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19 Cards in this Set

  • Front
  • Back
Etiology: most common type, loss of blood, plasma
Example: hemorrhage, vomiting diuresis
S/S: dependent on volume lost, acuity loss, age, health state
Hypovolemic shock
Etiology: systolic dysfunction (MI, severe HTN), diastolic (cardiac tamponade), arrhythmias, valvular abnormalities
S/S: tachycardia, hypotension, increased RR, crackles, decreased urine output, pallor, cool clammy skin, decreased cap refill, anciety or delirium
cardiogenic shock
Etiology: mass vasodilation from loss of sympathetic tone
(acute spinal cord injury, spinal anesthesia, vasomotor center depression
S/S: bradycardia, hypotension, poikilothermia
Neurogenic shock
Etiology: Sepsis, (bacterial, fungal, viral, parasitic infections)
S/S: hypotension, tachypnea, decreased UO, altered mental state
Septic Shock
Etiology: allergic reaction to substance - massive vasodilation, increased cap permeability
S/S: sudden onset, hypotension, wheezing, stridor, swelling of lips and tongue, flusing, pruritus, urticarisa, feeling of impending doom
Anaphylactic Shock
Stage___: May not be clinically apparent or subtle changes in VS (decreased BP, Increased HR, RR)
Stage 1: Initial
Activationof SNS, Release of ADH, activation of Renin-angiotensis-Aldosterone system, shunting of blood from non essential organs
S/S: Decreased BP, Increased HR, RR, alteration in LOC, Cool/moist skin
Stage 2: compensatory stage
compensatory mechanisms begin to fail
increased cap permeability, pulmonary arteriole constriction, generalized vasoconstriction, tissue hypoxia
S/S: increased hypotension, narrowing pulse pressure, tachycardia, tachypnea, edema, decreased LOC, urinary output
Stage 3: progressive stage
Irreversible, compensatory systems overwhelmed, multiple organ system failure
S/S: severe hypotension, decreased HR, RR and depth, unresponsive, ultimate respiratory and cardiac arrest
Stage 4: refractory stage
Disseminated intravasular coagulation
PC: shock
Adult respiratory distress syndrome
PC: shock
Multiple organ dysfunction syndrome
PC: shock
systemic inflammatory response syndrome
PC: shock
CBC, ABG, Electrolytes, blood cultures, liver function tests, renal function tests, cardiac enzymes
Shock Diagnostic tests
Dopamine, epinephrine, dobutamine, norepinephrine, Isoproterenol
Albumin, Plasmanate, Hetastarch, Dextran 40 or 60
Shock: Colloids
Whole blood, PRBC, Fresh frozen plasma, platelets, cryoprecipitate
Shock: blood components
venous access
administer fluids/meds
control bleeding
continuous assessment
Shock: interventions
Decreased cardiac output
ineffective breathing pattern
altered tissue perfusion
pain, fluid volume deficit
risk for injury
fear (anxiety)
Shock: nursing Dx