perfusion
this type of shock is caused by severe infection
what is septic or distributive
key regulator of the body's temperature
hypothalamus
conduction system of the heart IN ORDER :)
SA node. AV node. bundle of his. bundle branches (R-L). purkinje fibers
what is frostbite and stages with brief description
complication of hypothermia. exposed to temps less than 0C and progressive dermal ischemia leading to tissue necrosis
frostnip- redness, superficial- white waxy appearance, deep- blackening and death of tissues
give me 6 clinical manifestations of altered perfusion
cyanosis, pain, pallor, coolness, edema, SOB, tachy cardia and pnea, fatigue, hypo or hypertension, heart murmur etc.
these are the three types of circulation with definition
systemic- oxygen and nutrients are distributed to the body
coronary- blood flow to the heart's muscle support it to pump blood to body
pulmonary- circulation through lungs provides ability to transfer oxygen from atmosphere to body
types of heat loss with definitions and example of each
conduction- warmer skin to cooler surfaces; cold floor
convection- removal of heat due to air currents; fan
radiation- electromagnetic heat exchange; heat lamp
evaporation- vaporization of liquid on the skin; sweat is vaporized at skin surface
EKG waveforms with meanings
p wave- atria depolarize via SA node
p-q- depolarization of AV node and bundle branches
QRS- ventricles depolarize
t- repolarization of ventricles
u- repolarization of pukinje fibers
time when you would use therapeutic hypothermia and what it consists of
reduce ischemia, swelling, and oxygen demand- can improve survival after cardiac arrest, cardiac bypass, stroke/trauma, neonatal HIE
temp of 32-36 c
cool iv fluids, blankets, ice packs etc.
similar risks to accidental hypothermia so closely monitored
fever stages with description
prodromal- onset, nonspecific complaints
chill- rise in temp, feeling cold
flush- temp reaches new setpoint
defervescence- pyrogen level decreases naturally or through treatment
pathophysiological pathway for all types of shock
cellular hypoxia to anaerobic metabolism to lactic acidosis
hypothermia treatment for mild and moderate stages
mild 89.6-95- passive rewarming with blankets, insulated clothing, heated environment
moderate <89.6 - active rewarming with IV fluids, heated humidified oxyegn, external heat sources, may need core rewarming like lavage or ecmo
ALL 6 types of shock with cause of each
cardiogenic- heart doesn't pump good
hypovolemic- decreased blood volume
distributive- systemic vasodilation
septic- severe infection
neurogenic- brain or spinal cord injury
anaphylactic- IgE allergic reaction
hyperthermia and fever difference
hyperthermia is due to unregulated rise in core temperature, outside of hypothalamus control
all 3 stages of shock with definition of each
initial- sudden drop in perfusion, SNS and RAAS are triggered, cold, clammy, anxious, need medical help
progressive- lungs, kidney, gut, liver, decreased perfusion
irreversible- perfusion of heart and brain decreases MI and CVA likely
cardiac cycle aka blood flow through the heart IN ORDER :)
venous blood returns to heart. blood enters RA. blood goes though tricuspid valve to RV. blood goes through pulmonic valve to pulmonary artery and lungs. deoxygenated blood gets oxygenated by ventilation-perfusion. blood returns to heart via pulmonary vein to LA. blood goes through mitral valve to LV. blood goes through aortic valve to aorta. blood enters systemic circulation
what is fever, triggered by what, temp rises how
temp above 100.4 f
pyrogens
the hypothalamus resets the body temp to a higher one so your body has chills, and goosebumps. once tmep is reached the body will cool down by sweating and feeling flushed
diagnosis methods for acute MI
EKG-diagnosis stemi
blood tests- troponin, CK, CPK-MB, myoglobin
coronary angiogram- stent placement
which groups are at risk for altered thermoregulation
drugs and alcohol, cognitive impairment, athletes, elderly, neonates and newborns, homeless
heat conservation and heat dispersion methods
conserve- vasoconstriction, piloerection, shivering, BMR increases
disperse- sweating, vasodilation, decreased BMR
what is heart failure patho. right sided vs left sided with 5 manifestations of each
inadequacy of heart pumping so heart fails to maintain circulation of blood. impaired cardiac functioning, excessive workload demands.
RT- RV cannot pump efficiently. swelling of extremities. weight gain. JVD. lethergic/fatigue. nocturia. girth. edema. irregular heart rate
LT- LV cannot pump blood properly. dyspnea. rales. orthopnea. weakness/fatigue. increased heart rate. nagging cough. gain weight. bloody frothy sputum.
malignant hyperthermia and what it consists of
hypermetabolic crisis caused by genetic mutation RYR1, triggered by certain anesthetics, muscle relaxants like succinylcholine
core body temp great than 104
dantrolene will resolve it
what is an MI 5 clinical manifestations and 3 risk factors
prolonged ischemia of cardiac tissue leading to cellular death. complete obstruction of coronary artery due to plaque, thrombosis, plaque rupture
smoking, HTN, hypercholesterolemia, obesity, diabetes, family history heart disease
chest pain, pressure, squeezing. radiation to neck, jaw, left arm/shoulder. Levines sign. releived with rest/nitrates. brought on by stress exertion. dyspnea, dizziness, lightheadedness
hyperthermia stages with two manifestations from each
mild (heat stress), core temp- WNL or mildly elevated , caused by prolonged heat exposure
slow painful muscle cramps, sweating and flushed skin, fatigue, tachy cardia and pnea
moderate-heat exhaustion- >101, dehydration and sodium depletion
excessive sweating, thirst, n/v, dizziness, weakness, oliguria, changes in LOC
severe- heat stroke >104, thermoregulatory failure
hot dry flushed skin, no sweating, changes in LOC, tachy carida and pnea, hypotension, multi organ failure, cardiorespiratory collapse
hypothermia stages with 2 manifestations from each
mild- 32-35- shivering, HTN, tachy, cyanosis
moderate- 28-32- no longer shivering, respiratory acidosis, hypotension, dysrthymias
severe-<28- lactic acidosis, fatal cardiac arythmias, decreased reflexes, unconscious
profound- <28- survival unlikely, need ecmo, absent muscle reflexes