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SHOCK DEFINITION

A life-threatening condition in which tissues in the body lack adequate oxygen & nutrients to support vital organs and cellular function

SHOCK & MULTISYSTEM ORGAN FAILURE

HYPOVOLEMIC SHOCK

The most common type of shock.

Dx is made when inadequate tissue perfusion due to blood loss and intravascular volume is reduced by 15%-25%

HYPOVOLEMIC

SHOCK

NEUROGENIC SHOCK

ECG

62

What is it?

  • Caused by damage to the spinal cord.
  • Imbalance between the sympathetic and parasympathetic system.
  • Severe vasodilation.
  • Resulting in distruption of blood circulation to the body.

Causes:

  • Injury to the spinal cord
  • Spinal anesthesia
  • Medications depressing the NS

bpm

SxS :

  • Thirst
  • Change in mental status
  • Low BP + Temp
  • Cold & clammy skin
  • Weak & thready pulse
  • Tachypnea

SEPTIC SHOCK

TYPES OF SHOCK

HYPOVOLEMIC

SHOCK

  • Septic shock
  • Hypovolemic shock
  • Neurogenic shock

Tx

  • Blood transfusion
  • Fluid replacement

SEPTIC SHOCK

  • Sepsis: systemic infection

bacteria toxins cytokines systemic vasodilation & capillary permeability

  • Severe Sepsis: organ failure + sepsis
  • Septic Shock: low BP despite fluid replacement

Interventions

  • Passive leg raising: CO
  • Restrict pt's unnecessary movements

: O2 demand

MULTISYSTEM ORGAN FAILURE

NEUROGENIC SHOCK

Tx:

  • Abx
  • IV fluids

Interventions:

  • O2
  • safflower yellow

Symptoms:

  • Hypotension
  • Bradycardia
  • Dry warm skin
  • Hypothermia
  • Shock can progress to MODS (dysfuntion of 2 or more systems for 24-48 hrs)
  • If tissue perfusion not restored, irreversible end organ damage may occur
  • Kidneys & lungs affected most commonly
  • Prognosis is poor
  • Prevention is
  • Nurses should know early SxS!

Thank You!

NEUROGENIC SHOCK

Treatment:

  • Fluid replacement
  • Vasopressors

Interventions:

  • Immobilize patient to prevent any further spinal cord damage.
  • Elevate the foot of the bed & apply compression stockings.
  • Monitor for SxS of DVT.

SEPTIC SHOCK

HYPOVOLEMIC

SHOCK

HYPOVOLEMIC

SHOCK

SXS:

  • Fever OR hypothermia
  • chills, shivering
  • tachycardia
  • tachypnea
  • confusion, less alert
  • decreased urine output

Diagnostic Test/ Lab work :

  • Blood chemistry
  • CT Scan & Chest x-ray
  • Endoscopy
  • Echocardiogram

Causes :

  • Hemorrhage
  • Burns
  • Dehydration
  • NPO status
  • Excessive diarrhea
  • Vomiting

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