Cardiogenic shock
What is the most common cause of cardiogenic shock?
1. heart failure
2. heart attack
3. hypertension
4. fluid loss
Heart attack
What is the main treatment for hypovolemic shock due to hemorrhage?
1. iv fluids
2. diuretics
3. blood product transfusion
4. monitor, no treatment
Blood transfusion including packed red blood cells, plasma and platelets.
What is the first treatment for anaphylaxis?
1. diuretic
2. beta- blocker
3. epinephrine
4. atropine
epinephrine
Choose two early signs of systemic inflammation.
1. bradycardia
2. bradypnea
3. tachypnea
4. fever
5. low WBC count
6. tachycardia
Fever (temperature higher than 38 C or hypothermia (temperature less than 36 C)
Tachycardia (heart rate more than 90 beats per minute)
Tachypnea (respiratory rate more than 20 breaths per minute)
Leukocytosis (WBC greater than 12,000/cu mm) / leukopenia (white blood cells (WBC) less than 4,000/cu mm) with or without bandemia (more than 10%)
What is the number one cause of neurogenic shock?
1. brain injury
2. blunt cervical spine injury
3. car accident
4. lumbar spine injury
blunt cervical spine injury
What are the two causes of hypovolemic shock?
Hemorrhage (blood loss) and extracellular fluid loss
What should patients be encouraged to wear for safety?
1. watch
2. fitness tracker
3. ekg monitor
4. medical alert bracelet
medical alert braclet
What type of antibiotics should be administered to the patient and how quickly?
1. pcn
2. broad spectrum
3. narrow spectrum
4. bactericidal
Broad-spectrum antibiotics within one hour of diagnosis for all patients. Initial empiric anti-infective therapy should have activity against all likely pathogens and adequate penetration of source tissue.
Neurogenic shock is associated with which segment(s) of injury to the spine? SATA
1. lumbar
2. thoracic
3. sacral
4. cervical
cervical and high thoracic spine injury
What type of diagnostics may be ordered to evaluate a patient for cardiogenic shock? SATA
1. labs
2. chest xray
3. echocardiogram
4. cardiac CT scan
5. coronary angiography
6. ekg
Labs (such as abg, bmp, cbc), cardiac CT scan, chest x-ray, coronary angiography, echocardiogram, EKG
Choose three causes of hemorrhagic shock?
1. diuretics
2. bleed from ectopic pregnancy
3. diabetic ketoacidosis
4. liver failure
5. trauma
6. gi. bleed
7. infection
- Trauma (#1 cause)
-gastrointestinal (GI) bleed
-bleed from an ectopic pregnancy
-bleeding from surgical intervention
-vaginal bleeding
How will the physician determine the cause of anaphylactic shock?
1. physical assessment
2. medical history
3. allergy list
4. allergy testing
allergy testing
Name three signs/symptoms that will be observed in septic shock.
1. anuria
2. increased urine output
3. hyperactive bowel sounds
4. ileus
5. fever
6. nausea
7. agression
Altered mental status
Oliguria or anuria
Hypoxia
Cyanosis
Ileus
hypotension
fever
tachycardia
tachypnea
hypothermia
Besides trauma, choose three causes of neurogenic shock.
1. spinal anesthesia
2. lung cancer
3. autonomic nervous system toxins
4. hemorrhagic stroke
5. Trisomy 21
-spinal anesthesia
-Guillain-Barre syndrome
-autonomic nervous system toxins
-transverse myelitis
-other neuropathies
-Trisomy 21
-skeletal dysplasia
-tonsillopharyngitis
What is the main treatment for hypovolemic shock related to fluid loss?
1. blood product administration
2. encourage oral fluid intake
3. monitor, no treatment
4. iv fluid resuscitation
Fluid resuscitation with 2 liters of isotonic crystalloid solution infused rapidly. (Isotonic saline is hyperchloremic relative to blood plasma, and resuscitation with large amounts can lead to a hyperchloremic metabolic acidosis. Several other isotonic fluids with lower chloride concentrations exist, such as lactated Ringer's solution or PlasmaLyte. Fluid chosen will be upon patient chemistry and physician preference.)
Name the substance released by the body during anaphylaxis.
1. histamine
2. aldosterone
3. anti-histamine
4. anti-diuretic hormone
Histamine
Name four risk factors that put a patient at risk for septic shock.
1. hemodialysis
2. malignancy
3. urinating independently
4. stroke
5. heart attack
6. alcoholism
7. diabetes
8. trauma
Diabetes
Malignancy
Chronic kidney and liver disease
Use of corticosteroids
Immunosuppressed state
Burns
Major surgery
Trauma
Presence of indwelling catheters
Prolonged hospitalization
Hemodialysis
Extremes of age
Name the three things utilized to diagnose neurogenic shock.
1. CT/MRI
2. c-xray
3. clinical exam
4. previous medical history
5. hemodynamic monitoring
-radiographic imaging (CT/MRI)
-hemodynamic monitoring
-clinical exam
What occurs in the body during cardiogenic shock?
1. blood clots develop
2. decreased oxygenation to the brain
3. decreased blood and oxygen to all vital organs
4. release of histamines due to allergergic reaction
Your heart cannot pump enough blood and oxygen to the brain, kidneys, and other vital organs.
What is the first change in seen in vital signs in hypovolemic shock?
1. hypotension
2. tachypnea
3. increase in diastolic blood pressure
4. hypertension
5. tachycardia
6. bradycardia
Increase in diastolic blood pressure with narrowed pulse pressure.
Which is a result the release of histamine can have on the body?
1. diuresis
2. increased glucose
3. pulmonary edema
4. hypertension
-drop in blood pressure
-Fluid can leak into the lungs, causing swelling (pulmonary edema)
-heart rhythm disturbances.
Name three complications of septic shock.
1. acute liver failure
2. GI bleed
3. ARDS
4. breast cancer
5. multiple organ failure
ARDS
Acute/chronic renal injury
DIC
Mesenteric ischemia
Acute liver failure
Myocardial dysfunction
Multiple organ failure
Define neurogenic shock.
1. Injury to the spinal cord with associated autonomic dysregulation
2. Injury to the brain stem with associated autonomic dysregulation
3. Injury to chest wall with associated autonomic dysregulation
Injury to the spinal cord with associated autonomic dysregulation.