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Questions and Answers
Which condition is a cause of dissociative shock?
Which of the following is NOT a common sign or symptom of shock?
In which patient group can abnormal vital signs be absent until a significant volume of blood is lost?
What is one of the recommended management steps for a patient in shock?
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What should be avoided when managing a patient in shock?
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What position should a conscious patient be placed in during shock management?
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Which of the following statements about medication is true for a patient in shock?
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Which vital sign may indicate a near-fatal stage of shock?
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What type of shock is characterized by an acute loss of circulating blood volume?
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Which of the following is a common cause of distributive shock?
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What condition is most commonly associated with cardiogenic shock?
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What type of shock results from an obstruction in the flow to/from the heart?
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Which of the following best describes dissociative shock?
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Which factor distinguishes distributive shock from other types of shock?
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In addition to severe hemorrhage, which other condition can lead to hypovolaemic shock?
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Which of the following is NOT a cause of obstructive shock?
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Study Notes
Types of Shock
- Hypovolaemic Shock: Resulting from acute loss of circulating blood volume.
- Distributive Shock: Caused by widespread dilation of the peripheral vascular system.
- Cardiogenic Shock: Occurs when the heart fails to pump sufficient blood to meet metabolic needs.
- Obstructive Shock: Caused by obstruction in blood flow to/from the heart.
- Dissociative Shock: Resulting from decreased oxygen carrying capacity due to insufficient red blood cells or competing molecules.
Hypovolaemic Shock
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Causes:
- Severe haemorrhage (internal/external).
- Extensive burns leading to serum loss.
- Severe diarrhea or vomiting resulting in loss of water and electrolytes.
Distributive Shock
- Mechanism: Creates the effect of a larger container for the same blood volume, leading to “leaky” blood vessels and fluid shift to interstitial spaces.
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Common Causes:
- Anaphylaxis.
- Sepsis.
- Nervous system-related issues, such as spinal cord injury.
Cardiogenic Shock
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Common Causes:
- Myocardial infarction.
- Acute heart failure.
- Arrhythmias.
Obstructive Shock
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Causes:
- Tension Pneumothorax.
- Cardiac tamponade.
- Pulmonary embolism.
Dissociative Shock
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Causes:
- Anaemia, leading to insufficient red blood cells.
- Carbon monoxide poisoning, affecting oxygen utilization.
Signs & Symptoms of Shock
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General Symptoms:
- Tachycardia (increased pulse rate).
- Tachypnoea (increased respiratory rate or depth).
- Abnormal behaviour (agitation or confusion).
- Dizziness or fainting.
- Pale, cold extremities with delayed capillary refill.
- Sweating, dilated pupils, and excessive thirst.
- Severe Symptoms (Stage 4): Reduced level of consciousness (LOC) and bradycardia.
Patient Considerations
- Vital Signs: Certain groups (young athletic individuals, pregnant patients, those on beta blockers) may not exhibit abnormal vital signs until significant blood volume loss (1,000-1,500 ml) occurs.
Management of Shock
- Assessment: Conduct a time-critical assessment of the patient.
- Oxygen Administration: Provide high-concentration oxygen.
- Positioning: If conscious, have the patient lie flat with head and shoulders slightly elevated; if unconscious, place them in a stable side position.
- Lower Limb Elevation: Consider raising lower limbs to enhance perfusion.
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Additional Care:
- Treat other injuries and manage bleeding.
- Maintain body temperature; avoid overheating or excessive cooling.
- Handle the patient gently and provide reassurance.
- Perform constant observations (pulse, consciousness level, respiration).
- Withhold oral intake in case of potential anesthesia requirement.
- Transfer: Facilitate time-critical transfer to an appropriate medical facility and consider additional medical assistance if necessary.
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Description
This quiz covers the different types, causes, stages, and management strategies for clinical shock. Learners will explore hypovolemic, distributive, cardiogenic, obstructive, and dissociative shock, gaining a comprehensive understanding of this critical medical condition.
