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Nur-458
Quiz - Hypotension and Shock
Term | Definition |
---|---|
What is orthostatic hypotension? | Sudden peripheral vasodilation without rise in cardiac output |
How is orthostatic hypotension defined? | Systolic drops > 10-15 mm Hg; or diastolic drops > 5-10 mm Hg |
How is shock defined? | All shock is a result of inadequate tissue perfusion |
What occurs in the initial stage of shock? | Inadequate oxygen delivery initiates early cellular changes; not clinically evident |
What occurs in the compensatory stage of shock? | Decreased cardiac output triggers neural, hormonal, and chemical mechanisms to compensate for lack of tissue perfusion; clinical indicators are evident |
What changes to vital signs occur during compensatory shock? | HR goes up, BP changes some, RR goes up, anaerobic responses in cells; SaO2 dropping some; skin is cooler, paler and diaphoretic |
What occurs in the progressive stage of shock? | Compensatory mechanisms begin to fail and no longer maintain adequate perfusion |
What occurs in the refractory stage of shock? | Shock state is so severe and prolonged that death from MODS is imminent |
What are the four classifications of shock? | Hypovolemic, Neurogenic, Distributive, Obstructive |
What are the three classifications of distributive shock? | Neurogenic, Sepsis, Anaphylactic |
What is the descriptive characteristic of distributive shock? | Massive vasodilation |
What is involved in the sympathetic response to physiological shock? | SNS is stimulated and norepinephrine causes vasoconstriction and epinephrine causes increased heart rate and contractility |
What is involved in the fluid shift response to physiological shock? | Increased pressure in the vasculature and shifts into second spacing |
What is involved in the cardiac response to physiological shock? | Increased heart rate and contractility; will move from compensatory into progressive if it isn't caught at this point |