Shock: Types and Treatment Overview

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Questions and Answers

Match the condition with its associated symptom:

Cardiac Myxoma = Heart failure (HF) Cardiac Tamponade = Jugular vein distension Pneumothorax = Increased right heart pressure Pulmonary Embolism = Evidence of embolism

Match the treatment with its corresponding condition:

Tumor resection = Cardiac Myxoma Chest tube placement = Pneumothorax Pericardiocentesis = Cardiac Tamponade Thrombolysis = Pulmonary Embolism

Match the shock type with its cause:

Obstructive shock = Pulmonary Embolism Cardiogenic shock = Inability of the heart to fill properly

Match the consequence to untreated shock with its description:

ARDS = Lungs become stiff and fibrotic AKI = Acute kidney injury GI complications = Bowel obstruction or bleeding DIC = Bleeds from every orifice due to liver failure Signup and view all the answers

Match the primary usage with the hemodynamic response:

Maintaining blood flow = Response to shock forces Supplying oxygen = Tissue requirement Increasing heart rate = Compensatory mechanism Reducing fluid accumulation = Treatment for Cardiac Tamponade Signup and view all the answers

Match the symptom with its related condition:

Malaise = Cardiac Myxoma Weight loss = Cardiac Myxoma Fever = Cardiac Myxoma Fatigue = Cardiac Myxoma Signup and view all the answers

Match the term with its definition:

Multi-organ dysfunction syndrome = Frequent cause of death ARDS = Acute respiratory distress syndrome AKI = Acute kidney injury DIC = Disseminated intravascular coagulation Signup and view all the answers

Match the hemodynamic issue with its consequence:

Increased right heart pressure = Cardiac Tamponade Jugular vein distension = Obstructive shock Decreased blood flow = Heart failure Fluid accumulation = Pulmonary edema Signup and view all the answers

Match the sign with its possible cause:

Increased right heart pressure = Pulmonary embolism Jugular vein distension = Obstructive shock Fatigue = Systemic illness from Cardiac Myxoma Shortness of breath = Pneumothorax Signup and view all the answers

Match the type of shock with its primary cause:

Hypovolemic shock = Blood loss of 15% or more Cardiogenic shock = Heart not pumping properly Neurogenic shock = Spinal cord injury above T6 Anaphylactic shock = Histamine release due to allergies Signup and view all the answers

Match the type of shock with its signs:

Hypovolemic shock = Tachycardia and cool clammy skin Cardiogenic shock = Cyanosis and hypotension Neurogenic shock = Low BP and increased HR Anaphylactic shock = Abdominal cramps and hives Signup and view all the answers

Match the type of shock with its treatment:

Hypovolemic shock = Find the cause and replace fluids Cardiogenic shock = Increase CO and cardiac perfusion Neurogenic shock = Give NE and IV fluids Anaphylactic shock = Steroids and ephedrine Signup and view all the answers

Match the stage of shock with its description:

Compensated shock = Body compensates for blood loss Decompensated shock = Body can no longer compensate Irreversible shock = Loss of perfusion to vital organs Septic shock = Dangerous infection in the blood Signup and view all the answers

Match the physiological response with its receptor:

Increased heart rate = B1 receptors Vasoconstriction = A receptors Vasodilation = B2 receptors Pooling of blood vessels = Loss of SNS tone Signup and view all the answers

Match the cause of septic shock with its consequence:

Anticoagulation imbalance = Septic shock Fever = Signs of infection Leukocytosis = Immune response activation Metabolic acidosis = Tissue perfusion issues Signup and view all the answers

Match the treatment need with its type of shock:

Find the cause and replace fluids = Hypovolemic shock Mechanical support ECMO = Cardiogenic shock Give NE and IV fluids = Neurogenic shock Antibiotics = Septic shock Signup and view all the answers

Match the description of symptoms to the type of shock:

Tachycardia, hypotension = Cardiogenic shock Weak pulse, circulatory collapse = Anaphylactic shock Decreased MAP and SV = Cardiogenic shock H&H decrease in lactate levels = Hypovolemic shock Signup and view all the answers

Match the term with its meaning related to shock:

Compensated shock = Early stages where the body compensates Decompensated shock = Signs of BP decrease Irreversible shock = Body loses battle for perfusion Splanchnic vasoconstriction = Reduces blood to non-vital organs Signup and view all the answers

Match the effect of shock on the body:

Increased release of ADH = Hypovolemic shock Pooling of blood = Neurogenic shock Histamine response = Anaphylactic shock Fever and leukocytosis = Septic shock Signup and view all the answers

What is a primary treatment for cardiac myxoma?

Tumor resection Signup and view all the answers

Which symptom is NOT part of the triad symptoms associated with cardiac myxoma?

Chest pain Signup and view all the answers

What condition is characterized by fluid in the pericardium that compresses the heart?

Cardiac tamponade Signup and view all the answers

Which of the following is a consequence of untreated shock?

Multi organ dysfunction syndrome Signup and view all the answers

What index sign indicates increased right heart pressure in obstructive shock?

Jugular vein distension Signup and view all the answers

Which treatment is NOT used for obstructive shock?

Thrombectomy Signup and view all the answers

What does ARDS stand for in the context of shock consequences?

Acute Respiratory Distress Syndrome Signup and view all the answers

Which condition can lead to obstructive shock due to blocked blood flow to the heart?

Pulmonary embolism Signup and view all the answers

Which symptom indicates systemic illness in a patient with cardiac myxoma?

Malaise Signup and view all the answers

What is a common sign of obstructive shock caused by increased thoracic pressure?

Jugular vein distension Signup and view all the answers

What is the primary goal when managing a patient in shock?

Maintain cerebral and cardiac perfusion Signup and view all the answers

Which type of shock is characterized by an inability of the heart to pump properly?

Cardiogenic shock Signup and view all the answers

Which treatment is commonly associated with managing septic shock?

Giving antibiotics Signup and view all the answers

What is a common sign of anaphylactic shock?

Abdominal cramps and hives Signup and view all the answers

What physiological change is typically seen in hypovolemic shock?

Tachycardia and cool, clammy skin Signup and view all the answers

In neurogenic shock, which is a major treatment approach?

Providing intravenous fluids and norepinephrine Signup and view all the answers

What does stage 2 of shock indicate?

The body can no longer compensate for low blood volume Signup and view all the answers

What happens to blood pressure in cardiogenic shock?

Blood pressure decreases Signup and view all the answers

Which of the following is NOT a cause of hypovolemic shock?

Spinal cord injury Signup and view all the answers

What compensatory mechanism occurs during shock to maintain perfusion?

Increased heart rate through B1 receptor activation Signup and view all the answers

Study Notes

Shock: Types, Causes, and Treatment

Shock is the acute failure to supply peripheral tissues with adequate blood. A critical nursing diagnosis associated with shock is inadequate peripheral tissue perfusion, along with alterations in cell metabolism.

Compensatory Mechanisms in Shock

The body attempts to compensate for shock through various mechanisms. A key goal is maintaining cerebral and cardiac perfusion. Vasoconstriction occurs in the splanchnic, musculoskeletal, and kidney vascular systems.
Increased heart rate (tachycardia) is mediated by β1 receptors. Vasoconstriction is triggered by α-adrenergic receptors. β2 receptors cause vasodilation and bronchodilation.

Types of Shock:

Hypovolemic Shock

Characterized by significant blood loss (15% or more).
Causes: hemorrhage, third-space fluid loss (e.g., burns), vomiting, diarrhea, heat stroke, dehydration.
Signs: tachycardia, cool clammy skin, decreased hematocrit and hemoglobin, low lactate levels. ADH and vasopressin are released by the hypothalamus.
Treatment: Identify and address the underlying cause, then replace fluids.

Cardiogenic Shock

The heart's inability to pump effectively.
Causes: myocardial infarction (MI), heart failure (HF), arrhythmias, congenital defects, valve disorders.
Signs: cyanosis, tachycardia, hypotension, tissue hypoxia; decreased mean arterial pressure (MAP) and stroke volume (SV), increased central venous pressure (CVP).
Treatment: Increase cardiac output (CO) and perfusion through mechanical support (e.g., extracorporeal membrane oxygenation – ECMO).

Neurogenic Shock

Caused by loss of the sympathetic nervous system (SNS) tone.
Causes: spinal cord injury above T6. Catecholamine release is impaired. Blood pooling occurs.
Signs: low blood pressure, increased heart rate.
Treatment: administer norepinephrine (NE) and intravenous fluids.

Anaphylactic Shock

Triggered by an allergic reaction (e.g., medications, insects, latex).
Causes: Histamine release.
Signs: abdominal cramps, decreased blood pressure and weak pulse (circulatory collapse), hives, itching, cough, choking.
Treatment: steroids, epinephrine, antihistamines, and bronchodilators.

Septic Shock

Caused by a dangerous bloodstream infection.
Signs: coagulation imbalances, fever, leukocytosis, metabolic acidosis, thrombocytopenia.
Treatment: antibiotics.

Distributive Shock

Characterized by loss of vessel tone and widespread inflammation, leading to an enlarged vascular compartment.

Stages of Shock

Stage 1 (Compensated shock): Body can compensate for blood loss or lack of perfusion.
Stage 2 (Decompensated shock): Body can no longer compensate for low blood volume/perfusion; blood pressure decreases.
Stage 3 (Irreversible shock): Body struggles to maintain perfusion to vital organs. Organ dysfunction may occur even if vital signs temporarily return to normal.

Obstructive Shock

Caused by the heart's inability to fill properly due to:
- Cardiac Tamponade: Fluid buildup in the pericardium compresses the heart.
- Pneumothorax: Increased pressure in the thoracic cavity.
- Pulmonary Embolism: Blockage in pulmonary vessels.
Signs: Increased right heart pressure, jugular venous distension.
Treatment: chest tube placement, pericardiocentesis, thrombolysis/anticoagulants.

Consequences of Untreated Shock

Acute Respiratory Distress Syndrome (ARDS): Lung stiffness and fibrosis.
Acute Kidney Injury (AKI): Kidney damage.
Gastrointestinal (GI) issues: Bowel obstruction or bleeding.
Disseminated Intravascular Coagulation (DIC): Late-stage shock, severe bleeding from various orifices.
Multiple Organ Dysfunction Syndrome (MODS): Frequent cause of death.

Cardiac Myxoma

A benign heart tumor located in the left atrium.
Triad Symptoms: heart failure, evidence of embolism, systemic illness (malaise, fever, weight loss, fatigue).
Treatment: Tumor resection.

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Description

This quiz covers the types of shock, their causes, and the compensatory mechanisms the body employs in response. You'll learn about the critical nursing diagnoses associated with shock and the physiological responses involved. Test your knowledge on hypovolemic shock and its characteristics.