Phases Shock
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| Shock | show 🗑
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| All of your patients are at risk for shock | show 🗑
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| Shock Syndrome | show 🗑
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| Adequate tissue/organ perfusion | show 🗑
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| Perfusion is directly related to | show 🗑
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| show | Blood Volume: how much blood, plasma, platelets (all the components) is circulatingb) Cardiac Output: amount of volume in liters of blood ejected by the heart each minutec) Size of Vascular Bed: changes depending on vasodilatation/vasoconstricti
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| show | Total blood volume and CO are directly related to MAP, If blood volume increased, MAP increases, If CO increased, MAP increases…and vice versa
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| Inverse Relationship | show 🗑
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| Compensatory Mechanisms (All kinds of shock when there is a decrease in MAP) | show 🗑
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| Neural Compensation | show 🗑
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| show | 1. Underlying cause of shock must be treated!!!!!!!!!!!!!!!!!!2. If underlying cause of shock is not corrected and MAP decreases even further…3. Decreased renal blood flow causes increased renin (vasoconstrictor) aldosterone, and ADH production4. Th
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| Stages of Shock | show 🗑
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| Initial Stage | show 🗑
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| Non-Progressive (Compensatory) Stage | show 🗑
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| Progressive Stage | show 🗑
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| show | 1. Severe tissue hypoxia2. Release of myocardial depressant factor from the pancreas (depressed CO further)3. Build-up of toxic metabolites4. MODs (Multi Organ Dysfunction)5. Death is inevitable (“circling the drain”)
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| Factors that Affect Stages of Shock | show 🗑
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| Causes of shock | show 🗑
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| show | According to what function is affected by the shock1. Hypovolemic Shock2. Cardiogenic Shock3. Obstructive Shock4. Distributive Shock
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| Hypovolemic Shock | show 🗑
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| Causes of Hypovolemic Shock | show 🗑
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| show | a) external: trauma, wound, surgery (you will see; obvious to you) b) internal: blunt trauma, GI bleed, internal surgical sites (harder to see and dx; may take longer for you to notice s/s occur later; monitor CBC, H&H) * Inadeq
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| show | a) due to decreased fluid intake or increased fluid losses b) profound dehydration can be caused by: *viruses *anorexia with use of diuretics (over diuresised) *DI *NG tube without adequate IV fluid replacement
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| Cardiogenic Shock | show 🗑
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| Causes of Cardiogenic Shock | show 🗑
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| Obstructive Shock | show 🗑
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| Obstructive Shock Causes | show 🗑
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| Distributive Shock | show 🗑
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| Neural-Induced Distributive Shock | show 🗑
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| Chemical-Induced Distributive Shock | show 🗑
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| show | 1. Type of chemical induced distributive shock2. Do to an antigen antibody responsea) exposure to PCN may have had no problem the 1st time (or slight rash) but the body builds up antibodies3. Not likely to occur on the 1st exposure to and antigen
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| show | 1. Drugs (antibiotics, sulfa drugs etc.)2. Contrast media (question shellfish/iodine allergy)a) if needed pt premedicated with:Benadryl, corticosteroids, tagamet/pepcid3. Blood transfusions4. Insect bites (bee)5. Food allergy ( egg, peanut, she
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| Septic Shock | show 🗑
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| Risk Factors for Septic Shock | show 🗑
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| CARDIOGENIC SHOCK | show 🗑
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| show | Elevated CVP with JVD, elevated PCWP, decreased CO, elevated systemic vascular resistance.
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| show | Administer beta-adrenergic meds (dopamine, dobutamine) and afterload reducers (Nipride, Tridil) IABP, oxygen, decreasing work load of the heart.
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| SEPTIC SHOCK | show 🗑
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| SEPTIC SHOCK Key Assessment Findings | show 🗑
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| show | Antibiotics, Beta receptor stimulants which have a positive inotropic effect on the hear and vasodialate microcirculation, steroids
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| show | Histamine is released into the blood stream following an allergic antigen antibody reaction. There is a subsequent increase in capillary permeability and widespread dilation of arterioles and capillary beds. Causes included: contrast media, penicillins, f
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| show | Urticaria, laryngeal edema, bronchospasm, hypotension, confusion, warm moist skin
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| ANAPHYLACTIC SHOCK Management | show 🗑
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| Cardiogenic | show 🗑
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| Hypovolemic | show 🗑
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| show | PRELOAD - WNL/lowAFTERLOAD - DecreasedCARDIAC OUTPUT - Increased
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| Septic (COLD) | show 🗑
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| show | PRELOAD - DecreasedAFTERLOAD - DecreasedCARDIAC OUTPUT - Decreased
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