Hypovolemic
Cardiogenic
Obstructive
Distributive
Septic
Anaphylactic
Neurogenic
100
This is a hallmark sign of hypovolemic shock. (vital sign change)
What is hypotension?
100
Most often caused by this cardiac event _________.
Other causes include______
What is a myocardial infarction?
- Severe hypoxemia, Acidosis, Hypoglycemia, Cardiomyopathy, Cardiac Tamponade, and Dysrhythmias.
100
These are the respiratory and cardiac causes of obstructive shock.
- Pulmonary embolism or tension pneumothorax or mechanical ventilation with high levels of positive end-expiratory pressure (PEEP).
- Aortic dissection, pericardial tamponade, pericardial effusion, or a mass within the heart itself can also result in obstructive shock.
100
The underlying cause of distributive shock is _______.
What is systemic vasodilation, which results in decreased perfusion to the heart, brain, and kidneys, which leads to organ damage.
100
This medication must be started quickly after cultures are drawn.
What are broad-spectrum antibiotics?
100
This is the definition of anaphylactic shock.
What is allergen exposure that results in an antigen-antibody reaction causing massive vasodilation.
100
The definition and likely causes of neurogenic shock...
Loss of sympathetic tone causing massive vasodilation. The blood volume is displaced causing hypovolemia despite having enough blood.
Head trauma, spinal cord injury(above T6), and epidural anesthesia are the most common causes. (can also result as a reaction to insulin)
200
Name two interventions used to treat hypovolemic shock.
Hemorrhagic: finding and stopping the sources of bleeding. The infusion of PRBCs and other blood products, such as platelets and plasma.
Non-Hemorrhagic: rapid infusion of warm isotonic crystalloids for a total of 30 mL/kg (0.9% sodium chloride or lactated ringers)
200
Clinical findings of cardiogenic shock include ______.
May include chest pain, significant arrhythmias along with narrowed pulse pressure, elevated jugular venous pulsations, and adventitious lung sounds (pulmonary edema/shortness of breath).
200
The definitive treatment for cardiac tamponade is this procedure.
What is pericardiocentesis?
200
The three main types of distributive shock are...
Septic Shock
Anaphylactic Shock
Neurogenic Shock
200
Early in septic shock, the skin may appear this way before progressing to cool and clammy.
What is warm and flushed (warm shock)?
200
Patients in anaphylactic shock often develop this life-threatening airway problem.
What is laryngeal edema or airway obstruction?
200
This type of shock often results in this unique vital sign pattern..
What is hypotension with bradycardia?
300
The body compensates for hypovolemia initially by activating this system.
What is the sympathetic nervous system.
300
These medications are given to improve contractility and perfusion.
Inotropics (milrinone lactate, dobutamine)
Vasopressors (dopamine, norepinephrine)
Vasodilator (sodium nitroprusside, nitroglycerin)
If MI related (antiplatelets: aspirin, heparin, clopidogrel)
300
These procedures are used to relieve pressure from a tension pneumothorax that can be causing obstructive shock.
What is needle decompression and chest tube insertion.
Nursing actions:
- Monitor ECG, SaO2, breath sounds and color
- Set up a water seal chest-drainage system, attach it to suction, check for leaks
- Monitor and document the drainage and obtain a chest X-ray post procedure
300
For a client experiencing hypotension due to shock, what position should the nurse place them in to increase venous return.
Modified Trendelenburg: client lies flat on their back with both legs elevated.
300
Rick factors for septic shock include __________.
Chronic kidney disease, invasive tubes or lines, immunosuppression, recent major surgery, traumatic injury including burns, advanced age, and cancer.
300
This medication is the first line treatment __________.
Followed by __________ to reduce symptoms.
Epinephrine
Antihistamines: diphenhydramine
Corticosteroids: hydrocortisone, methylprednisone
300
Because neurogenic shock impairs perfusion, the patient is at risk for ________ which can cause ______ and dry, warm extremities.
What is blood pooling, and blood clots.
400
The risk factors for the development of hypovolemic shock include ________.
Recent trauma, abdominal aortic aneurysms, peptic ulcer disease, and maternal clients who have hemorrhagic disorders.
400
These advanced treatments may be initiated for mechanical circulatory support (MCS)
IABP: Intra Aortic Balloon Pump
LVAD: Left Ventricular Assist Device
ECMO: Extracorporeal Membrane Oxygenation
400
Clinical findings of obstructive shock include ______.
Dyspnea, pale skin, impaired mental status, oliguria, shivering, and hypotension.
Tension Pneumothorax: Jugular venous distention (JVD), cyanosis, asymmetrical breathing pattern, absent breath sounds in at least 1 lung field, subcutaneous emphysema.
Pulmonary embolism: Hemoptysis, pulsus paradoxus
400
When capillary fluid leaks into the surrounding tissue, it results in vasodilation, which causes what pathophysiological response?
Decreased systemic vascular resistance, decreased cardiac output, and hypotension.
400
Treatment for Septic Shock
Aggressive fluid resuscitation (30ml/kg crystalloids)
Antibiotic therapy (broad spectrum while waiting for cultures) Depending on the severity of the client’s condition, other supportive care such as vasopressors (norepinephrine is first line) and mechanical ventilation may also be needed.
400
Client education for discharge after anaphylactic shock.
Allergen avoidance, Carrying epinephrine auto injector (Epi Pen), Allergen/Medical Alert Identification (bracelet)
400
Manifestations of neurogenic shock...
Hypotension, flushed and warm skin, autonomic dysreflexia, temperature dysregulation, orthostatic hypotension, and brady arrhythmias.
500
Manifestations seen at _______ % of blood loss include:
- tachycardia, tachypnea, oliguria, and orthostatic hypotension.
The client may also exhibit manifestations of internal hemorrhage: hematemesis, bloody stool, and abdominal distention.
What is 20-40% blood loss.
500
What is this called? 
Arterial Pressure Monitoring
- An invasive form of hemodynamic monitoring that allows for continuous blood pressure monitoring.
500
Treatment for Obstructive Shock
The focus of treatment for obstructive shock is removing the cause. Additional treatment consists of IV fluid administration and administration of vasopressors if needed.
500
When fluids, antibiotics, and vasopressors are not enough, this rescue therapy may be considered ......
What is corticosteroid therapy?
500
What are the two major complications caused by sepsis/septic shock?
MODS: Multiple Organ Dysfunction Syndrome
DIC: Disseminated Intravascular Coagulation
500
These are the clinical manifestations of anaphylactic shock...
Airway/Respiratory: throat tightness, lump in the throat sensation, hoarseness, stridor, wheezing, dyspnea, tachypnea, bronchospasm, laryngeal edema
Cardiovascular: hypotension, tachycardia (early), bradycardia (late), dizziness, syncope
Skin: flushing, urticaria (hives), pruritus (itching), angioedema (swelling of lips, tongue, face, eyelids)
500
Treatment and Therapies for Neurogenic Shock include...
IV fluids, vasopressors, atropine, oxygen, and spinal immobilization.