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Shock - 🧠ANSWER ✔✔impaired tissue perfusion secondary to circulatory failure
Compensated Shock - 🧠ANSWER ✔✔Sympathetic nervous system (release of epi
and norepi- vasoconstriction), RAAS activation (inc serum NA and fluid), ADH
(renal NA and H2O absorption) and intracellular fluid shift (inc vasc volume)
Uncompensated Shock - 🧠ANSWER ✔✔edema/third spacing, respiratory decline
(crackles and dyspnea secondary to pulmonary edema), cardiac decline (inadequate
venous return and dysrhythmias), hypo perfusion to non-vital tissues, hypo
perfusion to myocardium and brain
Hypovolemic Shock - 🧠ANSWER ✔✔Traumatic/nontraumatic hemorrhage, fluid
shift, non-blood fluid losses, urinary fluid losses
Fluid Volume Intervention - 🧠ANSWER ✔✔crystalloid bolus: NSS is most
common-- 1-2L for adults; 20ml/kg peds
,Blood- typically PRBCs (no clotting factors here- just good for volume and O2)
Massive transfusion: 1:1:1 PRBCs, platelets, and plasma
D5W NOT USED- metabolized too quickly and does not contribute to volume
expansion
Cardiogenic Shock - 🧠ANSWER ✔✔Inadequate pump: typically caused by MI,
chest trauma, sustained dysrhythmia, valve problems, end stage cardiomyopathy
Disruptive Shock - 🧠ANSWER ✔✔Fluid and pump are adequate- but fluid is in the
wrong place (pooling, leaky capillaries)
Types: Anaphylactic, Septic, Neurogenic
Cardiogenic Shock Interventions - 🧠ANSWER ✔✔PEEP (force out pulm edema
fluid)
decrease pre-load (Nitro, MSO4, diuretics, semi-fowlers)
decrease afterload (nitro + antihypertensives)
inc contractility (dobutamine, IABP)
treat dysrhythmias
Cardiac cath/angioplasty
Anaphylactic Shock - 🧠ANSWER ✔✔Type of Distributive Shock
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STATEMENT. ALL RIGHTS RESERVED
,IGE mediated
IM Epi Q15-20 min
Fluids
Histamine blockers
Albuterol (ensure patent airway)
Corticosteroids
Septic Shock - 🧠ANSWER ✔✔Type of Distributive Shock
Must meet 2 SIRS criteria + known or suspected infection
Considered to be "shock" when pt is hypotensive despite fluid resuscitation
May progress to MODS
Neurogenic Shock - 🧠ANSWER ✔✔Type of Distributive Shock
loss of stimulation of sympathetic (fight or flight) nervous system (brain/spine
injury, spinal anesthesia)
Presents: bradycardia, bradypnea, hypotension, priapism, warm/dry/flushed skin
Intervention: fluids, vasopressors (phenylephrine), corticosteroids, atropine
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STATEMENT. ALL RIGHTS RESERVED
, Obstructive Shock - 🧠ANSWER ✔✔Hypo-perfusion because of resistance to
ventricular filling
Causes: pericardial tamponade, tension pneumo, PE
Shock in Peds Pts - 🧠ANSWER ✔✔Typically hypovolemia is most common cause
Assess for dryness
Shock in Geriatric Pts - 🧠ANSWER ✔✔Tachycardia may be masked by some
home meds (ie: beta blockers)
Also prone to dehydration/hypervolemia (500 cc bolus followed by 200cc/hr until
SBP 100)
Sepsis is also common cause
Cardiac Output - 🧠ANSWER ✔✔HR influenced by PNS (vagus nerve, drugs,
conduction abnormalities) and SNS (stress, pain)
Chonotropes Drug Class - 🧠ANSWER ✔✔drugs that affect HR at SA node
Inotropes Drug Class - 🧠ANSWER ✔✔drugs that affect contractility of the heart
Dromotropes Drug Class - 🧠ANSWER ✔✔drugs that affect automaticity (electrical
impulse velocity) at the AV node
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
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STATEMENT. ALL RIGHTS RESERVED