a paramedic unit that is stationed approximately 15 miles away.
    D. consider that he may actually be experiencing an acute asthma attack.
    A. repeat the epinephrine injection after consulting with medical control.
    (this multiple choice question has been scrambled)