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failure of the circulatory system to meet metabolic needs of vital organs (brain, heart, kidneys)
shock
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amt of blood pumped out the left ventricle per minute
normally 4-8 liter per min
cardiac output
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formula of cardiac output
stroke vol x hr
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vol of blood ejected by the ventricle with each contraction
stroke vol
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vol of blood filling the ventricle just before ventricular contraction
preload
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resistance to blood flow out of the ventricle during ventricular contraction
afterload
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forcefulness of myocardial contraction
contractility
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form of shock where the heart is unable to supply enough blood to the body bc of blood loss or inadequate blood volume
hypovolemic shock
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serious, abnormal condition that occurs when an overwhelming infection leads to low bp and low blood flow. vital orgrans, brain, heart, kidneys and livers may not function properly or may fail
septic shock
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dilation of peripheral vasculature from an allergic response that results in circulatory failure
anaphylactic shock
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severe disease caused by a toxin made by staphlococccus aureus, characterized by shock and multiple organ dysfunction
toxic shock
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cause of hypovolemic shock
- loss of blood vol
- -hemorhage
- -dehydration
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causes of septic, anaphylactic, toxic shock
- vasodilation
- decrease afterload (resistance of blood flow out of the ventricle during vetricular contraction)
- hypotention
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clinical signs of shock
- hypotension
- tachypnea
- tachycardia
- oliguria -decreased urine output
- altered sensorium
- cool, clammy skin
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abgs lab findings of shock
- hypoxemia
- metabolic acidosis
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electrlytes lab findings of shock
- hypernathermia (inc sodium)
- anion gap >16 mEq/Liter
- leukocytosis in septic shock (inc wbc)
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formula for anion gap
na - (cl + hc03)
normal: 8-16 mEq
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hemodynamic values for septic shock
- increase cardiac output
- decrease systemic vascular resistance
- normal pulm cap wedge pressure
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hymodynamic values of hypovolemic shock
- inc svr
- dec central venous pressure, pcwp, co
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5 types of treatment for shock
- o2 therapy
- mech vent
- replacement of blood vol
- antibiotics for septic shock
- vasopressor therapy for septic shock
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o2 therapy must be high/low concentrations?
high concentrations
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what type of mech vent settings to treat shock
CMV w/ PEEP, CPAP
- because of:
- resp muscle fatigue
- decreased sensorium
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