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19 Cards in this Set

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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
Catecholamines
Albumin, Plasmanate, Hetastarch, Dextran 40 or 60
Shock: Colloids
Whole blood, PRBC, Fresh frozen plasma, platelets, cryoprecipitate
Shock: blood components
airway/oxygenation
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